Dr Neil Paul

Has general practice IT got any better in the last 20 years?

· Originally posted on LinkedIn, Nov 2022

I was reflecting on the IT system my surgery had 22 years ago when I joined. We had our own server and back up server in the surgery - they never went down - a couple of ISDN links that gave us good connectity - we had a DOS based EPR that did pretty much everything the current system does with some advantages - it was fast and reliable… we had templates - and searches - and remote access. The only major change I can really see is E-prescribing - getting rid of the paper and being able to send scripts direct to a chemist is a real change - though the current interface could do with an upgrade.

What else? e-referrals - not convinced its really added anything? Advice and Guidance - I used to know all the local consultants and could ring any of them at lunchtime for advice - current system seems worse.. document management - well.. I used to have a pile of paper letters to go through every day - now I have a pile of on screen letters to read - and sometimes id argue the onscreen are slower to read and annotate..

Perhaps I’m having a downer - but what real leaps forward in IT do you think we have had? other industries have had real disruptive innovation… has primary care? don’t say SMS… while its been a huge change - really SMS.. is the major innovation? Video… no ones doing it? remote GPs - its not working… big data - extracting data still seems to not work properly.. no one has really made the most of smartphone/pad working - people have laptops with VPNs that just give them the same desktop client… banks / shops are really innovating with apps. User interface - well its WIMP and GUI but is it really any better? AI… not really happening.. working at scale… clunky and expensive and not really there yet..

Your thoughts welcome!

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