Posts by crackerbread

NHS patient letters meant for GPs went undelivered for years

OK, say you want to get rid of paper.

While there's a common language to send data between NHS entities, HL7, the systems these feed into are so very different. A lot don't accept external data via HL7, or rather, very few segments.

You may argue that these systems shouldn't be bought if they don't... you would end up with no electronic patient record if that were the case. Prove me wrong, name a single EPR provider that has full event driven HL7 export and import. Too hard? How about one that even openly advertises full HL7 export and import.

That's all at the back of queue behind a consultant having one less click to prescribe, despite that same consultant complaining that they can't see a patients updated demographics in a third party RIS.

NHS delivers swift kick to Microsoft's wallet over fee demands

License Management is relatively easy; run a piece of asset management software that can interrogate licenses against a license pool. That allows you to claw licenses back from machines not using it over a period of time or any other metric.

Again, Citrix can come in handy; say you have 5 licenses for visio, 10 people who have a usage requirement. Install on Citrix farm and restrict to 5 concurrent sessions, push out enterprise receiver to deliver the icon to those 10 users.

Good points on both sides.

Getting technology into the hands of the clinician and subsequently getting them to use it is hard enough with systems they know; the vast majority know Windows, a minority know Mac, very few know Linux. it's all very well and good saying "use FOSS" (horrible acronym) but the training costs would be phenomenal; IT training departments would have to be expanded/inflated with contractors.

Some systems are so widely used that you can't do it in a phased approach. Using a previous example, how do you integrate your [big corporate brand] PACS (digital xray) system and you new "free" PACS systems with bi-directional messaging so that windows users see what the Linux users see? You simply *cannot* have clinicians looking at the same diagnostic image/information and seeing 2 completely different versions of the information because it syncs over night.

A consultant struggling to use, for the sake of argument, Linux based IT systems would waste more cash in a single day than the cost of a single windows license+CALs. I say waste because they will give up, refuse to use it and potentially cancel their clinic.

The majority of NHS England applications (SPINE) require IE to work. Granted, you could use something like Citrix to deliver an IE environment to the user on a Linux desktop but there again, you need a CAL and a Citrix license per user (recurring cost), potentially platinum level if you want to used advanced features; this is all costly. The same could be said of any application that "requires windows" so you get better ROI but you need separate server pools for your applications which have different requirements.

Fact is, no single organisation can pay a development company to create all the applications it needs to run on Linux (again, for the sake of argument). NHS England/Government could as a whole potentially. Please tell me of an EPR Supplier that is "FOSS" compliant? I know of 1 EPR supplier who is potentially making their code base open source, but it runs on windows with SQL server.

I think at the end of the day, the costs are roughly the same.