On Monday 12 August 2002 18:03, david derauf wrote: > That there is no evidence YET that would withstand Cochrane type standards > is clearly understandable, BUT we should be looking at developing a body of > such evidence if we beleive strongly in this enterprise. IMO.
The scope is worth thinking about. British General Practice (Family Medicine) has around 30 years of experience in this, an while there are still GPs who choose to write, there are few or none who don't use computer systems for some aspects of activity which it is hard to find serious opposiion to the principles of. The prescribing aspect is generally accepted as a benefit, the advantages in coded summaries widely so, and the benefits of typed notes appreciated by anyone who actually reads notes made by others about their patients. More complex features are around, but less well-accepted, and it is particualrly disappointing how little the knowledge service, context-specific or general, is regarded as a major asset. But the general view of the craft (this specialty in the medical profession - BMA-speak) is not in doubt. As to hospitals - the doctors in them are not in doubt. Those who have seen lab systems etc as nurses also tend to appreciate them. This goes back to 1975 or so... What is less clear is the design of trials that would demonstrate benefits of specific or general systems. I wonder if the area of discourse should be more like the selection of tools for jobs, where the feel of the fit of it is a significant part of the preference? Part of the Royal College of Physcians is presently looking at criteria for the magic systems that will instantly yank the NHS into present time... it would do no harm for them to see some that could keep it going once it gets there. -- From one of the Linux desktops of Dr Adrian Midgley http://www.defoam.net/
