Looks like...
...the code review was less than diligent.
I'd make a cheap pun but I'm greater than that.
A bug in code that generates medical reports could force patients in Ireland to repeat their hospital and clinic scans. The Emerald Isle's healthcare bosses have admitted a flaw in the PACS software used to store documents in its National Integrated Medical Imaging System (NIMIS) causes some records to not display a single, …
"Maybe somebody tried a shortcut trick and it backfired."
Not necessarily tried a short cut. I've seen repeated failures to escape apostrophes (ironically, mostly in Irish names) keep reappearing. I put it down to each fresh batch of programmers on their 6 month visas having to be educated about generating well-formed XML because they thought you could just copy the raw text to the output.
I've worked with a system recently that completely broke if you typed & into a free text field. It threw away everything entered and gave an error message that explained nothing. And this was a mature system that had been running for years, but obviously testing hadn't noticed and no-one had thought it worth fixing.
And systems that can't handle Irish O' are so common that it's ridiculous.
I tried to do name normalisation for a client a while back, I naively set of with a 'Capitalise the first letter of the 2 names' rule, then realised that there were O'Briens (which is capitalised differently to D'eath) and so added an element to catch that, then a MacDonald was noticed so I added something to catch that and McD at the same time, then someone points out that there are people with hyphenated names, and people with 'van' in between names and on researching that I find that some people capitalise the Van and some don't.
I quit in the end and never finished it all, so if you receive a marketing email from a British car parking company (a National one...) and your unusual name is mangled you can thank me.
" then someone points out that there are people with hyphenated names"
And multiple word surnames without a hyphen, which are even worse.
I feel your pain. I had to deal with a situation where a client's client who had stuff properly structured decided they'd send us the names flipped with surname first but expected us to print them correctly. Add in the fact that there might be the occasion title; Prof or Sir etc in there and those names AFAICR hadn't been flipped. They saw nothing wrong until I pointed out a few examples. They then agreed to provide assistance. Instead of just sending the data as they had it the added a field to tell us which of 4 options to apply to reconstruct what they could have sent in the first place.
Why didn't you just give up and use what the form filler typed in? most people know how to format their own name, and people with unusual names are used to telling another human how to. Also, lose the first-name last-name crap, you only have a 50% chance of printing them in the order acceptable to the named person.
I did just give up; I changed jobs and stopped worrying about it!
But yeah, thats what I should have done, as it was I was replacing a convoluted set of VB laden Excel docs and one of the functions there 'corrected' the name and I said I'd replicate it without really considering the complexities.
What was there originally just capitalised the first letter of the two name fields so I got much further than it was originally but I'd have probably just given up and fallen back to the original if I'd stuck around to see it through.
"The majority of reports are either viewed on paper or electronically within NIMIS RIS, neither of which are affected by the symbol issue," the HSE added.
So it looks like the notes are stored with the symbol and there are work-arounds for getting the correct description- surely extra scans (and thus extra x-ray exposure) should not therefore be necessary.
As others said, it sounds like it could be a escaping problem converting the notes perhaps to HTML or XML - I wonder if ampersands also cause problems.
We had this problem with our lab system. Medics are in the habit of typing "~" for "approximately" in clinical details when requesting. This broke the transfer of results from the Lab system to the reporting system until the reporting system suppliers fixed it (and charged for it).
Programmers don't seem to realise that people free-typing stuff will type literally anything that the keyboard will allow (@ is another good example. So is the "any" key...)
Medics are in the habit of typing "~" for "approximately"
Which is a well-known and completely valid use for a tilde character..
Programmers don't seem to realise that people free-typing stuff
In a previous life I worked for a company that did occupational health tracking software. One release, we needed to do a database upgrade and data-matching exercise and tried to automate it.
Gave up in the end and hired a bunch of temps to re-key stuff because the medics only loosely matched the field name with the content they put in it..
Unfortunate result but they seem to be handling it in a more focused way than I suspect would happen in the NHS, although they are considerably smaller. So thumbs up for that.
So this weeks Top Tip:
Confirm all characters that can be entered on a data record can both be displayed on screen and on reports, or some sort of commonly understood equivalent is done so instead.
"<" (and while they're at it perhaps they should check ">" as well) are IIRC standard parts of ASCII, EBCDIC and Unicode. Others have suggested HTML and XML is where it gets tricky. :-(
I've encountered similar lack-of-escaping bugs on a pretty regular basis for years, in part because of my persistent habit of working in schools with apostrophes and/or ampersands in their names.
Some websites totally crap out when you try to submit the name to register a product or download companion software. One even had a hyper-sensitive "hacking detector" that admonished me then locked out the county's outbound IP address for a minute each time I submitted the offending text. (They probably thought they were being really clever by detecting attempts at SQL/script injection or something. Maybe I should have set up a script to submit it automatically every minute to see if they noticed the sudden lack of business coming their way from an entire county.)
One major technology retailer's site accepted the address but munged it on the shipping label, which isn't disastrous but is rather ugly - "St. Brutus's School & Deranged Orang-Utan Containment Facility".
Another completely omitted the address line containing the name of the school which is a little more troublesome - it took several failed (i.e. not attempted) deliveries before someone at the courier's depot thought to phone the contact number on the label (apparently, the drivers aren't allowed to carry phones) to find out exactly where in Snafu Road the parcel should be sent.
Some would say I should just omit the non-alpha characters as a matter of course but I like to break systems then see how (if) the companies' tech support folks handle the bug report.
I have been meaning to sort out my own code which display £ and other unicode as something other than it should for a while now. Will probably tackle the &lt; class of bugs as well. Thankfully it's not anything close to a critical system, and why no effort at all was put in to handle such things.
"A bug in code that generates medical reports could force patients in Ireland to repeat their hospital and clinic scans."
I cannot see why when the data itself is said to be stored correctly and it's only one of the display mechanisms which renders that data wrongly.
Hyperbole requirement for the week not met? Slow fake news day?
I wouldn't necessarily think this is an XML / escaping issue without knowing how their reports are stored. It may be as simple as a bad rule for non-printable characters for display, as DICOM tools can have varying abilities to deal with encodings other than ISO-8859-1. (On a PACS they may well be DICOM structured report rather than XML.)
This looks like poor escaping. There is supposedly a standard for interfacing between medical systems called "HL7". V2 of HL7 is bad enough. V3 is starting to be rolled-out and it is a total cluster****.
Anyway, as a regular user of these medical systems (not an administrator), I have yet to see one which correctly handles escaping across the various interfaces. Every single system I have used so far, at multiple hospitals and outsourcing firms, screws something up.
For example, a common issue is incorrect handling of escaping. The character & is a special character in HL7, so needs to be escaped. However, it is rare for the receiving system to de-escape the text. Hence "The patient was advised to attend A&E" becomes "The patient was advised to attend A\T\E".
Another common issue is incorrect handling of character sets. HL7 is meant to use UTF8. Occasionally, sending systems often screw-up the conversion from Win1252, or fail to do it, or do some sort of other incorrect conversion. More commonly, however, the receiving systems often assume that the incoming data is ASCII or ISO8501 and this buggers up accents (which some voice recognition software includes in phrases such as deja vu, or in the names of eponymous medical conditions). One example of this which has recently come to light is that dictating the word "dash" into dictation software generates an 'n-dash' character, which then gets lost in an incorrect character set conversion and converted to a question mark. This can significantly change the context of a medical opinion, by turning it into a question.
Having had discussions with a bunch of vendors installing the software I use, most of them aren't interested. I certainly showed the rep from one the chaos coming from loss of accented characters - there was no interest to fix it other than "don't use accented characters in your reports/letters", after their tech support closed the ticket as "won't fix".
Of course, it often isn't one vendor's fault - and at some sites, there are multiple systems doing incorrect escaping or format conversion - so you get HL7 escape characters interspersed with HTML codes like <BR>, or you get real beauties like A&E becoming A\\T\\E (at least 3 incorrect escaping there).