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Rapid Responses: Rapid Responses published:
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![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Not a Success
- Trefor Roscoe (7 October 2000)
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Don't just connect, motivate
- Mike Laurence (8 November 2000)
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Let's not get confused about security
- Russell Taylor (10 November 2000)
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Trefor Roscoe, GP Fellow - Doctors.net.uk Doctors.net.uk, Abingdon, Oxford
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This paper throws some much needed light on the problems associated with net working within Primary care. The authors have managed to enumerate the percentage of practices in Scotland regularly using NHSnet as well as demonstrating many other important aspects of the creation of the network. They highlight the problems associated with installing a connection without properly networking it within a practice. Knowing that most practices have installed their NHS net computer in a busy area such as the main office or reception explains why they are not being used. It is good to see the training issue also being focused on. Spending 15 minutes on teaching the use of Internet explorer may well have been 15 minutes well spent but it is by no means enough. It is also interesting to note that only a small percentage of the people attending courses on training were clinicians. While applauding the main points of this paper, I must take issue with the first sentence of the discussion which states that "the Scottish Primary Care communications initiative has successful in implementing a national network that links all Scottish general practices as well as most health boards and hospital trusts ". If only just over half of practices are using it weekly or more and if only one in seven GPs has had training in the use of the technology, which by their own admission is difficult to access because of lack of net working and physical placement of the machines, then I would conclude that it was not successful. Daily use by over three quarters would be success. Until we have the desktop to desktop communications that modern health care demands, with properly trained clinicians able to us it, we will have only a partial solution to the information problems that we all face. They do appear to partially agree with this but I felt it needed highlighting. It is absolutely imperative that the lessons to be learnt from this excellent study are applied urgently to NHS net implementation in the rest of the UK. Many practices that have recently been given a connection do not have it on their network and many more are not getting sufficient training. Unless we listen to the main conclusions of this paper large amounts of money will be spent to very little effect. Let's hope that is not the case. |
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Mike Laurence, GP Bacon Road Medical centre, Norwich NR2 3QX
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The NHSnet in Scottish primary care article rang several bells. Our practice [in Norfolk] has been NHS Networked for some months. It was clear from the outset that it had to available on every desk if there was any hope of colleagues actually using it. The main problems so far have been [1] lack of relevant training, especially on use of information sites on NHSnet and the internet [2] clumsy and hypersensitive email. The difficult logging on procedure puts off not only novices but also old internet hands like myself. The email address book is hard to use, and the addresses are completely unmemorable, consisting of long strings of numbers. Apart from the fact that the system is free, we cannot see any advantage over our old internet email system which was slick,reliable, fast and easy to use, with a simple address you could rattle off from memory. The security issue seems a red herring now we have secure internet banking. The main success has been getting the internet on every desk. In house training is now in progress to motivate clinicians to use the very attractive and useful sites such as BMJ, Bandolier, Cochrane and so on. The NHS Net home page looks dull and bureaucratic in contrast, smacking of fat, boring NHS executive documents rather than the potential fun of the internet. Motivation is as important as technology here. The latter should serve the former, not hinder it. Too many computers are expensive desk decorations, and too many clinicians are bored or frightened by them still. Lets not waste millions more on inadequate NHSnet technology but concentrate on getting people to actually use the very good systems that already exist. Competing interests - None |
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Russell Taylor, Information Director Borders Health Board
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As someone involved in the research conducted for the paper I can empathise with the objectives of Dr.Laurence re. the need for a more 'fun- filled' IT experience - and the singular failure of NHS systems to provide this experience but I do take issue with the notion of a secure Internet (especially re. banking). The recent very high profile failures of PowerGen, Halifax and Egg to keep their financial systems secure and the most recent news that Microsoft's own systems have been 'hacked' should demonstrate that security cannot be taken too seriously. This is why Dr. Laurence's colleagues in the BMA are calling for Public Key Cypher(PKC)protection of e-mail. This is unlikely to be taken forward however due to the RIP and Data Protection Acts and the confusion re. the Human Rights Act and its significance in this area. But there is another fundamental about this particular project and that is the need for a greater measure of adaptability amongst the user community. In my area we provide GPs with a 'no direct cost' connection to our local community network, NHSnet and Internet, together with e-mail, both local, NHSnet-wide and Internet (SMTP)mail using common name lookup and search facilities vai a National e-mail directory. We also provide a 'hot 300' list of medical and health related bookmarks for their web browsers - and they still complain! |
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