INTRODUCTION
The professionals of health traditionally use a body of documents paper, the medical records, to carry medical news. This showing file henceforth its limits, many teams worked on his computerization since the years 80. They confronted themselves to various problems (technological, of conception, of usage, etc.) and are besides passed of problematic ones linked to the treatments of the medical data by software (to do the epidemiological research, for the economical medical piloting, etc.), to a problematic one of management of the body of produced the news around the patients by software (to improve the care practices). In 2003, the project was launched to the University of Amiens with the intention of to computerize the health records in hospital environment according to approach documentaries. It is taken in collaboration with two sites pilots and a partner industrial. The project was done after the project, in which the document was considered as the central object of the system computerizing the electronic health records under the form of a hypertext.
At first, we had confronted to the difficulty to conceive a consensual vision on the document notion, divided by all the members of the project, furthermore coming from different disciplines. Our reflections were lit up by the document. The author there defines the notion of document and notably the evolutions linked to the support change (paper to the numerical one). It approaches the document notion according to three dimensions, while considering it as a form, a sign and a medium. We took a bibliographical research on the notion of document and we register ourselves completely in the three definitions of to study special documents: the medical documents. In parallel, we studied it.
We were interested all particularly to the existing electronic medical records on one of our two sites pilot, the file of the service of Pediatrics. This service has access to a health records paper and of a computerized file, centered on the data and used to do statistics. We reflected to the manner in which we could transform the file paper and the computerized file in a single computerized file. We realized that the health professionals annotate often the documents paper for they are conceived of such sort that they there can record the news body only they would want. We then asked ourselves if it was possible to construct numerical documents more pertinent allowing the seizure of the body of medical the news or well if it was necessary to transpose the practice of annotation of the documents paper to the numerical one. For that, we studied the positions where the professionals of health compose or consult the annotations.
According to our readings, we defined an annotation thus: An annotation is a special grade attached to a target. The target can be a document collection, a document, a document segment (paragraph, word group, word, picture or left picture, etc.), and another annotation. To annotation content, materialized by an inscription that is a track of mental representation that the annotator is done of the target? The content of annotation will be able to be interpreted to his turn by another reader. We call the anchor which secures the annotation to the target (a trait, a surrounded passage, etc.). In this publication we put ourselves three questions:
1. We ask ourselves which are the characteristics of the medical documents and how can one to computerize them. In the project the authors underlined importance, for an information system, to have access to a representation of the structure of the documents to treat them. In the project, we deepen this point.
2. We adopt an original vision on the documents while considering them provide with their annotations. We wonder how the possibility to annotate modifies the behavior of the authors and readers and in what practices it annotation is pertinent in a managing computer application of the medical records files.
