[log in to unmask],Net wrote at 08:07 on 01/10/98 
about "RE: Branch Surgeries and IT-what do you do?":
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>This is a bummer. I don't think I have ever seen a solution which
relies on
>the PSTN which is even remotely affordable when viewed in the cold
light of
>day. 

The class of problems this belongs to will be solved either by a 
fast ubiquitous network, which NHS Net doesn't seem to be yet, but 
believably could become...
which means that the whole of the UK, or the NHS, or the PCG is in 
the same building as far as networking goes.  Say 10MBit/sec but 2 
MBit/sec would do. 
And one just goes on with current systems.

Or
by intelligent design, where either the display unit (PC; Palm 
Pilot; DOS/dumb terminal or whatever) only receives the info 
necessary to display the screen (2k/0.1 sec peaks) over the network 
or else the database is replicated across a network of say 64k 
capacity in slack time.

Costings tend to support the idea of putting in a server in each 
building, and using the features implicit in each of the modern 
database management systems to synchronise them, but a bit of help 
from Gov or the Telcos could change that - for instance if a Telco 
which has lines past every surgery in the PCG decided that the 
service charges forever would support the immediate installation of 
2 MBit circuits, or the Gov decided that NHS Net would pay the 
charges for networking, and we managed to make a case for 2MBit 
connections...

On the whole I favour medical record systems which store 
notes in ways which allow individual notes to be sent 
asynchronously, while working from a copy, and there are several 
reasons for thinking this to be a good way to go.

The bandwidths available will allow use of a browser, or Internet 
enabled application - without impinging too much on the bandwidth 
required for accessing reference material in real time.


>> Andrew,
>> The practice I am visiting has about 10,000 patients equally split.
>> They are currently using two 9,600 lines to communicate between
>> surgeries (terminals run _very_ slowly).  They comment that a
kilostream
>> costing about £6000 is not a runner.  How would you respond to that
if
>> you wanted to convince them that a kilostream was a sensible option?
>> They are using System 5 as well, so if you have any other tips for
them
>> (they are slow uptakers of IT) I would be grateful.
>>
>> Regards,
>> Paul
>
>
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--- OffRoad 1.9r registered to Adrian Midgley


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