If patients carried around their own health 'smartcards', to plug in at the GP's surgery, the hospital or the pharmacy, the NHS spine will be even stronger, says Maldwyn Palmer.
The implementation of providing timely information throughout the NHS will be the true test of its new infrastructure.
Holding data is not enough as the particulars must be disseminated at a rate that is useful to the end users. Holding details on a patient is not acceptable on its own if the clinician has to wait ages for the transaction to appear.
Replication by using local clusters will help but they have to synchronise with the central core, and this is another overhead on resources. The main stumbling block will, most probably, be the networking system rather than the servers.
The use of personal smartcards would alleviate a large amount of the load providing instant information for urgent cases. What about the person knocked down in the street and cannot give their name or any details? Carrying a card would enable the clinician to read all necessary details instantly that could increase the patient’s chance of survival.
Any form of identification has political and legal drawbacks, but perhaps it is time to accept that this is the way of the real world. Some might argue that it is an ID card by the back door, but saving lives must be given precedence. The method of accessing these cards would have to be carefully considered as clinicians must be able to read them as well as the owner.
Of course, not everybody would carry a card through choice or whatever and a backup system would be called into action. The recall would be slower if central data has to be called into play, but still faster as the infrastructure would have less traffic.
Cards could be updated by different means but even batch processing could be used at the core to update non-urgent things such as addresses. One of the main dangers of the new initiative is to see enormous amounts of transactions needlessly bouncing around in cables and slowing down the whole reporting system.
The cards would also enable doctors to have an instant view of their patient’s records. The patient may have to type in a password to allow the doctor access, and even the most ardent freedom lover would not mind taking their card with them to see their local physician. The ease of use would be most apparent at this level as the GP would, inevitably, be at the end of a very long IT supply chain. Cards could also be updated at your local health centre, the internet or even your local library. Put your card in the reader/writer, type in your password and away you go.
Maybe this idea has already been mulled over, although I have not seen any discussions about it so far. If it has been mentioned but dropped as unworkable, perhaps it is time for a rethink as the advantages could be considerable.
The idea that everything has to be centrally managed will be a stumbling block in any new design and is not the way of the future. There are mentions of grassroots supply and design, but they do not appear to have any autonomy and are reliant on the local service providers' acceptance and future good will.
If innovation is to be a building block of the new improved NHS, then open minds must be inherent in that credo. There are a lot of clever people out there with good ideas and they are not limited to large corporations or governmental think tanks. If this is for the people, then listen to them.
What's your view?
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Maldwyn Palmer was one of the first people to use the C programming language in the UK. He wrote the original mobile phone texting software for Orange and ran his own consultancy during the dotcom boom. He now writes technical articles and humorous books.