Tuesday, 20 September 2011

Computer “games” and the current "state" that is NHS IT.

Not all of us at ND Central are of an artistic streak although most of us are when at the infamous Café Michelle watering hole. One of the team who is really sad is a scientist by training. A week ago for reasons best known only to the deviant scientific mind they decided to try and play an old computer strategy game.

You would think that as the software was already on their computer that it would be a case of pop a DVD into a disc drive and the game should work as it did a few years ago a bit like if you as a doctor had a holiday and came back and expected your NHS computer to work as it did before. It rarely does but it is always your fault.

Of course this was not the case. The game demanded that the user downloads many megabytes of software from a remote server which is all well and good if you live in the first world of internet communications but here in Northernshire this takes many hours. Please remember that what takes many hours on a private individual’s internet connection this amount of data would take days via NHS broadband.

After several attempts at downloading the compulsory patches the game did not work but all the right patches were there. After a lot of headbanging our Practice techie got the game to work by disconnecting from the internet and going back to basics.

The basics in this instance was to install the software on a computer but forego the added enhancement of the game being only playable via connection to a remote server by disconnecting from the internet. Problem solved game worked, hours of unnecessary and unworkable downloads avoided and the game worked.

This is similar to the way in which doctors used to use computers. Each Practice had its own set of data called patient records which it could access locally usually from a hard drive within the practice itself. Now the good comrades from the Za Nu Labour Party thought this was not a good idea for while politicians are allowed security you as patients are not your medical records should be in the hands of the all powerful Party.

Now there may also be some shrewd business movers here as there has been a move away from information created locally being used and held locally to having GP practice records hosted remotely on servers owned by the private sector, and this is worrying, paid for by the Party via its PCT lackeys. Business has used similar successful methods as these to great success for example transferring call centres to the Indian subcontinent.

As a great grandparent a patient said to one of the team a few years ago "My family and I have been with your practice for more than 50 years and have always trusted you and the doctors that work here over the years with our medical records. We’re not trusting any Government with ours so we opt out and want paper records with you only".

This is not too dissimilar to our scientist colleague’s dilemma. They had purchased a game that they were once able to play (access) and were now denied access to what they had bought. This is like doctors creating medical records the prime purpose of which is to allow them and other doctors the ability to see what has happened and is being planned for the patients they care for.

When we were at grunt school we were told that the medical record should be such that if another doctor who has never seen the patient picks them up and reads them they should then be able to follow on even if the original doctor is no longer there. It is like a lot of medical information it is primarily there for people treating patients and they are the ones who can use it and should have unfettered access to it.

In essence the purpose of the medical record is to be a record for medics and as such access should be primarily for medics in the same way that if you buy a game you should be able to play it at home on your computer without any 3rd party involvement.

We are aware that there is piracy with games and can to a point understand the games industry trying to preserve their copyrighted products but when they prevent you using what you have purchased they are denying you what you allegedly own.

The Party is no different for it to is potentially the biggest pirate of medical and personal information. It is increasingly trying to restrict access for doctors to medical information that doctors need and have indeed created. The Party wants remotely hosted medical information and if you do not know how vulnerable this system currently is look at this recent story and you can bet they said the same about the Titanic and our practice Titanic has already sunk many more times than once losing days of work as a result. We bet also that any GP practice regardless of which system it uses has had its own DOS (Denial of Service) story.

The Party want all healthcare workers to have Smartcards which is nothing to do with protecting patient data, for if this was a major concern then the national patient summary care record would be a non starter, it is nothing more than a command and control device which anyone dumb enough to use a “Smart” card will have experienced when all of a sudden you cannot log on.

Doctors no longer have control over the information that they created and need to use in order to do their jobs and this is becoming an increasing problem with the Party approved extended hours. We have commented on this before but if a computer goes down outside of normal NHS IT working hours 10.00-15.00hrs you are left in the dark that is assuming you can get through to a local PCT IT “help” desk who say its not our problem please ring someone else.

Bit like the computer game. What once worked now does not despite the improvements in technology allegedly improving things. The same has happened not just to computer medical records but to laboratory results access to x-rays all things that used to be easily accessed which are incredibly useful to doctors but increasingly denied by centralization of IT control usually by idiots whose terminally inability enables them to be intellectually unable to use the data they now control.

This minor handicap does not prevent them exercising their terminal inability to prevent those who can use the information they control doing so and in doing so seriously compromise patient care. This NHS underclass of IT technicians seek to deny to doctors information by increasing layers of bureaucratic retardation but then they could never spell the I or the T bit of IT for they were very, very big words. Hint the I in IT stands for in-form-a-tion and it helps doc-tors do their job if they can see it.

So if you get frustrated by your inability to play a computer game because of the need for remote access even if your computer is up to the game imagine how your doctor feels when they cannot access what used to be their records, hosted on their computers now only available from remote locations. It is not just doctors it is nurses, receptionists and secretaries who cannot play what used to be a simple game called the written record or locally hosted computer record.

All because the Party wants control of UK medical records. Why should that be so important and costly? Just let us do our jobs, easily. Give us our records back we do know how to look after them honest. More importantly we know how to use them too.

Praise be to the Party whose idea of NHS IT will means that in contrast to the concept of the world wide web surviving a nuclear strike the NHS IT revolution cannot even survive a power cut.

Those of us old enough to remember power cuts can remember eating and reading via candlelight paper documents. Could we do the same with medical records in general practice now? More importantly could we practice?

NHS IT making it easier to take down a health service than ever before and denying those who need the information to do their jobs via institutionalized incompetence. And they keep getting better at doing it with each upgrade.


Muscleguy said...

Ah yes, but the Grauniad is reporting that the centralised patient record bit is being scrapped. Also the IT bods will, if asked, bore you witless about the inevitability of EVERYTHING being put 'on the Cloud'. Google will even sell you a tablet that has no software other than what is needed to connect to the Cloud. If you need a word processor you use one on the cloud. Need a calculator app, one on the Cloud. Spreadsheet? ditto, database, ditto.

Internet being down or, heaven forfend the heavenly Cloud going out is something not to be even thought of. Yet it happened recently in the US, a large Cloud provider went down and people's data were not recoverable. Gone.

My wife works in a university and this morning was unable to work because the server was down. All the information you needed had to be stored on the server.

If you read the IT media such as The Register then the security of the Cloud, or rather the lack of it, will worry you.

It will all end in tears and scandal.

English Pensioner said...

In many countries patients keep their own records. When my wife was taken ill in Malaysia, when she left hospital she was given the results of all the test they had carried out - "They're yours, you paid for them".
We should do the same, except that we should have our data on a memory stick, which we could take along to our GP/hospital when we visit. They could add anything extra as necessary and the privacy of the data would be up to the individual. Simple, memory sticks are now dirt cheap, and no fancy software would be needed on existing PCs nor would there need to be an expensive IT department.

But it wouldn't cost a fortune, so it can't be any good.

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