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-----BEGIN PGP SIGNED MESSAGE----- Hash: SHA1 Rod Sheaff wrote: > NHS IT is a long succession of heart-sink stories. Instead of the current > enormous national IT projects they would if they had any sense impose a set > of national and open protocols for data capture, data exchange, data > encryption and security etc. and promote an open-source development model for > the software. As it is, the NHS has spent billions, has been horribly ripped > off, still doesn't fully own the systems and often pays outside organisations > to do quite basic data analysis. And people still carry pieces of paper > around. Except for general practice systems. These had some benefit from very early centrally funded experiments - the Micros for GPs scheme for instance, and the research done by IBM and various academics in Exeter, which defined the basic structure of a general practice system. (and, in the 80s, found some of the reasons why a single record system didn't work for specialisms and general practice, but that is an old story and I expect forgotten now) I agree with the FLOSS bit, but the effort to impose encryption centrally failed mainly because the encryption standard offered - a secret algorithm from GCHQ called Red Pike, and promptly rechristened Red Herring did not seem to our security advisers likely to be secure. GPs of course are not strictly NHS, we are independent contractors with a major customer. However the NHS has now seized our IT facilities, and I do not discern improvement as a result, despite having been involved in some efforts to produce it. As for polyclinics, one would start by dismantling every functioning practice in Exeter, along with the generations-long relationships with families living nearby, and whatever relations exist with patients who have moved in, and building new practices, on where? It seems an expensive way of breaking what by and large works. There are moves toward aggregation of Practices, for instance 5 in North TOrquay have commingled themselves, and two in Heavitree will soon, and we do also have the lab, imaging, physio, OT etc resources quite close at hand. Putting them in the same building would be resisted by them, on the grounds that they don't want to be divided into four smaller groups than they are at present. As for kit... I'd like an ultrasound scanner, so as to look at a few things, but the two things that stop me are nothing to do with size of building or polyclinic, they are:- 1. Nobody will pay me to do an ultrasound san and produce an image, and there is no apparent indirect compensation for it either (so the £5-£25k cost of the device won't be recovered over the 5 years they tend to last); 2. The imaging doctors (radiologists by antique tradition) argue that considerable training is necesarry to make sense of such things. I'm not entirely convinced ... The capitalisation of dental surgeries is frightening, but they have an income stream for their various bits of kit, ours is less, and while there are various things that could be handy from time to time, if any one of us did much with them we would be doing less of what we do now, time not being extensible. If you want FLOSS medical software look at Vista ( worldvista.org ) and at OSCAR McMaster. Gnumed is worth supporting with development. For my part, I'm looking at an Open Source workflow for clincial photogrpahy this week. - -- Adrian Midgley -----BEGIN PGP SIGNATURE----- Version: GnuPG v1.4.6 (GNU/Linux) Comment: Using GnuPG with Mozilla - http://enigmail.mozdev.org iD8DBQFHz0YFb80am9d/StcRArJ8AKD1UoBiIDywSJ0I1phPv3QjQx4e7QCgrZ0m za/YzxZH6OOKx1DsgzvBerI= =x7LP -----END PGP SIGNATURE----- -- The Mailing List for the Devon & Cornwall LUG http://mailman.dclug.org.uk/listinfo/list FAQ: http://www.dcglug.org.uk/linux_adm/list-faq.html