In-Reply-To: <[log in to unmask]>
Mary
> >Oh well. I'll just have to revert to ensuring that you guys get the
> >systems you deserve :-))
> The *implication* is that the Executive have a role in the design of
> systems.
Alas, I was attempting a joke. Also, to repeat, I don't work for the
Executive. Only their Scottish cousins.
> I had the impression that design (and purchase) of systems was
> up to the individual practice - and that this caused some problems for
> the executive. Could you elaborate ?
Agree with your impression. As to causing problems to my cousins, might
be the case right enough. For example, one of their interests is
supra-organisation. Communication between two or more people requires a
shared language. Difficult if one speaks French and the other Swahili.
> I'll put up a couple of points to facilitate discussion - I _think_ (but
> I'm not sure!) that we might agree on these - if nothing else.
Why so adversorial, Mary?
> 1.Installing a computer in a general practice is a major decission.There
> are issues concerning the "buisiness case"(we didn't call it that - but
> thats what it was!) , why we needed it, what we wnted it to do, and how
> far we were prepared to suffer the upheaval of a practice computer to
> gain the advantages we, as a practice, have identified.
> 2.Many - maybe most - computerised practices installed their first
> computer before the launch of the IM&T Stratagy in 1992.
> 3. IF the RFA was strictly enforced - i.e. NO reimbursement for
> individual practices whose systems did not conform to the latest RFA,
> computerisation at the practice level would be stopped.Now. This would
> have consequences for the Strategy.
Agree with all of that. The logic of RFA seems clear: eg.
non-proprietary standards re. French-Swahili, minimum confidentiality,
and even making it easier for GPs to transport data from one system to
another if changing suppliers. But little point in having RFA with
carrots and sticks.
One might go on to assert that there's little point in having a national
strategy without carrots and sticks. But how does reconcile the freedoms
of GPs as independent contractors with wider responsibities? Tricky.
Especially given the clearly better fist of 'computerisation' that
self-determiners like you make of it.
I've tried to address this swampland in our draft IM&T 'strategic
framework', subtitled Freedoms and Responsibilities. Even includes a
quote from Schopenhauer..."Freedom is the recognition of responsibility".
Document currently out for comment. Not sure if the quote will survive
until draft two! Some people, Mary, have no sense of humour :-)
Alan Hyslop
Computing & IT Strategy
Management Executive, NHS in Scotland.
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