I really like I.T – Information Technology, after all I've been using it since I was around eight years old. However, in those thirty years of using computers I'm also fully aware of some of the problems that I.T can make manifest.
Especially when you bring in the cheapest contractors, don't supervise them properly, don't consult properly with the people to be using the system and then start cutting budgets halfway through the project.
*cough* NHS *cough*
I mean, if you can't get contractors who are skilled enough to stick linoleum to the floor, how can you trust your commissioning people to find someone good enough to do invisible and arcane things with computers.
Therefore you end up doing daft things like sending letters with confidential information to the wrong people – as, despite what the 'Connecting for Health' person says, without serious thinking I can imagine two ways of a member of the public getting confidential and potentially damaging information because of these letters.
(And notice how the CoH speaks as faceless unit – the spokesperson doesn't have a name in that article)
Actually this is perhaps why we stick with outdated software – official web browser of the NHS? Internet Explorer 6.
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But I'm no Luddite – when a system works well, it works well.
Take my mum – she's currently under the care of a consultant and the consultant is juggling her medication for her. Slowly increasing the medication while looking for improvement or side effects.
Does my mum need an appointment to do this? No. The Consultant has an email address that we can send updates to, and the Consultant can suggest dose changes.
It works really well.
The problem only occurred when my mum went to the GP surgery (that has been there for some years) in order to get a refill of the prescription.
My phone rang that morning…
'Hello, it's the GP surgery, you mum has come in asking for more pills but we have no record of this – but she has told us about the emails from the consultant – can you fax the email to us please'.
Well, I haven't owned a fax machine for quite some time.
'Could I not forward the email to you? I have it on the machine I'm sitting in front of right now'.
'Sorry, no – our email isn't working yet'.
So I had to print it out and drive down to my mum's place (only five minutes and I did get a cup of tea for my trouble) with a printed out email in my hand. All because their email wasn't working yet.
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So, you can see how it works – someone embracing technology as an option (I know that email isn't hugely secure, but the important thing is that we had a choice about whether to use it or not), while another part of the NHS can't get it's email working.
Situation normal then – the luck of the draw.
At the place where I trained, we'd get electronic request forms from GPs. We then had to print these out and scan them back in to get them onto our RIS system. Weird system, but they seemed happy with it.
I can assure you that most IT staff in the NHS would love to have got rid of IE6 years ago! Unfortunately, when they were told it was able to move at the start of this year, that is just the beginning of the process. Things have to be tested.
As for NHS.net, remember this is webmail and can be read on any computer in the country – not just those nice secure NHS ones! Sending it from one NHS.net account to another is secure but since someone can read it on their home PCs or one in a public library you have to wonder how secure it is.
Thought I'd let you know this thing about the opt-out system for medical records, apparently if you don't opt out your records get uploaded to a central database to which hundreds of people, not just doctors, will have access to. Here's the FB page about it:http://www.facebook.com/#!/pages/Protect-Your-Medical-Confidentiality-ACT-NOW/330345503401?v=info
Don't know how much of it is paranoia but I'd rather err on the side of caution and opt out. It'd be fine if you've only got a couple of chest infections and a broken leg on your record and don't care who sees it, but a lot of people have stuff that could be used against them, like contraception history, or details of mental health problems.
Anyway thought I'd link to it, hope you don't mind. Would be interested to hear your views on it actually.
Information Technology
We have a very active nhs.net email working in the GP surgery where I work!
Technically the NHS should have moved to IE7 fron January 2010 as per the DH guidance.Some how I suspect this has not filtered down to all NHS organisations.
Anyway, why IE7 and not IE8?
NHS.net is as secure as these things get.*strokes account wuvvingly*
12.5bn for the new It system. How much of it is spent on consultants? How much time is devoted to consulting with the end users?I'm all for a new spanking system where the doctors can someone's medical history on a screen. Prior to my fourth heart operation a month ago, I had to see a cardiac consultant. He read notes from a folder and had to make an assessment of what needed to be done just on these papers. He had never seen me or my case notes before that very moment we met. Had the case been available on screen, he would have been able to make a more confident decision without all the faffing about and page turning.
Just for future reference: http://en.wikipedia.org/wiki/Internet_faxThere are usually a number of free fax gateways out there for the Googling, though finding one that's not just text-only can be tricky, if you need to fax a signature.
I admit, this might in your case save no time. But when some org in the US asks you to fax 'em, it comes in really handy!
I know this is gonna sound wrong but I had no idea what IT actually stands for up until now. I'm from Switzerland but we use the word like many other English words that have to do with the www and computers, so yeah.. just wanted to say thanks, you've really made my day *haha* It's one of those things.. words you use all the time but without actually knowing what the abbreviation stands for lolNina
Not a comment on IT so much as a note to say I just finished reading both your books and loved them. Made the shifts go faster as I was sitting in my own “motor” at the time waiting for calls. Keep it up!Tim Maher AEMT-P
Paramedic Supervisor
Rochester, NY USA
Strange with all those well brained washed by Unis, there is a very cost effective way to use data [personal], keep it off line , always. Old word was shanks pony data.It should be stored on 4/8 gb usb mem. chip or flash drives cost less than 10$ for 4 gigs. enough to keep pics as well as text. Your primary MD has 2 copies duly marked as master and Backup like he did with the old brown folder, when required the patient takes a marked xeroxed digital copy with him and the consultant reads it, like any paper file, The computer just becomes like any pen and paper. Data is so easily lost when it is kept on laptops, asked the spy services, they keep losing laptops galore.Back in the good old days data was kept in 64k disks and read when required, no spy service could read it, unless there was collusion between the holder and the inquirer.If necessary a program can be easily assembled, to actually read this special encrypted data and write over the data placed on any reading computer by replacing the data with ones over the original data when the memory chip/flash drive is removed . It just takes a law, just like the law required to burn a paper file that has sensitive info. Unfortunately the decision makers have no knowledge of the work they control, thus it will never happen to have true privacy.