Is it the IT or is it the People?

Status
Not open for further replies.
falcon123

falcon123

Well-Known Member
Relationship to Diabetes
Type 1
Many of us seem to get issues with repeat prescriptions and/or appointments. Most of these systems are now computerised. However, having worked in the IT arena for over quarter of a century I know that many applications are flawed. This sometimes starts from a vague or unclear requirement and propagates through the whole process. At other times it just seems that the systems cannot handle anything away from the standard. So someone who gets regular repeats for, as an example, BP tablets and pain killers, does not have a problem whereas a diabetic may have over half a dozen items can get issues two times out of three.

The thing that started this train of thought was that I have recently received a letter relating to my annual review. This had a blood test form with the usual tests and a follow up appointment a week later with the DSN and a review of my medication immediately afterwards. Usually I get an appointment for my review fairly early in the day as it is more convenient to be a bit late than leave early and find there are problems with the homeward commute! I decided to ring up to see if I could change the follow up appointments. In the end I did not as it turned out the GP I would be seeing was in fact my own, who is a diabetes specialist and extremely hard to get an appointment with, and not the one stated on the letter (this had puzzled me). There were two other errors in the letter. Firstly the blood test appointment had not been booked (!) ? I was advised to turn up with the letter as it could take weeks to get an early appointment (fasting!) ? and secondly the time of the appointment with the DSN was 15 minutes earlier.

So is it the IT or is it the People?
 
Someones gotta be typing the info into the computer in the first place, as the saying goes a bad workman blames his tools,I think its the people but hay ho thats MY opinion.I guess mistakes can be made on both parts.
 
I agree. My experience is that a computer is only as efficient as the person/people using it and when things go wrong the computer is a convenient scapegoat.

Don't get me wrong, computers are fantastic - look at this forum after all.

I can remember in my business, a time before the advent of computers and i look back on it with happy memories but that's probably just me getting old? Life was so much simpler when you just wrote things down and acted on them as an individual or picked up the phone and discussed a solution.🙂
 
Last edited:
Many years ago when I was learning to usea computer to update my skills the course tutor talked about GIGO which stands for Garbage In Garbage Out. Computers are designed to obey a set of instructions. If the instructions are wrong in the first place it takes ages to find the mistake and correct it. The computer does as it is told.
 
As with everything there's a bot of both, I would agree that these computer systems are very complex and it is hard to code them so every human eventuality is catered for, and how much testing was done before they were roleld out? But I'm probably too forgiving! Well done on getting the special doc for your appointment Michael! I'm seeing chirop the morrow, what joy!
 
The problem is the loose nut on the end of the mouse!!
 
To err is human. To have a real calamity, you need a computer. --> clean version (not as good, in my opinion!).

There are just so many ways a computer system can go wrong ...
1) Its initial design.
2) Its implementation.
3) Its use (lack of training or understanding by the people who use it).

Also, from my many years of being in the IT industry, it became apparent to me that good analyst programmers tended to get promoted into management positions. At a stroke you then loose their capabilities and replace them with trainees. It's no wonder that the resulting systems are then not quite up to scratch.

But, on balance, I think that I'm still in favour of computers! I actually think that they help more than they hinder (and I now work for an agile little IT company rather than a monolith!).
 
There is a system planned for prescriptions which will do away with paper prescriptions, when you see your doctor they will prescribe for you on their computer as they often do now, however, there won't be any paper and you will need to nominate a pharmacy to collect from. At the press of a button the prescription will be sent to the pharmacy and also begin it's potential journey through the accounting systems.

It should also be possible for your GP to repeat up to six or so prescriptions to your pharmacist, different items, ready for you to go in and order/collect. I recall the ultimate model will be on a pick and mix type of model, where one month you might need no needles, the next you need more. So long as you don't exceed the total for the duration of the repeats you're ok.

The issue while removing the risk of prescription fraud from the patient is that the pharmacy could do very nicely by issuing phantom prescriptions, those where the patient doesn't collect them. This was highlighted as a further use of national ID cards...

As for your GP's sending appointments that don't exist or the times were wrong, it depends entirely on how their system works, if it's an operator looking at a diary and typing a letter or a computer automating the process. One is operator error, the other is systems. Both are unacceptable.

Seeing today that there are fears the government might push through the final purchase of the EPR (Electronic Patient Records) in healthcare it is worrying. Especially as all GP surgeries in the UK have been computerised for 5 years or more and still hospitals are paper based, with notes being in the wrong clinic or consultants office, worse still lost.

Not entirely sure on the NHS Information Authorities transformation into Connected for Health. It strikes me for connection each end needs to be connected, not just one end.

Oh well. It's only money... oh, and life!
 
I remember my surgery's first purchase of repeat perscription software - you had to nominate the items you did not want. Talk about confusing! You often ended up with two perscriptions - one printed and a hand written one for the items that were ticked but actually wanted!
 
rossi_mac said:
I'm seeing chirop the morrow, what joy!
Click to expand...


Check your toes before you leave as you cannot go back after! I go Saturday - it is a private practice as I was unimpressed with the NHS treatment and the fact some people seemed to think you could spare half a day at the hospital to trim your toenails!
 
Einstein said:
As for your GP's sending appointments that don't exist or the times were wrong, it depends entirely on how their system works, if it's an operator looking at a diary and typing a letter or a computer automating the process. One is operator error, the other is systems. Both are unacceptable.
Click to expand...


I got home from seeing the DSN and GP yesterday to find a letter saying that my (blood test) results had come through and I should make an appointment to discuss them with my GP. It seems that both apply, mixed in with a little left hand does not know what the right one is doing!
 
Personally i don't trust electronic prescribing systems. We just got a new one, it's not as good as the old one (our receptionists are barely allowed to look at it, they used to be able to add notes and things, which was helpful) and we've had vertually no training on it. well, "here, press this button and put your password in here, then press this". The major failing, as ever, is that the whole system relies on a Doctor hitting a "send" button. Not that i know what the send button looks like, coz information on the program seems to be distributed on a "need to know" basis only. And i don't "need to know" except how to click the "dispensed" button and put in my password.
There's that, the robot that breaks down on a regular basis and a label printing and stock control program that looks like it was wrtitten on a ZX Spectrum (ok, maybe not a Spectrum, maybe an Acorn....). It's all very well giving out (or forcing people to buy) swanky new IT systems but they have to a) work and b) you have to train people how to use them. Things will still go wrong, and we'll all look silly, as several previous posters have pointed out.😛
 
From my experience it is ultimately down to people. Some people just cannot grasp the use of a computer. Some systems are so utterly complicated that you need to spend a lifetime learning how they work so for that I blame to designer. Some people are so concerned about timescales and budgets that software and systems are not tested as well as they should be or even in some cases not finished. This again is down to people. The best computer sysem ever would have no human input! As such it wouldn't be needed. Heh such is life
 
Status
Not open for further replies.
Back
Top