[log in to unmask],Net writes:
>From: "Ahmad Risk" <[log in to unmask]>
>Subject: Re: Distributing and controlling medical records
>Date: Mon, 03 Aug 1998 19:47:25 +0100
>On Mon, 3 Aug 1998 19:35:11 +0100, Adrian Midgley wrote:
>>THere are 600+ list members, of whom at a rough count there are you and
>>Ahmad in a nihilistic phase (al Nihil?) presenting the view that all
>>NHS money spent on computing should have been spent on something
>else...
>Sorry. I have not said that.
Ah, David, one then, not two.
You are in the unfortunate position of going over the top toward the
machine guns shoulting "follow me chaps". Perhaps heorism and a fixed
bayonet will carry the day?
Back to Ahmad
>My argument pivots on defining processes. IT is only *part* of the
>process.
>Crap proceses = crap IT = more crap processes.
For a moment I thought you had gone off message, but no, we are as one
again.
But, who crapped in the porcess?
Take for instance IoS Links:-
The NHS IM&T establishment, under a former and frankly discredited
leadership,
decided that the system to be implemented would be an electronic copy
of the
archaic and Byzantine paper one.
Meanwhile, as that work came to fruition, or at least began to
vegetate, a brave
band including largely GPs looked at the system and said "that is
crap". In a few
short weeks they fined it down to the current GMS 3 and 4 system, and
instituted
the idea of maintaining an audit trail at the practice, where it could
be confidential,
BTW, which actually removed most of the raisin d'etre from the
overblown foliage of
Links.
Clinical computing ontheotherhand if it is run by clinicians, and
accepting Ahmad as arch-user not code-runner, there is nevertheless a
great need for the peculiar breed of GP of which Jon Rogers, Mike
Bainbridge, David Jehring and myself are merely four examples - the
programming GP.
Apart from the obvious benefits of an interface between the profession
and the programmer which helps produce usable interfaces, there is a
new role which has become acutely important now. This is to function
as a bullshit detector for their PCGs.
You don't need many - anymore than a multi-fund needs many finance/GPs,
or a big practice needs many managerGPs, but you need one in each.
>GP IT cost over 500 million the past few years. There is very little
>return to show for that investment.
Hmm. Over the last few years, how much have GPs spent on cars? and
what return is there to show for it?
I agree that the obvious return on IT is less than one might hope -
partly this reflects that stopping things working is easier than making
them work, but it is I think larger than very little. Much of it is
not on show though.
There are too many people in the NHS who feel able to send out a form
by post, in an envelope addressed to Dr Midgley, Homefield Surgery, and
which starts with Dea DOctor, please write your name and address on
this form.
Examples can for instance be found in the N&E Devon HA IM & T
department (you can run but you can't hide) where at present they are
preparing to mail us a demand for information they need to handle the
Y2k problem, with a strict timetable for replies.
We need people running IT who would be ashamed to ask a question to
which they already hold the answer, and we are more likely to find them
among our own profession than the currant incumbents. A few
Conan-Doyles, regarding the whole thing as an exercise in logic, would
not go amiss, and indeed there may be a need for a few Conan the
Barbarians to sort it out.
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