Tell me about it! Before we both retired, I worked for one of the contractors supplying patient record systems to GPs, and the XYL worked in reception at a surgery scanning the paper correspondence.
Why is there not one single patient record system, rather than the fragmented system we presently have?
Every test, result and appointment I have with my GP goes on my patient record on the GP's server, which I have full access to. Hospital appointments, tests and results not so - to appear in my online record, it relies on the hospital sending to the GP paper letters, which the surgery then has to manually scan to then appear in the record.
ISTR that there was an outcry about patient confidentiality when an integrated system was suggested?
Because the writing of the software was out sourced? And badly specified?
My hospital told me they had no method of adding my email address to my record - or the part of it they use to contact me. But can store my mobile number, which is a later thing than email.
This arose because they wanted to email be documents. When this happened a second time, and they asked for my email address again, I queried why.
In article <qa6p0b$7r0$ snipped-for-privacy@dont-email.me, Harry Bloomfield snipped-for-privacy@NOSPAM.tiscali.co.uk> writes
In the early seventies a colleague went off to New Zealand for a few years to help implement a payment records system. Several years later when I next bumped into him he had returned and couldn't believe we had mad absolutely no progress. ISTR Wessex Regional health Authority were the first to try spurred on by IBM. It was a disaster. But when central government decided to have a look they called in the same idiots to advise them - and it was a disaster.
It happens that bert formulated :
So, how come it can work (reasonably?) effectively for the GP surgeries then? Do the GP's use just a small local system, or is it national?
GPs are private sector businesses. They can (within reason) buy their IT from whom they choose.
snipped-for-privacy@gowanhill.com presented the following explanation :
Absolutely crazy. So, if I were to move GP surgeries, likely they would need to transfer my records to a different and incompatible system.
security paranoia.
Because civil servants don't want it to work. If it did large numbers would lose their very generously pensioned jobs.
When I worked in IT I thought government employees were stupid. Now I think their only function in life was to drag everything out until their retirement.
Another Dave
Because the nhs has been fragmented for years and each trust was allowed to do their own thing. Its a mess, The nhs app was supposed to be out by now. I can guess where the problem is, handshaking with all the totally incompatible information formats used by the NHS. Bah Humbug. Brian
Its more likely they use one of a small number of systems and there is a mechanism for moving records between them.
And the most blame should be directed at T Blairs lot.
Back in 1974 the NHS acute services were reorganised into three tiers. At the top was the Dept of Health and under it were 13 regional health authorities. Under the RHAs were a number of Area Health authorities each of which had a number of District Health Authorities with one hospital, plus outlying clinics and associated GP practises.
Each RHA ran a blood transfusion centre, ran the ambulances, did all the payroll, HR and accounting for every AHA and DHA. The payroll system was bespoke, supported by the Bristol RHA and common to all 13 RHAs. The RHA would do planning, allocating contracts for major works and again used a common methodology. AHA's had smaller budgets local issues.
6 hospitals were part of a Dept of health strategy to implement computerised records, namely St Thomas' with a rank xerox IBM360 clone, QE Birmingham and The London hosp Whitechapel using Univac 418-III's and three others that I have forgotten. The London Hosp system was way ahead of its time (1970s) with 120 VDU's and printers around the campus, running 24 hour 365 day service that connected all the laboratory analysers via CT mod 1 mini computers and allowed blood tests and other investigations to be made online in the ward and allowed the doctors to view the results on any VDU. Overnight the full-time computer operators ran batch jobs that printed out bar coded sticky labels and the previous days cumulative lab reports that were delivered overnight to the wards. patient admin, waiting lists, obs and gynae booking lists and a host of other applications were all written in Univac *assembler*. They even wrote their own transaction processing system with pre-post journalling and relational database management system - all in Univac assembler.Despite being created by harold wilson lot, Mrs T, nor John major never made any serious changes to this structure, though a lot more disjointed computerisation projects occurred across the NHS, with a number of different patient admin and lab systems being implemented that were all standalone. Every person in the country still had their green manilla folder at the GP, which followed them if they moved to a new address, while hospital case notes (some truly massive) folders never ever left the hospital.
Then in 2002 'Nu Lab' scrapped the RHA, aHA and DHA tiers and brought in over 100 Primary Care Trusts that were allowed to do their own thing with a hotch potch of accounting, payroll and HR systems. Plus the big one, the plan to have a massive patient admin 'backbone' for the entire country. The London Hosp system was simply scrapped.
It seems to be like this all over. But when things get urgent, they send paper records by fax. The NHS is, apparently, the world's largest purchaser of fax machines.
The usual blame game so loved by Tories.
If something was that wrong, they've had some 10 years to put it right.
Making any blame firmly on them.
If only they did sticky backed paper for a fax.
Wondered why I had to pick up the paperwork for a blood test from my surgery. Was obvious when I saw it - the labels for the specimens were part of it.
Mine were sent manually, there is a 3rd party that specialises* in doing this.
*specialises might mean losing them or in my case losing them for about a year.This is despite both surgeries being computerised, albeit with different systems.
The facts speak for themselves. It was NuLab who inflicted the biggest, most massive, eye-wateringly expensive, far-reaching, top-down, FULL reorganisation that the NHS has suffered since
1974 when the post-war hotch potch nationalisation of the health service was given a workable management structure. One that served it well right through MrsT and John Majors time in office who left well alone, even though Wilsons and Callaghans government were behind the 1974 reorg.The NHS cost £38 Billion a year in 1997, but by 2010 Gord and Co had got that figure up to £115 Billion.
Well thats the price of a computerised path lab. Bar codes are used to identify specimens and they have to be printed somehow in a way that they won't be detached from the request form.
Maybe you'd prefer to go back to the 1974 version where the doctor would hand write *EVERY* blood test request form, getting the correct CRN number on every form (at 4 AM having already worked 100 hours that week). Then he/she might take the bloods as well, sometimes using the wrong container, so no use to the labs. Then each container also had to have the patient name written on to it, more potential for mistakes.
The labs would then receive a plastic bag containing a few dozen request forms, sometimes contaminated with blood where a specimen container had leaked, and in a busy lab doing multiple tests on 200+ patients per day there would be unlabelled specimens which go straight in the bin , even if there was only one unlabelled one, and one request form with no specimen.
Preprinted barcoded sticky labels, and vacutainer collection tubes have revolutionised hospital path labs, and in the era of HIV and other blood born diseases made life a lot safer for the lab and ward staff too.
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