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United Kingdom Medicine

'Operating in the Stone Age': NHS Staff's Daily Struggle With Outdated Tech 113

The Financial Times: In the paediatric centre at one of London's largest hospitals, doctors are confounded each day by a ward computer that is not connected to a printer. The computer is used for managing the daily list of patients. Doctors can only access and update the list, using one shared account. So twice a day, two doctors on the ward said one of them had to log in to this computer, update the patient list, send the list to themselves via NHS email, and then log in to another nearby computer to print it off for the team. "I am at a top London hospital and yet at times I feel as though we are operating in the Stone Age," said one paediatrician on the ward.

Tackling the frustrating delays caused by outdated technology [Editor's note: non-paywalled link] is one of health secretary Wes Streeting and Prime Minister Sir Keir Starmer's core missions, having vowed to shift the service "from an analogue to a digital NHS." The monumental task of moving the world's largest publicly funded health service into the digital age is not lost on doctors working on the frontline of the NHS. While many sectors of the economy have been "radically reshaped" by technology in recent years, a landmark report into the state of the health service in England last month concluded that the NHS stood "in the foothills of digital transformation."

But doctors and nurses point out that the basic infrastructure needs to be brought up to a minimum standard, given significant regional variations between hospitals, before politicians extol the virtues of cutting-edge tech. "Some of us just want the printers to work," noted one NHS hospital doctor. "The complete flip-a-coin nature of how equipped your hospital is is mind-boggling," they added. "I have worked in hospitals that are at least 12 years behind others." A report published in 2022 by the British Medical Association, the UK's main doctors' union, estimated that doctors in England lost 13.5mn working hours a year as a consequence of "inadequate IT systems and equipment." One reason for the outdated infrastructure is that the country has spent almost $48bn less than its peers -- such as Germany, France, Australia -- on health assets since the 2010s, according to a government-commissioned study by Lord Ara Darzi last month.
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'Operating in the Stone Age': NHS Staff's Daily Struggle With Outdated Tech

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  • This is no accident (Score:1, Interesting)

    by Anonymous Coward

    It is intentional sabotage to manipulate public opinion towards privatization and the culling of old people.

  • by Snotnose ( 212196 ) on Tuesday October 22, 2024 @12:40PM (#64884531)
    Computers are infrastructure. If you don't have a line item in your budget to repair/upgrade them then you are failing as a manager. And I'm including printers, networking, etc etc etc in the umbrella of "computers".

    I remember at Qualcomm, every 2-3 years some guy would come by with a cart and say "go away for a couple hours". I'd come back and the only difference is my computer would be faster. The engineer's computers went to marketing, marketing's to the secretary, and the secretary's ran automated tests or somesuch.
    • by rsilvergun ( 571051 ) on Tuesday October 22, 2024 @01:23PM (#64884655)
      But here in the United States we literally have routine bridge collapses. We have bridges held together by the civil engineering equivalent of Scotch tape and Elmer's glue.

      Tax cuts make great campaign issues especially when you need to get money from the upper caste for your campaign and you can promise them big fat cuts.

      But fixing infrastructure is incredibly dull. Nobody wants to hear it let alone pay for it.

      If you want stuff like that you need a better educated class of citizen with more critical thinking skills and more media literacy.

      The only problem with that is, number one the people who don't want to pay for your infrastructure namely the 1% don't want citizens who can do that stuff and number two Little Johnny is going to come home with all those critical thinking and media literacy skills and point them at his parents sacred cows. Then his parents are going to freak out and start banning books like they always do and like they're doing right now here in America
      • by courteaudotbiz ( 1191083 ) on Tuesday October 22, 2024 @01:31PM (#64884717) Homepage
        Not sure about UK or USA, but here in Quebec (Canada), the healthcare system still relies on Fax machines for communications between different departments or hospitals. Same thing with the passport office in Canada, when they require a document, you have to send it by Fax machine, even if you have the document in your hands and are standing right in front of the person requesting it at the passport office.

        Another thing, the healthcare system in Quebec still requires having embossed cards for health insurance AND for the hospital card. You could be dying in the emergency room, if you don't have your hospital card, they'll let you die until they had time to print your embossed card. There is even a hospital that almost stopped working because their embossing printer stopped working.

        Outdated systems is not a conspiracy. It's because it's so complex to publish RFPs and deliver projects that most administrations will let existing systems go to collapse before they're replaced or upgraded urgently and with steep budget busts.
        • In Canada it is not only the fact that people keep voting for tax decreases but also conservative governments want privatization so they undermine the public system. Let's face it, even if taxes stay the same, they are less after inflation.
          • No they are not, taxes are anpercentage so evennif they stay at the same rate they go up and down with the consumer index automatically.
            $1 product 15% tax, I pay 15 cents in taxes
            product goes up to $2, I mow pay 30 cents in taxes
          • Still true in the US. for several reasons.

            First, it is an infrastructure technology that, for medial practices and hospitals, proved to be very useful and workable, starting in the 1980's. By the 1990's, every doctor office had fax, and it facilitated the workflow of exchanging info between office, hospital, insurance, vendors, labs, other offices, etc. It is so convenient to run an office with fax (as I have done since the 1980's), that why throw away what works really well?

            Second, although email and ot

          • Not one government in Canada has ever cut health spending. Occasionally someone tries to hold increases to near the inflation rate, which people then scream about as being a cut.

            • I'll just cut to the chase and say the problem is the wealth gap. As the wealthy hold onto more, inflation slowly squeezes salaries down as people don't get raises and most companies only pay what the other one is paying in many industries. This means fewer and fewer people can afford taxes. Now getting back to the point, either taxes (and budgets) need to go up during this time or people need to make more so that they both pay more income tax and buy more. People are squeezed from both sides, so they c
        • Also because of the fact that hospitals have these damned annoying things called patients that keep taking up everyone's time and leave little to no time or budget for dealing with IT issues. Like schools, they tend to have the worst IT imaginable because any resources they have get used for more important things.

          And before someone leaps in to say "well they just need to fix it then", would you want to go into a situation where you have to sort out a duct-taped lashup of crap going back 20-30 years, mostl

        • by mjwx ( 966435 )

          Not sure about UK or USA, but here in Quebec (Canada), the healthcare system still relies on Fax machines for communications between different departments or hospitals. Same thing with the passport office in Canada, when they require a document, you have to send it by Fax machine, even if you have the document in your hands and are standing right in front of the person requesting it at the passport office.

          Another thing, the healthcare system in Quebec still requires having embossed cards for health insurance AND for the hospital card. You could be dying in the emergency room, if you don't have your hospital card, they'll let you die until they had time to print your embossed card. There is even a hospital that almost stopped working because their embossing printer stopped working.

          Outdated systems is not a conspiracy. It's because it's so complex to publish RFPs and deliver projects that most administrations will let existing systems go to collapse before they're replaced or upgraded urgently and with steep budget busts.

          In Australia they used to use fax machines as it was simple and secure, met all the regulations for handling sensitive patient data and then some. It was considered more secure than the post. Of course they still had things like email for things that weren't that sensitive or post for things that weren't text. It took ages to get a replacement system not because they didn't exist but because the fax was good enough. I believe it was the NBN (National Broadband Network) and the demise of copper land lines th

      • If you want stuff like that you need a better educated class of citizen with more critical thinking skills and more media literacy.

        But to get those better educated citizens you need to spend lots of money on educational infratructure... and you need a better educated class of teacher...

        "Recursive": see "recursive".

        • from leaded gas age out of voting. But yeah, that's why progress is so slow. It's still there, but it's *slow*, and if you fuck up and put the wrong guy in office you can regress, sometimes hundreds of years.
          • from leaded gas age out of voting. But yeah, that's why progress is so slow. It's still there, but it's *slow*, and if you fuck up and put the wrong guy in office you can regress, sometimes hundreds of years.

            Nice try, but you'll have to wait longer.
            The lead-soaked slow ones are being replaced by people who use (non-iodised) pink himalayan salt.

      • 'But here in the United States we literally have routine bridge collapses. We have bridges held together by the civil engineering equivalent of Scotch tape and Elmer's glue. '

        In the UK they are crumbling as well, and hundreds of school have concrete floors that had their end of life in the last millennium, ditto for hospitals, several cannot treat fat people on the upper floors, too dangerous, the building might collapse, the heavy diagnostic machines were moved to the ground floor years ago for exactly the

      • When you have an attitude toward teaching math and engineering like we do , this is to be expected. But of course, it's because we don't hire based on competency, especially in the public sector.
    • Computers are infrastructure. If you don't have a line item in your budget to repair/upgrade them then you are failing as a manager.

      Sensible. But that's not possible in the NHS; everything is done on a vast scale and from a great height, mostly be people who have never practiced medicine or even met a patient.

      At my local NHS surgery I was deterred from sending email when a doctor told me that all incoming email is automatically sent on to a central hub from where it is supposed to be sent back - in due course. But in practice it doesn't work, so staff warn patients not to email them.

      It's most unlikely that anyone in a given NHS building

      • by AmiMoJo ( 196126 )

        On the other hand, some NHS local authorities have found that adding the dreaded administrator role has reduced waiting list times and improved efficiency.

        The main reason why the NHS is struggling is the same as it always is - Tory under-funding. 14 years of austerity takes a huge toll.

  • epic healthcare can install an system with an lot overhead cost!

  • After brexit a few hundreds millions will flow through NHS every week!
    • Re: (Score:1, Troll)

      by rsilvergun ( 571051 )
      You know I really don't get what's preventing the UK from rejoining the EU besides pig-headedness.

      As far as I can tell the UK is still bringing in just as many if not more immigrants so you didn't get any of that.

      And the shape of your bananas didn't change. I guess you got a different colored passport there is that.

      As near as I can tell brexit happened because nobody thought it was going to happen and a shit ton of dipshits did protest votes.

      As an American facing down somebody who has liter
      • You know I really don't get what's preventing the UK from rejoining the EU besides pig-headedness.

        As a British citizen, I can tell you: we are saddled with one ghastly bureaucracy run by moronic self-seeking ideologues - we don't need another one layered on top of it.

        No matter how bad things are, more government always makes them worse. As that great American Will Rogers said, "Be thankful we're not getting all the government we're paying for".

        If you Americans think the EU is so great, why don't you join it? Whenever I hear Japanese business leaders saying they wouldn't invest in the UK unless we were "

      • You know I really don't get what's preventing the UK from rejoining

        Well, you see

        the EU besides pig-headedness.

        Oh.

        As far as I can tell the UK is still bringing in just as many if not more immigrants so you didn't get any of that.

        Oddly enough it's harder to deal with such a problem if you aren't cooperating with your neighbours.

        And the shape of your bananas didn't change. I guess you got a different colored passport there is that.

        Funny thing about that. There is a grain of truth in the claim, but a half tru

      • You know I really don't get what's preventing the UK from rejoining the EU besides pig-headedness.

        A desire for independence?

      • Re: (Score:1, Informative)

        by Ryanrule ( 1657199 )

        UK wont get back in on the sweet deal they had before. And EU isnt interested in letting in them in if they just haul off and leave again when the tories or reform get power.

  • a couple hundred billion pounds.

  • by VeryFluffyBunny ( 5037285 ) on Tuesday October 22, 2024 @12:48PM (#64884551)
    ...with the NHS. The problem is 40+ years of chronic under-funding, mismanagement by non-medical executives, & various attempts at stealth privatisation by both parties whenever they were in power. It's time for all parties to understand that Brits love their NHS & want it restored to it's former glory; it used to be the envy of the world & a model for many other universal healthcare systems.
    • by Bongo ( 13261 )

      ...with the NHS. The problem is 40+ years of chronic under-funding, mismanagement by non-medical executives, & various attempts at stealth privatisation by both parties whenever they were in power. It's time for all parties to understand that Brits love their NHS & want it restored to it's former glory; it used to be the envy of the world & a model for many other universal healthcare systems.

      This.

    • Good luck. Over the next 30 years the ratio of retirees to workers in in the UK will increase by 50%.

      https://cdn.statcdn.com/Infogr... [statcdn.com]

      • Re: (Score:3, Insightful)

        So making the system less efficient & more dysfunctional is a way to address that?
      • Good luck. Over the next 30 years the ratio of retirees to workers in in the UK will increase by 50%.

        Funny how even well-informed lay people know such facts, yet governments never see them coming a month in advance.

    • by serviscope_minor ( 664417 ) on Tuesday October 22, 2024 @02:01PM (#64884923) Journal

      It's time for all parties to understand that Brits love their NHS & want it restored to it's former glory

      I think the Tories understand, they just don't give a shit what the public want. If they can win after their media buddies stoke fear of immigrants they will sell off whatever shit they can to their cronies. One fundamental tenet of conservatism is pointing and howling at the other side about something bad that the conservatives are doing. Take Thatchers: "the problem with socialism is eventually you run out of other people's money". Classic conservatism: sell off shit cheap to their cronies then hand over the resulting car crash to Labour to fix, who of course won't be that popular because the economy will keep tanking for a while, then rely on the rigged election system to get back in.

    • Almost like one of the negatives of socialized medicine is that it's subject to the whims and vicissitudes of politics and political funding?

      There's no shortage of medical clinics in the US.

      • No shortage of clinics in the US?? Maybe in Los Angeles or Miami but how about Spearfish South Dakota? or in rural Louisiana? This is a growing problem in the USA, so maybe this comment is incorrect? https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2766043.

        • Read the report.
          "...disadvantaged neighborhoods never having or losing health care facilities between 2000 and 2014..."
          NEIGHBORHOODS or small rural communities.

          You're right, they are generally losing clinics & such, but this is a matter of convenience.

          Not everyone needs a clinic 5 mins from their door. Yes, it sucks if they have to drive an hour for a clinic, but this is simply a reality: not every corner in every neighborhood can have a $100 million regional health center with the advanced diagnostics

      • Medical bills is the leading cause of bankruptcy in the USA. The USA spends more per capita & gets poorer results than any other OECD country. Universal healthcare is a no-brainer & that's why most developed countries have it.
        • First, let's be clear that US healthcare isn't a "free market" - it is the most heavily-regulated, heavily-govenment-involved segment of our economy.

          As for the quality of the care itself, we are world class. If you've got no issues with money and you get sick somewhere else in the world, the USA's your destination. No rich guy gets cancer and starts looking for flights to Havana.

          Further, it's also important to remember that part of the reason for high costs to Americans is the cost controls of other countri

          • I call bullshit on the social contract & that the USA is somehow subsidising pharma in the rest of the world.

            When 'Muricans get sick, they head to Mexico. When rich Americans want special treatment, they head for Switzerland.
            • Facts is facts, sorry: https://aspe.hhs.gov/reports/c... [hhs.gov]
              "ASPE contracted with RAND Health Care to carry out three studies analyzing data on U.S. prescription drug prices and availability in comparison to drug prices and availability in other Organisation for Economic Co-operation and Development (OECD) countries. In 2022, U.S. prices across all drugs (brands and generics) were nearly 2.78 times as high as prices in the comparison countries. U.S. prices for brand drugs were at least 3.22 times as high as pr

              • I didn't dispute
                that medical care & insurance in the USA are expensive. I disputed why they're expensive. The fact is that without a government to look out for their best interests & beholden to the private healthcare industry, US patients get taken to the cleaners.

                Simply put; universal healthcare works far better for the vast majority of patients than privatised, individual services & the scandalously frequent denial of services.
    • I worked for a company that ran IT for two London hospitals. I have been a patient and have witnessed a doctor writing a letter to another doctor for a referral for a good 15 minutes. There are MASSIVE inefficiencies associated to letting each and every hospital in the UK to run their own IT. They should all rely on a single system and benefit from economies of scale, like many other countries do. I am sure the problems you mention exist; nevertheless is not enough to put more money and better professionals
      • I agree that the IT systems that UK hospitals procure seem to be over-priced dysfunctional money-pits provided by "friends" of the people who make the final decisions, i.e. basically crony capitalism.

        & yes, establishing standardised open data models that all hospitals can adopt & built their IT systems around does make a lot more sense. Many years ago, I knew a developer who was doing just that. He & his team were doing it for one region & collaborating with other teams in other regions f
    • It's time for all parties to understand that Brits love their NHS & want it restored to it's former glory; it used to be the envy of the world & a model for many other universal healthcare systems.

      The problem is that medicine is a lot more expensive (and higher quality) than it was in 1970. MRI machines, leg replacements, artificial skin, etc, all this stuff costs money. Open heart surgery wasn't a thing a few decades ago.

      • The NHS was established in 1948, not 1970. A large percentage of commonly prescribed medicines now cost next to nothing because their patents have run out & the NHS can bulk buy generic drugs. The NHS is also in a powerful position to negotiate lower costs for drugs that are still under patent. The NHS also does its own studies on the efficacy of new drugs to see if they're any better than what's currently available. Often, they're more expensive with little or no real improvement in healthcare outcomes
        • Medicine has gotten significantly more expensive than in 1948, because treatments are better.
          • ...or you could say that profits for pharma companies have got substantially higher since 1948.
            • Yeah, but those go out of patent after 20 years. New medicines are part of the higher cost, but that's not all. Paying a surgeon for open heart surgery is expensive, and that didn't happen very often in 1948.
              • ...the most expensive thing in any hospital is the expertise, i.e. the teams of doctors, nurses, & medical administrators who keep wards running smoothly. The NHS pays liveable wages to doctors & not anything extravagant. Some senior doctors do moonlight in private medicine & make large sums of money from doing so, but that's a different kind of scandal from the routinely over-priced doctors & surgeons typically found at US hospitals.

                Again, profiteering in one form or another.

                • Yeah. But in 1950 cancer meant hospice. Now it means a bunch of treatments that will make you better. But it takes a lot of work.
                  • Just follow the money & you'll see a tiny minority of obscenely rich people complaining about taxes, why they have to pay people "living wages," & all this "regulation" that's preventing them from making even higher profits. It's the same in privatised healthcare & health insurance as it is in any other sector that's subject to the ravages of the so called, "free market."
    • by BigZee ( 769371 )
      Sorry, that's not true. The last Labour government improved the NHS considerably. It's more accurate to say that the tories have never liked the NHS and have done their best to undermine it.
      • The Blair administration continued the stealth privatisation ideologies & programmes initiated by the Thatcher & then Major administrations, e.g. PPP financing was introduced under the Blair administration.
  • The last big cpu upgrade for many organizations was from xp to 10, now early Windows 10 machines are not eligible for upgrading to 11 which means that yet another waste of money and hardware to upgrade must be performed.
  • REAL stone-age typewriter about 44 seconds into video [facebook.com].

  • "the world's largest publicly funded health service"

    Is this even remotely true? England isn't even the world's largest speaker of english, their population is a meager 58 million, they're a tiny, tiny island that's economically propped up by london's finance center, which has been significantly impacted by brexit (most everyone picked up and left for frankfurt germany within 3 years, covid helped a lot too with remote work). Without London england's income per capita would rank dead even with missis

    • NHS is astoundingly big. It has 1,499,368 personnel. Wikipedia claims this makes it the second largest non-military public organization in the world, but while it cites an official NHS document for the personnel figure, it does not appear to cite anything for the second-largest claim, nor does it state what the biggest is.

      • by Hadlock ( 143607 )

        Healthcare is often the 2nd or 3rd largest employer in any district, along with primary schools. But england is a tiny tiny island country, they don't even crack the top 20 for population. Presumably any larger country with socialized healthcare will have a larger organization, or, a number of smaller regional orgs that together far eclipse the NHS (and likely share a centralized system as well). Vietnam is 100 million people (so, 72% larger) and probably has a much larger nationalized healthcare system, fo

      • But while it cites an official NHS document for the personnel figure, it does not appear to cite anything for the second-largest claim, nor does it state what the biggest is.

        Look up the Indian railways and Postal companies.

    • Try again troll, the fastest search shows the UK runs the 'British Commonwealth' (King Charles is the head of the commonwealth):

      "As of 2024, there are 15 Commonwealth realms: Antigua and Barbuda, Australia, The Bahamas, Belize, Canada, Grenada, Jamaica, New Zealand, Papua New Guinea, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Solomon Islands, Tuvalu, and the United Kingdom."

      that's 2.7 billion people or 1/3 of the worlds population.

      • Which country of that group is weighing in at 2.5 billion, population-wise??
        • by rossdee ( 243626 )

          What is India, Pakistan and Sri Lanka, Ken?

        • That was a list of the 15 "commonwealth realms". That means (nominal) kingdoms. The commonwealth also contains 36 republics, including India and Pakistan.
      • even if every one of those tiny islands (most of which you can walk across in a day) had a population larger than england, you'd have trouble cracking 900 million people. did you forget India left the failing british empire almost a century ago?

        Australia is physically large but i think they only recently cracked 7 million population, and new zealand famously has more sheep than people it's not especially crowded

        once londons financial industry fully collapses mid century (i don't know any mil

    • Re: (Score:2, Interesting)

      by Archtech ( 159117 )

      You shouldn't confound the UK with England. The population of the UK is officially approaching 70 million, but there are so many uncounted illegal immigrants that it could be as much as 10% higher than that. It's the world's 21st most populous nation, but obviously it's not the largest English-speaking nation: that would be India, the largest nation of all.

      I have no idea why you think the UK is "dependent on the USA", except that you Yanks seem psychologically dependent on feeling that someone, somewhere ne

      • by Hadlock ( 143607 )

        Go tell your PMs to stop crowing about "special relationship" with the US every time they need something, then
         
        https://en.wikipedia.org/wiki/Special_Relationship
         
        I didn't make it up, you did. Or rather, Winston Churchill did.

        • Go tell your PMs to stop crowing about "special relationship" with the US every time they need something, then.

          He's not "my" PM. We don't have a democracy here. Do you stand behind everything "your" President says?

          I didn't make it up, you did. Or rather, Winston Churchill did.

          Make up your mind! Churchill was half American - his English father was literally mad.

      • well we know the US is dependant on the RAF to do all that pinpoint low bombing in all the wars you start.
    • If any comparable organization is counted by region/city, then yes. But that is just splitting hairs.
      Its also a matter on if you are just counting the doctors and technicians, nurses, low level healthcar staff, and the janitors.

  • by PPH ( 736903 )

    a ward computer that is not connected to a printer.

    There may be a reason for that. It apparently has patient information on it. In a shitty DBMS (no concurrent user support). Or worse yet, a spreadsheet. So tracking who printed a hard copy of sensitive information could be a problem. So, send it out by e-mail and now you know who received copies (and can be fired for improper use).

  • Umm. So. Ok. Why are they making hardcopies of daily routine tasks? They need more wastepaper to line the parrot cage?

    Can't they just use a fax machine, or have the schedule handcrafted with gold inlay by the local monks?

    Are they out of Hollerith cards and paper tape? HAVE THEY EVEN CONSIDERED 8" FLOPPY DISKS?

    • According to doctors, the interfaces on the systems used in hospitals are really really terrible to the extent that it's actually a vast time saver to use paper.

      HAVE THEY EVEN CONSIDERED 8" FLOPPY DISKS?

      It's going to be delivered some time in the near future, but the testing budget was cut so unfortunately there's a few years delay. Until then please just keep everything in core and use the bootloader that's written up next to the machine if the power cuts and it needs to be restarted.

      • it's actually a vast time saver to use paper.

        It's a vast time saver... until, for example, there's a recall on an implantable medical device and someone needs to comb through a mountain of paper to figure out which patients need to be brought back in.

        There's certainly room for improvement in some of the more archaic bits of software I've seen used in hospitals, but you could have the slickest, most UX-friendly system the world has ever seen and you'd still have a subset of doctors clamoring for scribbling on paper - or, better yet, talking into a di

  • in one place is so they can flog it off to whomever will pay for it,
  • If they cannot operate Stone Age tech, they're not going to be capable of using modern tech. Largely because in either case they just do not know what they are doing.
  • And you get what you pay for.
  • Stormshadows (Score:2, Informative)

    UK gov is too busy trying to blow up Moscow, imprisoning people for telling cops to do their job*, and import the third world onto the Dole to spend money on clinical information systems.

    Guy Fawkes had some ideas.

    * he just died in prison this weekend

  • They didn't have internet or social media.

    However, have you use medical services lately?
    Nobody knows anything, you're just shuffled around to make work for the other specialists.
    In Canada everyone's hands are tied and captive of the hospital enterprise software.
    The software calls the shots, nobody does anything other than look at screens puzzling over which field to fill in.
    They are USELESS.

    if the system is down due to cryptojacking or whatever, you'll die on the operating table, because no one has autonomy
  • I was unfortunate enough to have to spend a significant amount of time in a hospital in New Jersey USA recently. I wasn't the patient, but someone close to me was. I was quite impressed with the technology in use. Many of the computers were on carts so that they could be moved around easily. Codes on drugs were scanned before they were administered to maintain a complete record matched with a patient. All lab tests were done this way also. During rounds the team of doctors would use one or several of the co
  • then log in to another nearby computer to print it off for the team.

    Why exactly does this need to be printed? Why can't it be used on the computer, or on a tablet etc? Printing just wastes paper and creates duplicate copies of the list which is ok if the list remains static but a huge pain if anything needs to be updated.

  • ...they didn't use Boris' 350 millions per week from the Brexit bus for the NHS to buy new computers?

  • Look at what happened at the Post Office when they got shiny new computer systems.....

  • by Budenny ( 888916 ) on Tuesday October 22, 2024 @04:48PM (#64885617)

    This is the short version of the explanation.

    There are two functions, actual heath care, and health care insurancew. Either can be state provided or private sector provided.

    History and statistics show that the configuration which works the best for a country is government insurance and private sector provision. This is the European and Australian model.

    The reason is government insurance covers everyone and eliminates competition between insurers to avoid bad risks, which costs a fortune. The government is the low cost producer.

    The reason why private provision works best is provider competition and lower overheads and local decision making. Ask yourself why the hospital in the story just clean up its IT systems. Not that hard, surely? The reason is, its all centrally managed.

    There are two systems which work relatively badly. State insurance combined with state provision. This is the NHS model, and it has far worse outcomes than the European model of state insurance and private provision. Higher avoidable death rates, and ridiculous waits for treatment. The UK waiting list is now north of 8 million people, out of a total population of about 70 million. You can wait two years for a hip operation. Its free, but its rationed. The UK system throws the financial risk of too many of the wrong sort of cases onto the patient, in the form of denial of treatment via waiting lists. The Euiropean model, the financial risk is taken by the government, which is the way insurance should work.

    The US model fails differently by comparison to the European system - high costs and limited coverage. Though maybe Obamacare and Medicaid have been moving to the European model.

    The fourth case in the two by two matrix is private insurance and state provision. I don't think anyone has ever tried that. It would be the worst of all worlds. Though the UK is arguably inching in that direction, as people unable to find treatment from the NHS that they have paid for in taxation, are increasingly turning to private provision at their own additional expense. And some of this treatment will happen in the same hospitals which put them on the waiting list in the first place. Because what is happening in the UK, in response to the failures of the NHS, is both people buying private treatment because the free tax funded treatment is rationed, and also the NHS facilities are taking privately funded patients.

    Are the NHS problems the result of underfunding? No. /the UK is spending as much as European countries, its just delivering worse outcomes. And this is primarily because of organization and method and being a monolithic government organization with huge management overheads. Its another failing nationalized industry, it doesn't matter how much money you throw at it, it will still define its aim as rationing nor providing, and the system will still doe worse than the European model while costing more. What needs doing is change the model.

    All this goes back to the foundation of the NHS. The original welfare system proposals were worked out by the Liberals, Beveridge in particular. But the postwar Labour government was in love with nationalization, so it insisted that the health service be a nationalized industry. This was the great mistake. The British then were sold the fantasy that their system was the envy of the world. They never asked why, in that case, no-one was running to copy it. Asking that was a real faux pas. And so you had that grotesquely embarrassing opening ceremony at the London Olympics. They have been sold a fantasy, and the consequences are becoming more apparent every day.

    Before you react with fury to this, as some Brits will, stop and answer some questions. If the NHS is such a great system and the envy of the world:

    -- Why is no-one copying it?
    -- Why does it have such worse outcomes than Europe at the same or greater expense?
    -- Why does it have an 8 million waiting list?
    -- Why does no other developed country have a similar waiting list?

    And don't get me started on 'chest feeding' and 'birthing parent' and other similar insanities that it spends its time and money on, instead of treatments. Or the regular periodic scandals.

    • by Xarius ( 691264 )

      The United States has the worst healthcare system out of the 10 wealthiest western developed countries. ranked 10th out of 10 in health outcomes and overall [commonwealthfund.org]. It is a laughing stock and a terrible tragedy for so many of the people who live there.

      Every single other democratic country is baffled at how awful the USA's system is. If it was so good, why has no-one copied it? Most democratic countries use a predominantly social system with some elements of paid-for or limited insurance options. In fact, that's wh

      • by Budenny ( 888916 )

        The classic British delusion or bad faith argument. Arguing that there are two choices, the US model and the UK model, and the UK model is better than the UK model.

        It may be, but it is far, far worse than the European and Australian model. There are three models not two, its not a binary choice, its a two by two matrix.

        How to explain this to people who don't want to know? Its like you are going from A to B. Your friend says, driving is better than going on a motorbike. As if those were the only two cho

    • History and statistics show that the configuration which works the best for a country is government insurance and private sector provision. This is the European and Australian model.

      Actually, almost nobody even tries to do "private sector provision" because it doesn't work. A combination of private and public sector provision is the normal model.

      The problem with leaving provision to the private sector (alone) is that companies will compete for the very profitable bits and will not bother with the marginal b

  • I call a bit of bullshit on this.

    PAS systems are centralised and do not use shared accounts for auditing purposes as you need to know who accessed it and who updated it.

    I think it is just one doctor who was pissed that computer could not print which is more an issue with configuration/setup than lack of resources.

    Printer management and consumables are an absolutely huge cost so in most hospitals there is an active plan to reduce their use which is often met with resistance as many in healthcare are absolute

    • PAS systems are centralised and do not use shared accounts for auditing purposes as you need to know who accessed it and who updated it.

      I have no doubt the use of shared accounts is against trust policy. I also have no doubt that many such policies do not survive contact with end users.

  • Why printers at all? Information can be exchanged in a bit more efficient way than a hodgepodge of book with random cut papers and a gluepen.
  • Moving standards are the biggest problem, not being technically obsolete. For one, the industry needs to settle on a GUI Browser standard. It would be designed from the ground up for stateful biz & admin GUI's with the common GUI idioms that HTML either lacks or does wrong. The vast majority of GUI actions shouldn't need JavaScript or equivalent because they are ubiquitous in GUI World.

    If we had done this in the mid 90's when GUI's generally reached maturity, we wouldn't have to be dealing with it now.

  • (or trepanning) That was literally "operating in the Stone Age."

It is better to travel hopefully than to fly Continental.

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