Views & Reviews Personal View

To boldly go from “computer says no” to an iNHS

BMJ 2013; 346 doi: (Published 24 June 2013) Cite this as: BMJ 2013;346:f4028
  1. Terence Stephenson, professor and chair, Academy of Medical Royal Colleges, London EC1V 0DB, UK
  1. t.stephenson{at}

It’s IT, Jim, but not as we know it, says Terence Stephenson, with some suggestions for improvements

Captain’s log. Stardate May 2013

  • 0830-0930: Consultant led handover as per Francis.1 The cases are projected by the trainee, Dr McCoy, on to the screen of the NHS Enterprise. Mr Chekov says, “Let’s just take a quick look at the chest x ray.” Bones has to come out of the current program, decline several on-screen queries, open a new program, and re-enter his username and password—only to be told that the x ray software won’t open unless he begins again and closes the word processing program. Three minutes have elapsed, and we have 60 minutes to discuss 20 cases. We give up, noting the excellent radiologist’s report but missing a valuable teaching opportunity. Thank goodness we didn’t have to access anything as complicated as the tricorder or switch the phasers to stun.

  • 0930: Consultant led ward round2 starts on ward A. The first patient has sickle cell disease and a fever and has been seen by another NHS hospital more than a year ago.

  • 0945: The general practitioner and St Elsewhere’s Hospital are telephoned for past medical records, …

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