Old Systems Look Odd
----------------------------
The Exeter GP Sstem was designed at the dawn of time. It's
philosophical and political antecedents are impeccable, its users are
conspicuously satisfied with it's function and development, but it's
interface while entirely functional has now been rendered very
non-standard - by IBM and Microsoft.
EMIS is a more recent system, the cmpany although not owned by the
users does appear to show a degree of responsiveness which may actually
be beyond the capacity of a company with more pure commercial aims,
it's users are predominantly satisfied with most of the tools provided,
but its interface while entirely functional has now been rendered
decidededly non-standard - by IBM and Microsoft.
Does this matter?
I think it does.
The Rest of the World Looks On
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Neither system has captured the entire UK NHS GP market, and even if
they had there should be severe doubts whether the GP community is
sufficiently large, united, and influential enough to withstand the
pressure form the rest of the world's software suppliers to expect a
common user architecture (CUA) design of interface.
The coming integration in one form or another of secondary sector and
other organisation's information services with those of primary care
compounds the problem - administrators of such systems face the task of
training all users in the interface of each system involved - a
daunting task, or persuading each system to present information in a
manipulable lingua franca, and then displaying it in the form they are
used to. The latter is a large task and grows exponentially larger as
more connections are made. Experience of this is one of Reuters' main
stocks in trade, and certainly something with which Torex are acquanted.
Meanwhile, the second reason most of business adopted Windows is that
it means a secretary trained in Word for Windows (say) by corporation A
can be put immediately to work by corporation B using the same
software, or even a different word-processor with only occasional
confusion.
One File per Document Again - a Digression
-----------------------------------------------------
Indeed the interoperability goes deeper than this, and common file
formats offer us great benefits. If corporation A can be persuaded to
save their Word documents in Rich Text Format (RTF) instead of
proprietary Word .doc format, then corporation B can have them e-mailed
or sent by disk, and open them in AMi-Pro or whichever other
word-processor they use, including those running on more sophisticated
operating systems such as Unix, MacOS, RISCOS or BeOS..
There is something to be said for applying this principle to the file
format of the medical record, and certainly it would be in the
interests of GPs and probably their patients.
But, back tto the interface.
Costs
-------
The costs of retraining every entrant to general practice - which will
soon include the doctors and nurses as well as the traditional typing
trades - away from the interface they are used to and into a maverick
system will rise, and represent a drain which is theoretically
unneccessary but may be fixed upon us by now.
The Future Interfaces of Legacy Systems
--------------------------------------------------
Both Exeter and EMIS have windows front-ends to their legacy systems,
and quite reasonably these look very similar to the old interface,
random changes in shortcut commands can irritate users considerably and
GPs have never been keen on falling into line with the rest of the
world. EMIS' forthcoming NT version which is assumed to migrate away
from MUMPS toward SQL is also forecast to show the same interface.
However, can we look forward to seeing a browser front end, running
over a TCP network, perhaps even an NHS wide intranet, which displays a
picture of the old text-based screen?
It may even be the best way to go, but to the world outside general
practice in the UK it is going to look increasingly dated, insular and
odd.
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