All in a day’s work from the consulting room

Regular columnist Dr Neil Paul ponders – again - the enduring mystery of why the internet runs slowly in the afternoon and reflects on some of his other recent encounters with healthcare IT.

I have had some feedback on one of my columns – proving, at least, that I’m not the only person who reads them.
A couple of people have been in touch to say that they have also noticed that the internet seems to run more slowly in the afternoon: although nobody seems to know why.

One of my correspondents put forward the rumour that it slows over lunchtime because everybody starts surfing in their lunch-breaks; but I have never seen any proof that this is true or an explanation of why it should continue all afternoon.
In any event, we hear of countries like Singapore having invested in super high-speed fibre optic links to every home; why couldn’t the National Programme for IT in the NHS have invested in future proof, high-speed links to each practice and NHS provider?
 

Wi-fi and why not
 

You may know that I Twitter as @sandbachgps. I only send the occasional message, and try to keep those to good PR. One of the conversations I mentioned above came about after I talked about my idea to provide wi-fi in the waiting room for patients to use.

The patient who tweeted me wondered why the local town council didn’t offer wi-max to the whole town so it could be used by residents, schools and other services, especially when people were out and about. I have had quite a few comments from locals who thought this was a great idea.
 

But it looks like the only way I’m going to get my wi-fi is if I pay for a completely separate system, out of practice funds, with a separate line and its own BT homehub. My worry is that if I do this, all the doctors will want to sit in the waiting room to access the internet, as it will be more reliable, faster and easier to use than our official link.
 

Simpler desktops – for whom?

In my IT role, I have been getting copied-in to lots of complaints about PCs being locked down, which seems to be a perennial problem.

One practice had all its desktop icons moved into a folder; but no one told the staff, so they turned up one morning to find they couldn’t log on. Unfortunately, no one had told the helpdesk either. Panic ensued - until someone noticed the new folder and clicked on it.
 

While it is probably wise to lock down certain bits of the user interface, it does drive anyone who can use computers mad - and must generate more work for the helpdesk as we can no longer fix simple things ourselves.
For example, despite running a home network, at work I am not allowed to change my desktop wallpaper. The other day, I accidentally managed to set a photo I was viewing as my desktop image and now I can’t remove it. Luckily, it was a picture of my wife!
 

I spent most of my primary care trust’s last professional executive committee meeting trying to get one of my colleague’s laptops to access the wireless network in PCT headquarters, so he could check his email.

Whenever we have guests at our building, we end up having to unplug cables from the back of computers in the conference room so they can access the internet for their presentations. Until wireless 3G cards become commonplace, it would be nice for the IT department to remember that while security is important, we need to be able to work as well.
 

Name, rank and number
 

I have also been having a dispute with the NHSmail people over the name field for NHSmail. They seem to insist on names appearing as Surname Forename then some code for where you are. Their documentation suggests you can change this, but the option isn’t active.

Now this drives me mad – everyone calls me by my surname, which I used to hate at school, and hate even more now. Plus, nobody knows who I am or where I work or what my role is.
 

I would like the field name to read Dr Neil Paul GP PEC Member Ashfields PCC, Sandbach in CECPCT. If we followed the Microsoft common user interface convention, it would at least read PAUL, Neil (Dr) GP etc. Nobody seems to have a reason for the way it has been done.

Sadly, we needed to save some money this year so NHSmail migration has been de-prioritised for our health economy – finally, an IT meeting worth turning up to.

Joining the ranks of programmers

Lastly, a shameless plug - I have written an iPhone and iPod touch app called iCalcRisk, which is now available on iTunes for download. It is a graphical cardiac risk calculator based on the JBS BNF rules that you can carry round with you.
Writing and developing my own software has given me some interesting insights into what some of the big companies must go through - and I will revisit this in future columns.