In-Reply-To: <[log in to unmask]>
> Mike Carey - GP Systems Marketing Manager Doctors' Independent Network
wrote:

> I'd be careful not to extrapolate nationally from the Durham
> experience. I travel the length and breadth of the UK talking to GPs
> every week and the pattern changes radically depending where you are.
> The one thing that seems consistent is that EMIS is usually seen as
> the system of choice in the pre-Windows marketplace. I get the feeling
> this will change with the advent of System 6000 and Vision.

I wasn't extrapolating from Durham, just quoting what was happening in
Durham. The problem all the space cadets (and I'm not saying you are
one, by the way) fail to recognise is that relatively few GPs are
interested in operating systems, or even computers. They want to practice
medicine, own a car that works, repaint the house etc. The type of
interface on a clinical computer system is immaterial to 90% of doctors.
Windows won't catch on until practices can afford it. Right now, they
can't, because the cost of the hardware is so high. If you consider the
fact that there isn't anything that Windows GP systems offer that makes
it a "must have" for the GP in the street, then the reason that Vision
and System 6000 haven't swept the board becomes clearer. The first time
VAMP could have launched Vision was in 1993, yet three years later, it
still has yet to sell in significant numbers. In my opinion, it will be a
long time before it is installed in any large number of practices.

> The trouble is (if it is a trouble) that there is a sea change in GP's
> feelings about what clinical systems should look like and, for better
> or worse, Windows is what they seem to want.

Perhaps we talk to different groups of GPs. The people who write and
e-mail me from around the country ask questions like: how do I afford the
cost of putting eight thousand quids worth of network into the Victorian
sem we practice from? or: I can't work out how the expense of going to
one of these windows computer systems is going to help me treat patients
any better, can you tell me? or: company X tell me that when I install
the new windows system I will be able to download MRI scans, but when I
asked our local hospital about it they just laughed and said 'first we'll
need to get an MRI scanner, then we'll need to get a proper network in,
and then we'll try and get lab links working properly, and *then* we
might think about it'. I quote from real examples here, by the way.

FWIW, I am not a techno-luddite. This message is being typed on a Pentium
Pro with 64Mb of RAM and a 2 Gig hard disk, running NT 4. At home, I have
a fuck-off PC, because it pays for itself. At work, I have a PC that does
the job, and no starry-eyed view of software and hardware. The average
practice will go to Windows when there are pressing reasons to do so, and
when they can afford it, but not before. Ewan Davis knows this, and Tony
Jones knows it, but whether VAMP knew it when they started development on
Windows is a good question. I hope they do if they want to survive and
turn a profit.

Andrew

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Dr. Andrew N. Herd MRCGP
GP, Journalist, and Medical Adviser to Durham Health Authority
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