From the consulting room on keeping up with home users
Once, business was in the driving seat of IT innovation. Now, home users are leading the way. And the NHS is struggling to keep up, says GP Neil Paul.
During a presentation at a recent local heath community IT meeting, I had a revelatory moment when somebody argued that IT used to be driven by business, rather than home users, but this was no longer the case. In fact, the opposite is true.
Business was definitely the driver once. I remember playing with an old PDP-10 that a firm donated to my school; and my school winning its first IBM PC in a business game that we entered.
Disk drives, hard disks and scanners all started out on business computers and then came over to the home market. Now the home market seems to be where innovation happens, driven by digital photography, videos and gaming.
BBQ and chips
At a barbecue with some GP friends I realised just how far ahead the home market now is. We were discussing gadgets - at least the men were - and all but one of us had a 1TB USB hard disk at home for backup and file transfer.
“We keep thinking that NHS computing should be better than what we do at home - whereas the truth is that it is struggling to keep up.”
We all had home wireless networks and discussed the joys of streaming music into different rooms. Everybody had a phone with Internet and email access. At work, however, I was the only one with a laptop, a wireless network or anything remotely up-to-date.
My primary care IM&T group has been critical of our local shared ICT service’s ability to get the basics right – but I now start to understand why it is having such a hard time. We are probably expecting too much. We keep thinking that NHS computing should be better than what we do at home - whereas the truth is that it is struggling to keep up.
Bigger, faster, brighter
One example of this is that almost everybody I know complains about how long it takes to get their computer going in the morning. Three of us at the BBQ use Macs at home, and we all leave them on all the time - letting them go into sleep mode and waking them instantly at the touch of a button.
“If we could get start up times to less than five seconds, I reckon the whole NHS workforce would be more positive towards IT.”
I know PCs can do this, but they can’t the way the IT department has set them up at work - and Windows XP hibernation never seems that reliable anyway (we’re prevented from upgrading to Vista to give that a go).
So every morning starts badly with the10-minute wait for our computers to start. If we could get start up times to less than five seconds, I reckon the whole NHS workforce would be more positive towards IT.
Also, at home I have a 24-inch screen, and I change or upgrade my computer every few years to one near the top of the range.
Contrast this with my practice, where my computer is almost five years old and was at the bottom of the range when it came out. I’ve had to pay for more memory from my own pocket to stop it crashing all the time – disabling the smartcard and Choose and Book also helps.
I recently splashed out - again from my own pocket - to buy a 22-inch widescreen monitor and to upgrade to Microsoft Office 2007, which isn’t supported or sanctioned by our IT department. Indeed, if I read it right, it is on the GPSoC (GP Systems of Choice) prohibited list, presumably because it conflicts with the piece of rubbish that is Choose and Book.
However the monitor makes my life so much better and Office 2007 is great. Outlook’s preview pane and tasks work great on a big screen. The reading pane layout in Word finally makes sense when each page is almost life size.
In comparison, my EMIS system is really showing its age. Set at its biggest, it still takes up only a tiny part of the screen, looks ancient and is in desperate need of a revamp.
Level up, not down
As a member of my primary care trust’s Professional Executive Committee, I realise the importance of targeting limited resources at poorly performing areas. But, perhaps naively, I’ve always thought that in doing so, we should be trying to bring all GP practices up to the level of the best.
Unfortunately, these principles haven’t applied in IT. In Central and East Cheshire, it feels like we have old kit and old software because the spec works for most users most of the time – and IT support understands it.
Luckily, we are starting to have a good dialogue with the ICT service, which is showing some willingness to understand that different users have different needs. Some of the IT managers even agree with me that Office 2007 and the IE 7 web browser are better.
We have some way to go before our computers at work are as good as the ones at home. But next month, I will discuss the five priorities we have decided on to start changing that, and how we are making excellent progress in some of them.
About the author: Dr Neil Paul is a full time GP working at the Ashfields primary care centre in Sandbach. He sits on his primary care trust’s professional executive committee and has a lead role for IM&T and Payment by Results.