TheAnatomiser

12 BILLION pounds they’ve spent. Of your money. And to show for it? Well, we can now get xray images electronically, which is nice. But also means that instead of losing the odd xray like we used to, now when the server goes down (which it does about once a fortnight - despite promises made that it never would) we can lose all the xrays at once. That’s progress.

What we also have - still - is three separate systems to log into in the department where I work. One - the one to order path lab tests - so old that it simply refuses to talk to any of the others. We have a fairly good program for tracking patients through our emergency department, but it’s made by a small company, not one of the ‘big players’ in the initial push for an overhaul of NHS computing.

Then there’s the centralisation of patient records, the so called ‘data spine’ that all our records will soon be on; unless you opt out of the scheme like I have and a lot of GPs have. I can tell you exactly how that scheme will be used primarily. By nosey staff who want a gander at someone else’s medical records. Either out of pure prurience, or for more sinister means such as during employment disputes. It’s just human nature I’m afraid. If you really hated your neighbour and had a bit of plastic that enabled you to see that they were treated for genital warts last Christmas, you’d use it. You know you would.

And unfortunately the ‘data spine’ will not add to patient care at all. Sure, it’s sometimes frustrating in the middle of the night not to have an up to date list of a patient’s meds, but that has never to my knowledge actually held up anyone’s treatment. I actually heard someone talking about this saying that instant access to someone’s blood group could be life-saving. Absolute rubbish. Blood is always ‘cross-matched’ immediately before being transfused. There are many antibodies in blood that are not defined by the simple ABO and Rhesus groups, and one of the easiest ways to kill someone is to give them improperly matched blood. So no - knowing someone’s ‘blood group’ beforehand - whether it’s from a computer or from one of those bracelets people who like to think they’re fighting in the Korean war sometimes wear - that piece of knowledge will never be useful and would sometimes be dreadfully harmful.

In similar vein, how are you going to be sure that the unconscious patient you have in front of you is in reality the same person whose data you are looking at on screen? I work in an area with a large British Asian population. Many of the older people do not know their date of birth - usually it is on records as ‘1/1/35′ or something similar. And many share indistinguishable names too. Am I really expected to decide that someone is not allergic to penicillin, for example, from such flimsy data, before injecting them with the drug which will undoubtedly kill them if the decision is incorrect?

So as you can gather, I’m not a big fan of the NHS Care Records System, and have personally chosen to opt out of having my details on line. A lot of other hospital-based doctors and GPs have too. Details of how to opt out can be found here.

There’s a lot of controversy brewing about the initial decision to go ahead and splurge £12bn in a bit of a hurry. Computer Weekly have it covered here, and wikileaks have a leaked briefing document here.

Twelve.

Thousand.

Million.

Pounds.

Someone I know in the healthcare IT business reckons he could have come up with something that would have worked well for about half a million. You know the most salient question? It’s this. How did they manage to spend that much money and NOT come up with something useful?

Tags: Health politics //