Comments are now allowed
Wednesday, January 31st, 2007Akismet has been doing a good job & I finally feel able to open up comments here.
It might be interesting to see what comes of this.
Archive for January, 2007
Universal healthcare - an idea whose time has come?
Wednesday, January 31st, 2007In the US of A that is.
The 2008 presidential season is already in full swing & the big names are looking for their USP, especially since most of the prospective Democratic challengers are on the same side of the Iraq debate. Obama got there a few days ago, Bush’s State of the Union gets a positive recommendation from the Economist (though it is a case of too little, too late & under duress), Hillary still has the scars on her back from 1992 and John Edwards etc have more to say on the subject.
It is interesting watching this discussion from the other side of the pond & I regret that we are taking steps, small but true in the other direction.
Something for you to ponder while we wait. Also a comparison of various national EPR experiences.
Deja vu
Wednesday, January 31st, 2007To throw in a pop culture reference, “All of this has happened before. All of this will happen again.” (from Battlestar Galactica, arguably one of the better shows on TV today).
People in busy environments will bypass any obstacles. well meaning or otherwise put in their way. Due to the poor design of the software in use, login times can take quite long and when you consider that you are supposed to log out & back in whenever you step away from the computer, you end up spending a considerable proportion of the working day just waiting for the system to let you do your work.
In practice shared logins are a fact of life in most hospitals and South Warwickshire has done the sensible thing in ignoring the asinine policies recommended by CfH. This is however hardly a great advertisement for the security & performance of the system. Add to this the toothlessness of the Caldicott Guardian & you have a recipe for massive abuse.
At what point does repeating “I told you so” become embarrassing? (Ref Launch of the Care Record Guarantee in London. 2005 & numerous times prior and since.) Are you guys listening, Richard Granger et al?
CfH gives ground?
Monday, January 29th, 2007It appears that the Information Commissioner has weighed in on the opt-in / opt-out debate with a reversal of his previous comments.
“NHS Connecting for Health has confirmed that people living in areas introducing Summary Care Records will be contacted before any of their medical records are uploaded on to the NHS Care Record Service,” the ICO report says. “They will be given information about their options to limit the future scope of the information on the Summary Care Record or the option not to have one at all and they will also be given the opportunity to make arrangements to view their information before it is uploaded. They will have a specified period before their information is uploaded to consider their options.”
EU wide sharing of medical records
Saturday, January 27th, 2007What is it that we are actually trying to do here?
The oft repeated chestnut about access to medical data in an emergency is way down any practising clinicians priority list & there are dozens more improvements that are needed right now & can save lives. People with a peripheral understanding of healthcare have been seduced by technobabble & sign up to pie in the sky ideas without undertaking a cost / benefit analysis. After all, look where that famous chat in the No 10 living room with Bill Gates & his acolytes got us in the shape of Connecting for Health.
K.I.S.S
National IT Programme for sale?
Tuesday, January 23rd, 2007So Isoft is on the block & one of the bidders is Cerner. So after all the chest beating about promoting a choice of systems & a wider ecosystem of suppliers which was the rationale given in the early days of the NPfIT for the numerous disastrous choices they made, we are now in a situation where one LSP controls the implementation plan for the acute sector in the entire country with the other players in supporting roles.
And we have ended up with the worst of all worlds. with a poor modification of an off the shelf system instead of a solution that suited the requirements on the ground. Whither diversity?
With the new mantra of local ownership of the CfH programme, I hope that the clinical community are involved more than they have been so far or we might as well just write off the billions still to be spent & return to writing on pieces of slate.
How we care for our elders
Tuesday, January 9th, 2007That Britain has an aging population is an acknowledged fact. What appears not to be accepted however is the duty to provide care in an equitable manner to patients in their twilight years. From prioritising surgery according to chronological age instead of that persons individual level of fitness to simply withdrawing treatment from older individuals with life-threatening conditions, there is an institutional blind spot towards their healthcare needs.
When this situation coincides with an episode of cerebrovascular illness, it is simply begging for a test case under age discrimination & human rights legislation.
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