In-Reply-To: <[log in to unmask]>
Ahmad/ Adrian/ Vashek
If you'll allow me to summarise your various points, you agree with the
ends but not the means. Main point made by you is that the chosen
standards are wrong. You advocate IP/SMTP/POP3 instead, presumably, of
what you term obselete x400 and EDIFACT.
Fair enough, and the Mercury and BT contracts allow for all these. In
Scotland we're increasingly going down the IP route. (BTW, rumour has it
that a partnership has been formed between these companies and Microsoft
and that MS Exchange/ Explorer will become the software products on offer
which encorporate these standards in NHS communication)
So your beef is about prices from these two, and exclusion of other
service provider companies. You also take issue with my contention that
Internet access is marginal to the main reason for communication.
What I mean here is that Adrian has got it right when he talks about
getting it right on a local and user-needs-led basis. This is precisely
the philosophy behind these contracts.....
1. Local organisations get together and describe their ENTIRE
communications needs (phone, fax, email, file transer, fire alarms,
telemedicine, web, lab results, referrals, IoS, video conferencing, etc,
etc).
2. This IS NOT a tekkie issue. In fact, tekkies should be kept out of
it. It's for users to state their requirements, including quality and
speed of service.
3. The companies figure out how to meet the requirements, and submit
their prices.
4. Because these companies have signed general contracts guaranteeing
certain tekkie standards, the users can concentrate on evaluating who
best to hand the operation of their total communication service.
Anyway, that's my interpretation of what's supposed to happen.
Incidentally, what about standards for meeting user requirements that
SMPT/ POP3 can't meet? Suppose a GP says 'I want lab results
incorporated directly into my patient's computer-based record'. Hence
EDIFACT. Now some will say that EDIFACT is less than ideal, but it's
currently all we've got (other more healthcare-designed are under
development).
As to prices, when email or something is looked at in isolation then of
course it looks expensive. But you'd be mad to consider these NHSnet
contracts to meet just one or two of your entire communications needs.
But if the total package is contracted out - and if useful applications
are offered - then I'm assured it will be cheaper overall. Considerably.
One-stop shopping.
Returning to the vexed question of getting Internet access to clinicians,
this is a problem. For the tekkies. Because of the dangers of mixing
patient-data networks with Internet, the current solution demanded by the
tekkies is that they cannot guarantee safety unless there is no
inter-connection between the networks. Really tough for teaching
hospitals etc, and it's important to get better solutions. This is part
of the reason for NHSweb - a safe web set-up which can co-exist on the
NHSnet. BTW NHSnet is the generic name for what these chosen companies
offer.
> I believe that this List and IMG would benefit greatly from knowing
> what is going on in Scotland. Most of the stuff up there is probably
> on the right track :-) :-)
Nice of you to say so, but for us too these things are genuinely tricky
obstacles standing in the way of achieving the benefits. My view, for
what it's worth, is that we should re-double efforts to focus on the user
needs while banishing the tekkies.
Alan Hyslop
Computing & IT Strategy
Management Executive, NHS in Scotland.
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