Managing your practice IT

Originally published in GP magazine .

Written for GP magazine around 2005. This is the version I submitted - the published article may have been edited.

While PCTs have taken responsibility for your IT, are they really bothered about providing an excellent service for you, or just providing the cheapest equitable service for your area? Your practice is your business and I would suggest you still have an IT strategy in place. Most PCTs also seem mainly concerned with the clinical IT systems, and there are plenty of other things your business may need from an IT point of view.

Asset register. Good idea - however, rather than just keep an eye on equipment, why not track what software is on which machine, which users use it and what patches are installed? Don’t accept anything less than what you expect. Make sure all antivirus software is auto-updating and all machines are patching. Although your connections may be free, if you have lots of machines you can slow them down significantly. There are ways of downloading patches to one machine and distributing them without each machine having to log on. As well as looking at it from the machines’ point of view, look at it from the users’ point of view. What software does each person need access to? Can they access it from everywhere they work? A friend at a nearby practice uses a different room one day a week but can’t access his email from it, which drives him crazy. We identified a need for several key members of staff to have wireless phones and we have a wifi phone which works off the wireless network anywhere in the building and allows them to be contacted.

Standardise on one version of software to ease training. Set up distribution lists, which are a quick way of sending emails to numerous groups of people. Shared folders and intranets facilitate sharing of information. There are numerous ways of standardising log-ons, including roaming profiles and log-on scripts that assign the My Documents folder to a secure hard disk.

Security levels. With some of the clinical software suppliers it is easy to have everyone on far too high a security level, such that they can alter templates by mistake. Have one person responsible for knowing what different individuals should be able to do, adding new staff and so on. Password changes are important, but again set realistic targets - changing every week will drive people mad. A retired partner at a nearby practice let himself in via a code door several years after he left, to bypass the queue in reception!

Similarly, PCTs have a habit of setting everyone to the lowest level possible, such that you can’t access everything. We had a problem in that the default user profile only allowed logging on Monday to Friday, 8-6, and when a partner came in one weekend to work he couldn’t get on. Make sure that people who need access to things can access them. However, some security features are worthwhile - you can set up group policies that restrict adding new programs or deleting things or changing settings.

Track problems with likely fix dates and monitor performance. Set up regular meetings with your IT department to discuss major topics and to review your and their performance against agreed targets.

Don’t get sucked into thinking only about clinical software - there are plenty of other packages that can help you run your business. A lot will have some form of accounting software or payroll, but room booking, rotas, stock control and online banking all exist.

As the relationship with your PCT becomes more dependent, consider setting up a formal SLA rather than just relying on their goodwill. This may need to be negotiated on a patch-wide approach rather than just by individuals, but will help clarify your and their responsibilities. It should cover things like response times to problems and the helpdesk. Don’t be afraid to approach this in a selfish manner - if your business is open till 6.30 and they are supporting the IT, they need to be open as well in some form for emergencies.