inactionman wrote: Wed Jul 24, 2024 8:51 am
Jock42 wrote: Wed Jul 24, 2024 8:28 am
inactionman wrote: Wed Jul 24, 2024 8:20 am
The earlier attempt was a bit of a disaster.
https://www.theguardian.com/society/201 ... ystem-10bn
As I understand it, one of the issues was a lack of engagement and understanding of the GP side of it - as suppliers and not direct employees/internal functions, they can use whatever business processes (Within reason) and IT systems they want on their side, and integrations to these were not well thought through.
(There were many issues, but I raise just one to highlight that integrating disparate services is not easy - you can't just throw data over a wall.)
It must be larger issue than that as different trusts can't share info but that definitely makes sense for GPs. A fairly recent development allows GPs (I don't think hospitals can) see any report forms the ambulance service generates about one of their patients. I'm not sure how long the info is available for though.
Yep, the whole thing should have addressed the whole patient lifecycle which would include intra-trust sharing, but it didn't really work so we're not really much further on.
It's a tough ask, as so many parties have a touch upon a patient and medical care is a complex old beast, but to my outsider's eyes it looks like there wasn't sufficient upfront business service, process and commercial alignment. I'm basically an architect it IT who tries to align information and process understanding before the techies begin, which is a frequently overlooked aspect and causes all sorts of downstream problems, and I suppose I always see problems through that lens.
GPS seeing ambulance reports makes absolute sense, I'll admit to some surprise that hospitals can't. I assume they just take a set of information straight from paramedics as the patient comes through the doors of A&E? Seems ripe for something to be missed.
I have actually found the NHS up here quite well connected between hospitals, labs, GPs, imaging, etc. Anytime I have had tests, treatment etc then no matter where I have been the medic has had access to all my records and results.
From my experience the number of legacy systems (patient record, pharmacy, labs, procurement, HR, finance, payroll, estates, imaging, ambulance, theatres, etc plus individual speciality systems for audit etc ie neonatal care, cardiac surgery, diabetes, etc.) across the NHS is a major problem and they are supplied by a range of suppliers and some date back many, many years. Often commercial systems weren't available or affordable and individuals/groups/ professions developed their own in house systems for local use and these often spread across the wider NHS and were maintained by one man and his dog. Connecting up everything in a safe and secure manner is a major technical problem.
A few years ago one NHS board in Scotland had to upgrade its Windows operating system it found it had well over 100 legacy systems and it had major problems with implementation as a result. Bringing all these systems up to date and then ensuring they can all speak to each other safely and securely is still a major problem. Also many systems need to link with or speak to other 'external' systems - ie junior docs training and education is also managed through post graduate Deaneries and junior docs will rotate across a number of different employers so info needs to flow across them all. It really is a very complex issue!