From black bag to black box: will computers improve the NHS?

BMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7043.1371 (Published 01 June 1996) Cite this as: BMJ 1996;312:1371
  1. Liam J Donaldson
  1. Professor of applied epidemiology Department of Epidemiology and Public Health, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH

    Evidence must shape implementation

    As information technology advances, the drumbeat of punditry is swelled by visions of social upheaval, personal enrichment and fulfilment, and even a new world order. The word most often used to describe this prospect is revolution. If our lives are to be transformed and our world remodelled, will our health services too be revolutionised by computers? Some would say they are already poised on the brink of fundamental change. Telemedicine and the Internet have already created a “virtual hospital” in Iowa and a “cyberspace hospital” in Singapore, and the time is said to be coming when it will be as easy to consult a physician across the Atlantic as across the corridor.1

    Faced with such captivating images of the future of medical practice, it may seem churlish to stop and ask for evidence of the benefit of computers to health care. In this issue of the BMJ (p 1407), Lock highlights the irony of the NHS, constantly exhorted to strive for greater evidence based cost effectiveness, spending £220 million a year on information …

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