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MP's 'horror' at getting £4.2bn to digitise NHS with no plan

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BBC News:  MP's 'horror' at getting £4.2bn to digitise NHS with no plan

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George Freeman's role was digitizing the NHS - but he had not been involved in the 2016 public spending talks.

And he said his civil servants were ordered to set out how they would spend the money only after it was allocated.

This is how things are done in government, said Mr Freeman, and, he suggested, why they go wrong.

So the civil service objective was to obtain the funding, not to do anything useful with it.

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Ah, "digitising." Any time someone talks about wanting to digitise something it's a sure sign that their thinking hasn't got further than "ooh, new and shiny and buzzwords". If they actually had any hope of achieving anything useful they'd just say what they were doing instead.

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I recently had a "digital" examination at my GP's. It would appear the NHS attach a very different meaning to the adjective in question. In light of this, it seems entirely plausible we are labouring under a gigantic misapprehension.

If you wanted to give them the benefit of the doubt you might say it involved something like this:

share.png

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Part of my job role is to refile patient records so that they are easier to use for Doctors and Nurses. Newer paperwork is filed in a structual manner and older paperwork is scanned onto a system that can be read by consultants and doctors. Unfortunately not all consultants at my NHS trust are aware of the software that allows them to read up of the hernia operation that Mr. Bloggs had in 1973, etc.

(Image taken from the BBC article)

image.png.6e1fbe213ccfa269787e8ef188646227.png

It's not unusual to be given a stack of notes like this can be up to One Metre tall! Before they are sent to us for 'reduction', imagine the secretaries and admin staff struggling to move around rectangles of papers like that!! Or the clinicians using up precious time trying time trying find the information they are seeking.

Coincidentally, George Freeman visited our Trust a few years ago.

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On 04/10/2018 at 22:50, Sledgehead said:

I recently had a "digital" examination at my GP's. It would appear the NHS attach a very different meaning to the adjective in question. In light of this, it seems entirely plausible we are labouring under a gigantic misapprehension.

If you wanted to give them the benefit of the doubt you might say it involved something like this:

share.png

:lol::lol::lol::lol: ah yes, the old digital backdoor Trojan

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1 hour ago, MattW said:

It's not unusual to be given a stack of notes like this can be up to One Metre tall! Before they are sent to us for 'reduction', imagine the secretaries and admin staff struggling to move around rectangles of papers like that!! Or the clinicians using up precious time trying time trying find the information they are seeking.

Coincidentally, George Freeman visited our Trust a few years ago.

The problem with many new systems is that they just replicate this in electronic form, so you now have to login and open up a record only to have to scroll through 4000 pages of verbiage to find anything relevant - without some structure, digitising things will not solve the core problem.

In many companies, not just the NHS, there is a culture of "save everything, forever" with the result it becomes increasingly hard to find any key information under the mountain of out-of-date irrelevant crap.

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On 04/10/2018 at 22:50, Sledgehead said:

I recently had a "digital" examination at my GP's. It would appear the NHS attach a very different meaning to the adjective in question. In light of this, it seems entirely plausible we are labouring under a gigantic misapprehension.

If you wanted to give them the benefit of the doubt you might say it involved something like this:

share.png

Are you sure that is not far too modern than what NHS hardware and software can handle?

Perhaps the message should be delivered in this older and simpler form?

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.........\.................'...../

...........\.............. _.·´

............\..............(

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Lol!

I'm sure there's a good reason which making something digital is described as "digitizing" (lang students?), but surely, we could have made an exception and gone for the much less confusing "digitalize".

After all:

Actual -> Actualize

Brutal -> Brutalize

etc -> etcize

thingy -> thingyize

your eg -> your egize

So many prior examples!

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On 21/10/2018 at 09:00, MattW said:

Part of my job role is to refile patient records so that they are easier to use for Doctors and Nurses. Newer paperwork is filed in a structual manner and older paperwork is scanned onto a system that can be read by consultants and doctors. Unfortunately not all consultants at my NHS trust are aware of the software that allows them to read up of the hernia operation that Mr. Bloggs had in 1973, etc.

(Image taken from the BBC article)

image.png.6e1fbe213ccfa269787e8ef188646227.png

It's not unusual to be given a stack of notes like this can be up to One Metre tall! Before they are sent to us for 'reduction', imagine the secretaries and admin staff struggling to move around rectangles of papers like that!! Or the clinicians using up precious time trying time trying find the information they are seeking.

Coincidentally, George Freeman visited our Trust a few years ago.

A long time ago I did my work experience in the records department of a local hospital and became very familiar with these. Rather on topic for this thread, I said I wanted to do something 'with computers' and ended up in a room with loads of carousels of records and one computer in the corner, which was very rarely used.

The system was that if people were admitted then their records were on the ward or in the records room with its many carousels for about a week. There was then a storage area for older files which were no longer urgent which was an old disused building out in the grounds, like something from Resident Evil. Going down to the next level there was also an off-site storage location for older-older records, everything was moved around by car or van when required and then carted around the hospital when needed on wards, etc.

There were indeed files like the one shown in the image above, in fact ones much larger as well. The only bounds for the size seemed to be the number and strength of the elastic bands that could be found.

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4 hours ago, Bradbury Robinson said:

The system was that if people were admitted then their records were on the ward or in the records room with its many carousels for about a week. There was then a storage area for older files which were no longer urgent which was an old disused building out in the grounds, like something from Resident Evil. Going down to the next level there was also an off-site storage location for older-older records, everything was moved around by car or van when required and then carted around the hospital when needed on wards, etc.

There were indeed files like the one shown in the image above, in fact ones much larger as well. The only bounds for the size seemed to be the number and strength of the elastic bands that could be found.

:lol: Yes that pretty much describe how things are now.

My trust should be moving to a 'forward scanning' means of patient records in the next 4 to 6 years (ha!). In the meantime there are hundreds of thousands of files to contend with.

My dominant arm is still aching after a fortnight (no crude jokes please! :P ) moving some of these honking great files around and are a few incindences due to the vast operation of it all.

We have to hold deceased patients' notes for 8 years after they croak, thus taking up valuable shelf space.

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The problem with the NHS and IT is that most software suppliers have a roughly 5 year cycle after which everything is obsolete and you are expected to throw it away and start again - that is fine if you are running a shop or a garage or a food distributor or a chemical factory or whatever, but it doesnt work for patient records that can be needed in 50 years time.

Also the whole thing with scanning - instead of a huge bundle of paper you will just have a computer screen and have to page down 500 times to get to the relevant information. I don't think thats going to be an improvement, more likekly key information will be missed.

At my Dr's surgery all the screens are still 12 inches, to read an A4 document they have to page down 3 times.

Will they give decent monitors to the people on the front line or will all the money go to friends of the goverment at incompetent companies like Capita?

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On 10/11/2018 at 11:01, Habeas Domus said:

The problem with the NHS and IT is that most software suppliers have a roughly 5 year cycle after which everything is obsolete and you are expected to throw it away and start again - that is fine if you are running a shop or a garage or a food distributor or a chemical factory or whatever, but it doesnt work for patient records that can be needed in 50 years time.

Also the whole thing with scanning - instead of a huge bundle of paper you will just have a computer screen and have to page down 500 times to get to the relevant information. I don't think thats going to be an improvement, more likekly key information will be missed.

At my Dr's surgery all the screens are still 12 inches, to read an A4 document they have to page down 3 times.

Will they give decent monitors to the people on the front line or will all the money go to friends of the goverment at incompetent companies like Capita?

Surely, the advantage of scanning lies in ocr. Scrolling is then irrelevant, unless you want to read the whole doc.

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41 minutes ago, Sledgehead said:

Surely, the advantage of scanning lies in ocr. Scrolling is then irrelevant, unless you want to read the whole doc.

OCR or typing it all in, it's still going to be the same amount of text to scroll through.

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This sounds familiar.

https://forums.theregister.co.uk/forum/1/2018/11/19/nhs_it_advisory_board/#c_3660788

Quote

Real Time bed booking system hell.

Some time ago, my company was supplying an expensive team of software engineers to a firm of management consultants ( who shall remain nameless) to install a real-time bed booking system in a London hospital. A real-time system was costing far, far more than an online service seemingly for no benefit to anyone and it's purpose was a constant cause of speculation amongst the team and was a complete mystery to all involved. As time went by, more and more engineers were thrown at the project to the point additional office space had to be found.

Eventually, our company became seriously concerned at the sheer size of the monthly cost of running the contract and our financial director was having to seek larger and larger amounts of working capital just to keep the show on the road.

Just why it had to be real-time and not online was never explained officially but it became increasingly obvious that some senior manager didn't actually appreciate the difference between real-time and online. Vast amounts of money were thrown at an increasingly vain attempt to implement the system, and at no time was any money spent on disaster recovery or even a robust backup system.. Towards the end, it had become obvious to everyone involved that what was required of them was impossible to achieve, and several representations were made to the management that the plug should be pulled, however these were ignored, possibly because everyone involved was making more and more money from the doomed project.

Eventually, the whole thing collapsed leaving absolutely nothing in usable code and a small mountain of unusable hardware. The strange thing was the seemingly inexhaustible budget.

 

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It will never change - this was in the 1980s

https://www.independent.co.uk/news/uk/health-authoritys-catalogue-of-wasted-millions-a-secret-document-reveals-mismanagement-and-conflict-1470775.html

It is noticable that the people in charge of these grandiose schemes always seem to retire somewhere half way around the world as soon as the money runs out. Richard Granger was the last one, where is he now?

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