Growing up in South Africa in the 60s, I heard many people talk of the need for an 'International' qualification. In the restrictive apartheid bound environment in which I lived, everyone was looking for a way out. Medicine was an internationally accepted degree and many waves of South African doctors left to seek a better life during that time and moved to the UK, US, Canada etc. Moving seemed effortless. There were few barriers and the best and brightest left in droves to take up senior positions all over the world.
When I graduated in 1981, the ability to move from one country to another had become increasingly more difficult. Physicians were still in high demand in most developed countries, but licensing and qualifying examinations were the norm and even in Canada, it had become very difficult to move between provinces.
You may ask why I am writing about inter-jurisdictional movement of physicians on CanadianEMR, a blog devoted to Electronic Medical Records? The answer is actually quite simple. Once all of the licensing restrictions, examinations, priveleges and requirements are stripped away, medicine is still an international language. The diffierences between how a physician practices in the UK, Denmark or Canada are so infinitessimally small, that we can use almost exactly the same literature and evidence to support practice decisions. Obviously there are local or national differences and protocols, but the bottom line is that disease is disease in whatever country one practices.
That is why this article from the UK got me thinking. GPs in the trusts have been using computers in their practices for over 20 years. Almost all GPs use computers and electronic medical records and yet they still face exactly the same kind of issues that GPs and private practice specialists face in Canada. Hardware gets old. There is a lack of transparency in decision making. Computers are locked down in private practice clinics. Physicians are not using their computers and EMRs to really drive out value. They still desire training to learn how to use their technology and EMRs more effectively. Sound familiar?
This is the universal language of medicine. The problems may be of a different scale and at a different level of EMR adoption, but they still seem exactly the same.
How can we learn from our UK colleagues in terms of the issues and problems they have faced and continue to face? Is this really a problem or is it just a reality that we must expect and devote our energies to incremental improvement? Read the full article by clicking on the link and share your thoughts with readers of CanadianEMR.
Earlier in the year, I decided to undertake an email survey of the practices in our new primary care trust. My old PCT had merged with one of its neighbours and we had quite different IT histories. My old PCT was almost exclusively using EMIS as its main clinical software supplier, while there was much more of a mix in the PCT we joined. I had chaired a primary care IT committee, but recently all IT in Cheshire has been taken over by one service. I wasn’t happy, as no one seemed to be asking primary care users what they wanted. I got a great response to the survey. By its nature, it was always going to uncover a lot of complaints, but I was quite surprised by the number. I think it is worth relaying some of the key points; you might want to reflect whether your IT is better or worse.
Servers and desktops were big issues. Quite a few respondents felt their server was slow or old. Many worried that there was an agenda to centralise and that this was causing delays in the replacement programme. I think it would be helpful to be open and transparent and let people know where they are in relation to their peers - who may well be even worse off. Good communication is key and needs to be improved. Desktops were also a real worry. Many respondents felt their machines were in need of updating and that everything crashed a lot. In some surgeries, desktops have been locked down to prevent tweaking and the installation of new software - but this just infuriates some experienced users. There was a lot of concern around what the minimum specification for a PC should be. Power users were unhappy that they were running up to ten programs on the same spec machine as a receptionist just looking at appointments. Link: GP columnist calls for IT consultancy and not just quick fixes for practices
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