On 19 Dec 96 at 4:54, Alan Cooper wrote:
> First let's use an analogy. Private telephone exchanges (switches in
> the modern vernacular) are getting cheaper and smaller yet some users
> are demanding more and more sophistication. BT now offers shared
> capacity on its main public switches so that many users in an
> organisation can have their own virtual switch. This is particularly
> useful for organisations spread over many buildings in a locality. All
> calls within the organisation are free as they are in effect treated
> as internal calls. Within the rental fee everything is managed.
Otherwise known as Featurenet - one of the best procurments undertaken
by NWN - now proving of great benefit in Wales (implemented across the
NHS in Wales), Cumbria, Newcastle and North of Tyne. The funny thing
is, it becomes really cost-effective when the GPs in a community join
in; while the individual saving per practice are small (c. Stng 1,000
per annum), across 90 - 100 practices, it's quite significant. Get
your HAs to investigate in the New Year!
> Now, apply the same principle to many practices (or super practices
> under the new PC model) that combine together to have a single system
> linked together, say, by BT or a low cost cable company. OK the market
> place would shrink but there could well be economies of scale in
> maintenance, customisation, training, data conversion, and the use of
> the more sophisticated hardware and software. The unit cost of the
> system could be much higher than current systems, typically used in a
> practice of 3 or 4 GPs, but the cost per GP or per terminal, lower. In
> fact, using the switch analogy, there may no need to purchase the
> system but instead rent the use of it.
It's like the old bureau services we used to know and love - and it
could just be the solution for the future....
> It needs working out, but if potentially viable, some systems provider
> may decide to try to be first to market and take the lion's share.
> They might even take a new object oriented system from the states and
> plug-in the bits that are different. With sufficient common core, the
> market actually becomes global with affiliates in each country
> localising the functionality.
Ah, but here's the rub. Which supplier is going to make the PFI
investment to provide such a service? BT could; AT&T could; Reuters
could; - but would their internal structure and market approach
allow them to be that creative? (Please Santa, can you have a word
with them?)
-----------------------------------------------------
Henry Cohen
Windeler Cohen Associates/Health Web Services Limited
Phone: +44 (171) 731 5354 Fax: +44 (171) 731 5764
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