In message <[log in to unmask]>, Alan Hyslop
<[log in to unmask]> writes
>In-Reply-To: <[log in to unmask]>
>Mary Hawking, having pressed the wrong button, replied-to-my reply
>direct. Now we're back in public....
Alan,unfair - Turnpike thought you had replied to me direct .. and the
wrong button is a Turnpike problem(I think - anyone else have the same
problem?)
>
>Mary...
>> As far as I can see, most GPs only buy computers if they can make a
>> buisiness case for it (they cost an arm and both legs) - and use them
>> for money and time saving functions - registration,claims,repeat
>> prescribing etc. Don't be mislead by GP-UK - we're the exception.
>
>Alan...
>> ... get into looking at fresh areas of benefit that have become possible
>> by folk such as you using consulting room modules?
>
>Mary....
>> Takes twice as long in consultation.I don't know how long I'll be able
>> to afford the luxury!
>
>But Mary, you wouldn't be using the computer during consultation,
>especially if it takes twice as long, unless there was a least a believe
>in benefit. Or are you dafter than you sound?!
>
I have a particular problem in my practice,due to having been caught in
a time warp in 1990.This meant that, until Dec 1994, we were stuck with
a very,very low staff budget - and no prospect of improving it.Things
have improved.. but the computer has to earn its keep.
Don't think I like that last remark - is it showing? Where _did_ I put
the stress line number?! :-(
>Mary...
>> What benefits are you talking about? I enjoy things like the hayfever
>> thread - but it's an anti burnout tactic - I work 67 hours a week
>> (shortest working week since I qualified!) and there comes a time when
>> the only benefit sems to be to the executive.
>
>Yet surely the hay fever thread was an excellent example of real
>benefits, and not just a wee interest. All you folk casually giving the
>precise number of folk with diagnosis X getting treatment Y. At the
>touch of a button, more or less. How long/ what cost to get someone to
>plough through manual records to answer the same question?
Typical executive remark! It's only because we have computers that
inanities like the recently abolished health promotion bands could be
introduced!
If I had to plough through manual records, of course I wouldn't bother -
but anyway,who cares and how valid is the data produced (first law of
informatics)?
>
>Of course, this is not directly attributable to recording during
>consultation. Just to recording. But is not cheaper and more accurate
>for you to record directly rather than to employ someone to enter your
>scribbles into the machine?
I certainly couldn't afford to pay anyone to enter clinical data -
administrative data is a different problem - we need to get that right
unless we want to starve .. the fault,dear Brutus..
>And the benefit? Quality of patient care.
Can you show quality of care *is* improved?Evidence please!
> (BTW, I think that by-product
>production of clinical audit information is a relatively trivial benefit
>compared to things like:
> - intelligent prompts and reminders
> - structured record schema for particular conditions
nothing to do with me - that's software!
> - enabling better communication
with whom and who benefits?
> - patients perception that they're being taken seriously!
definitely not helped by computers!
> - making a sometimes boring job more interesting!
"they're all queer but thee and me - and even thee's a bit odd!"
>
>Problem is that there's no direct financial reward to the GP doing this
>kind of thing, outside of a few iffy targets. Reward in heaven, and all
>that.
That isn't the problem - the problem is that both computers and GP time
are expensive - and scarce!
> So a good reason for quantifying quality-type benefits might
>therefore be in anticipation of reimbursement scheme which DOES recognise
>the value of keen folk who use the system during consultation.
another target payment , maybe? over 90% consultations recorded on
computer? Quality controls? in an ideal universe..
>
>Maybe all 400 GP-UKers could design and carry out a mega-study.
>Objective? Getting rich as well as famous!
we work under the retroactive pool system - and clawbacks! If you can
think of an *outside* source of such generous funding, I might be
interested..
Mary.
PS Alan,previously you've identified yourself - this time you
haven't.Is that significant?!:-)))
>
>Alan Hyslop
>
--
Mary Hawking
Kingsbury Court Surgery
Church Street
Dunstable
Beds LU5 4RS
tel:01582 601289 (home)
01582 663218 (surgery)
fax:01582 476488 (surgery)
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