On 17 Dec 96 at 1:24, Mick Ibbotson wrote:
> >One of the problems in GPPL is that next to no
> >funding has been provided for development of clinical software. This
> >is a fairly general state of affairs.
>
> But surely, the clinical systems suppliers are all blazing away
> developing this *next* selling point. Funding will surely come from
> the users as part of their maintenance fees or is R&D something
> different.
The above may be true, but current clinical systems are based on a
specific' view of the GP environment. In addition (and apologies if
I'm wrong) they've not been designed for a client/server environment
and so don't easily fit into the IP distributed network world. Now
given the number of suppliers in this market, one has to ask (a) how
many of them are likely to produce a LAN-based client server solution?
(b) how many of those solutions will be truly interchangeable (eg
relational database, SQL, client server, browser-enabled, IP support
etc)? (c) and if they do deliver a true client server solution what is
the likely upgrade cost? (d) will this upgrade cost also include the
re-wiring of your practices to support LAN-based services, and the
replacement of dumb terminals by PCs or thin clients to deliver
services to the desk?
In this scenario (in a 5 partner practice say Stng 2,000 per practice
to re-cable and Stng 7,500 to provide PCs and Stng 10,000 to upgrade
the practice software and Stng 5,000 for the X.400 MTA plus maintenance
etc) is Micks's comment that "Funding will surely come from the users
as part of their maintenance fees" viable? If General Practice can't
afford it are the HAs likely to fund this level of upgrade? The
Syntegra Rome proposal appears sensible, but I understand it only
deliver a "point" solution, when I guess you need something integrated
with your practice system - but wouldn't integration invalidate the
supplier's maintenenance agreement, unless they did the integration? So
does progress in this area then depend entirely on the GP system
suppliers?
Or wouldn't it be easier and cheaper to access the information on an
as required basis, rather than hold it on site, with all the above
issues and costs..............?
-----------------------------------------------------
Henry Cohen
Windeler Cohen Associates/Health Web Services Limited
Phone: +44 (171) 731 5354 Fax: +44 (171) 731 5764
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