Peter Machell wrote:
On 26/06/2007, at 11:51 AM, Greg Twyford wrote:
What is best for our users? A single big, increasingly unresponsive
corporate-owned product? A range of boutique clinical products each
with low market-share and the potential for takeover, market
annihilation, or disablement of a single, key developer?
Hyundai isn't going to go broke anytime soon. This doesn't mean that
Jaguar and BMW will.
How will most Divisions, with no, little or decreasing IM&T staff time
and expertise support a range of clinical products, let alone one
predominant one? How is the market going to resolve any of this? How
will government or Divisions resolve any of this?
I can't speak for how or why divisions are or should be doing IT
support, but I can tell you how I do it - hire great technicians, train
them well and pay them well.
Can we really recommend to anyone that they place their patients
health records in any of the products in the market under the current
circumstances? Possibly yes, if you have a narrow commercial
self-interest. Probably no, if you have an interest in the nation's
health outcomes in the long run.
Leaving any interest out of it, what is the alternative? Provided the
data can be extracted from the product, it's a hell of a lot better off
in there than on paper.
Peter,
That statement 'provided the data can be extracted from the product' is
a big caveat. A qualifier might be 'at a reasonable price, in a way that
doesn't hamstring a practice, etc.' What about standard formats to
support use of the data for public health outcomes? We are a long way
from that. Use of HL7 pathology results is a still a minority activity,
for example.
Quality support is very important, but how many practices see the need
or feel that the investment is justified? The one's that do fair better,
I agree, but a large number don't make good use of their systems, don't
have them maintained properly, and don't put enough data into them for a
good benefit to anyone. This unfortunate fact is well recognised.
This list is generally populated is the GP IT interested, the capable
and the relatively IT literate. Its participants have been referred to
as 'zealots' by the bureaucrats, who, of course, resent anyone who knows
more about anything than they do.
So it may be fine to retreat into a practice with such people, but as I
said, has the outcomes of GP IT uptake really benefited more than these
few, who've had the capacity, with help in many cases from quarters like
yours and the divisions, to make a go of it? What about the rest?
My chairman has just come back from a meeting where AHS IT staff were
complaining they don't have equipment with the capacity to run security
properly, so its not just GPs.
Greg
--
Greg Twyford
Information Management & Technology Program Officer
Canterbury Division of General Practice
E-mail: [EMAIL PROTECTED]
Ph.: 02 9787 9033
Fax: 02 9787 9200
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