Our new GP columnist calls for IT consultancy and not just quick fixes for practices

In the first of a new series of columns, Cheshire GP Dr Neil Paul outlines the results of a survey that he recently conducted about IT concerns among local practices.

He argues the results suggest his area’s new IT team needs to raise its eyes above day to day niggles and provide a consultancy service: one that will help users find IT solutions and get the most out of them.


Earlier in the year, I decided to undertake an email survey of the practices in our new primary care trust. My old PCT had merged with one of its neighbours and we had quite different IT histories.

My old PCT was almost exclusively using EMIS as its main clinical software supplier, while there was much more of a mix in the PCT we joined.

I had chaired a primary care IT committee, but recently all IT in Cheshire has been taken over by one service. I wasn’t happy, as no one seemed to be asking primary care users what they wanted.

I got a great response to the survey. By its nature, it was always going to uncover a lot of complaints, but I was quite surprised by the number. I think it is worth relaying some of the key points; you might want to reflect whether your IT is better or worse. "Many worried that there was an agenda to centralise and that this was causing delays in the replacement programme."

Servers and desktops

Servers and desktops were big issues. Quite a few respondents felt their server was slow or old. Many worried that there was an agenda to centralise and that this was causing delays in the replacement programme.

I think it would be helpful to be open and transparent and let people know where they are in relation to their peers - who may well be even worse off. Good communication is key and needs to be improved.

Desktops were also a real worry. Many respondents felt their machines were in need of updating and that everything crashed a lot. In some surgeries, desktops have been locked down to prevent tweaking and the installation of new software - but this just infuriates some experienced users.

There was a lot of concern around what the minimum specification for a PC should be. Power users were unhappy that they were running up to ten programs on the same spec machine as a receptionist just looking at appointments.

Seeing the wood for the trees

A large number of respondents felt that the IT people couldn’t see the wood for the trees. They complained that problems were being dealt with on a one by one basis, while trends and underlying problems were not being spotted or resolved. “Several practices wanted the IT department to do more than just implement national programmes and fix minor software problems. They felt they should be receiving a full IT consultancy service.”

People also felt there was a lack of knowledge about what was available and what could help practices work smarter and more efficiently. A simple example is that several practices asked how they could print patient labels, when several cheap solutions already exist. I worry that practices without a partner interested in IT are getting left behind.

Train smarter

Most respondents wanted more training. Even in my own practice, I can find people who didn’t know they could tackle a certain task on the computer, or who have been doing something in a long winded way because nobody showed them a short cut.

I wonder if, as businesses, we shouldn’t be investing in our own IT more and relying less on the PCT - but I realise this is controversial.

On this theme, several practices also wanted to learn from others about best practice. It was evident that a lot of wheel reinvention goes on. Lots of practices were asking the same questions and spending time finding out the answers and this seems inefficient to me.

For example, everyone wanted remote access and solutions for home visits. Numerous exist - but which is best or cheapest? Several practices - including mine - had also invested in electronic workflow solutions and wanted to know why the local acute trust couldn’t deliver information electronically, when other nearby trusts could.

Consultants not menders

One way and another, several practices wanted the IT department to do more than just implement national programmes and fix minor software problems. They felt - rightly or wrongly - that they should be receiving a full IT consultancy service.

By this, I mean that they felt they should have their usage of IT analysed, problems identified and solutions offered. Our new Cheshire IT service was copied into the results and says it will address these issues.

This isn’t meant to be a criticism of them – after all, they’ve only just launched. It’s more a guide to the things they need to address – and that other IT services may well need to think about. It will be interesting to see what things are like in a year and I am interested to hear what IT support is like in your area; is it proactive and consultancy-like - or non-existent?

About the author

Dr Neil Paul is a full time GP working at the Ashfields primary care centre in Sandbach. He has just been appointed to the PCT’s professional executive committee and has a lead role for IM&T and Payment by Results.
He says: “My first computer was a BBC B and I have used Ms-Dos and Windows in most varieties, although I have yet to use Vista properly as it isn’t being rolled out by our PCT.

“I took an A-level in computing in my spare time while in sixth form and helped to fund my way through medical school by working as a junior IT support person. So I can sometimes see both sides of the fence.”

The practice uses EMIS LV, Docman for letters and Frontdesk for appointments. It is on a PCT network and shares a VoIP phone system with the PCT, local acute trust and other practices. It also has “all the usual IT-related kit” including ECG machines, Spirometers and a website.

Dr Paul’s main machine at home is an Apple iMac. “I am writing this on Microsoft’s Office for Mac, which is great value from the Microsoft Home User Programme,” he says. “Microsoft has just announced that a new version will be released in January 2008, and I am really looking forward to trying it out.”