DATA-COLLECTION AND CHANGING HEALTH-CARE SYSTEMS .1. UNITED-KINGDOM

The adoption of ''Read Clinical Codes'' for computerised patient recor ds could profoundly alter the nature and quality of Western medicine i n the next decade. The increasing awareness of the need for a standard ised coding system has led to the funding of a pilot project to test R ead codes in Australian general practice. Read codes are a comprehensi ve nomenclature of clinical terms incorporating over 100 000 codes in a structured hierarchical form. Designed by a general practitioner, th ey are now owned, controlled, and developed by the British National He alth Service (NHS). Selected as the basis for clinical coding across t he NHS, they form the cornerstone of computerised patient records. Com puter use has been encouraged in general practice in the UK, with fina ncing schemes and functional inducements resulting in 70% of practices being at least partly computerised, and 84% of these using Read codes . Their promotion has been backed by a major development program to br oaden the codes to include all clinical specialities, nursing, and pro fessions allied to medicine. The codes will require significant adapta tion for Australian use, including the development of an administrativ e chapter and a pharmaceutical classification. The impact of informati on management systems on health care in the UK has relevance for the c ontinuing development of the Austrailan National Health Information St rategy and for future record keeping in general practice in Australia. If the trial proves successful, the adoption of Read codes as a stand ard for information management in patient medical records will need to be considered.