Information society : agenda for action in the UK : evidence received after 31 March 1996 / Select Committee on Science and Technology.
- Great Britain. Parliament. House of Lords. Science and Technology Committee.
- Date:
- 1996
Licence: Open Government Licence
Credit: Information society : agenda for action in the UK : evidence received after 31 March 1996 / Select Committee on Science and Technology. Source: Wellcome Collection.
13/324 page 315
![‘ Dr A W Macara, Dr SIMON JENKINS, ; 16 April 1996] Dr Couin SMITH AND Dr Ross ANDERSON [Continued BMA activity is concerned with medical informatics and information systems generally. In addition we can claim to be leading the medical world in developing electronic information and _ library services as a benefit of membership. We are convinced that development of the information superhighway will play a crucial role in changing medical education and medical practice for the better. We represent, of course, every part, every strand, of our profession and we are anxious to do everything we can to ensure that the benefits of information technology are realised through effective education, research and development, that they are used by all doctors, not just the technical enthusiastic few but by all doctors to benefit our patients and that they are not discredited in the minds either of doctors or patients because of unnecessary and preventible breaches of our traditional ethics of confidentiality and our traditional and professional values. 408. Thank you very much. I wonder could you give us some indication of the ways in which you are laying out a £1 million a year to help your members? (Dr Macara) Of course, we do have a number of activities which we are undertaking in the profession, and I think it would be more helpful to you if we expatiate on those because the £1 million that we are spending within the British Medical Association is primarily to make sure that we are networked, that we are linked up not just within BMA House nationally but in our 17 regional offices from which we provide services to members. Of course, there is a library, an information side, which we will speak about when we have the opportunity in detail perhaps a little later on. It might be helpful if Dr Jenkins and then Dr Smith can tell you something of what we are doing widely within the profession to encourage use. (Dr Jenkins) Thank you. I think first of all perhaps I could say that from the general practitioner’s point of view the actual take-up of computers by GPs in the United Kingdom is really a remarkable success story. Over 90 per cent of GPs now have computers in their surgeries and well over half of those actually have them and use them in the consulting rooms. It is probably the largest single group of clinicians anywhere in the world who have actually found a real and practical benefit for patient care in the daily use of computers and information technology in the context of the consulting room. The actual reasons why this has actually occurred over the last 15 years have been many but the driving force behind these reasons has been the perceived benefits for patient care, for individual patients, by their general practitioners. The computerised patient record, of course, brings many benefits. It enables the GP to identify which patients would benefit from follow- up. It helps with prescribing. It helps you to monitor the prescribing of individuals on complex prescribing regimes. It also helps to increase the rate of generic prescribing and thereby reduce the actual cost of prescribing. In fact, if one looks at the implementation of the immunisation and cervical smear programmes of the Department of Health, these have been carried out by GPs and it has been really because they have had computer systems in their practices that they have been able to get such very high uptakes. One of the actual impediments to progress at the moment is the need to legitimise the computerised medical record because at the moment it is part of the terms of service of GPs that they must make records on paper. If that can be removed from the terms of service, and we hope that shortly it will be, then GPs will be able to concentrate and improve the computerised medical record. Once that computerised medical record is improved they can then start looking towards using their computers more for communication. It is quite remarkable with an enormous take up of computers by GPs the actual need to communicate outside the practices has not really taken off. I believe that the main reason for that is primarily because that is being administratively rather than clinically driven. The success in general practice of computing has been because it has had a clinical basis for its activity. 409. Thank you. (Dr Smith) My Lord Chairman, if I could just expand on that in two directions. Firstly you asked a question about what is the BMA doing? If I as a user could say one of the prime functions that the BMA has provided me with is access to library information and it is in the development of that area that I think the BMA is a key proponent of the use of network systems. Further, it is the repository for clinical audit nationally and it is the use of similar systems that is part of the key to the development of the hospital and general practice services. Within the hospital system we are perhaps a little bit behind general practice but there are many changes taking place, probably led through the academic world but hospitals are showing the way forward I think in using network systems for both education and patient care. If I could give you two examples. The first is that already there is both nationally and _ internationally availability on the network of educational programmes which are at a relatively simple level at the present time but are rapidly being developed. My colleagues in Southampton are developing such educational programmes. But there is a much more exciting development and that is telemedicine. That is the care of patients at a distance by consultation in the presence of the general practitioner with a consultant at a distant site, as is happening at Arrowe Park, or—more challenging—of doing surgery or highly skilled investigation at a distance. One example of that is the academic department at Manchester Royal Infirmary is already in a position to train surgeons using virtual reality at a distance, with feel. Similarly there are other examples of distance investigation. The Japanese have developed a system already where down the network I—as a gastroenterologist—could investigate somebody’s bowel using a joystick on my computer desk. That is but one simple example of patient care at a distance. The downside at the moment is that part of medicine which is—how can J put it—the personal bit. Whilst you do get with video telematics the conversation, the dialogue, you do not have that personal contact or feel and that is the downside. Nonetheless there are dramatic changes taking place which we wish to encourage in the use of distance medicine and distance learning. Perhaps we might return to that at a later stage. (Dr Macara) | think Ross Anderson may want to add a perception from the non medical side. (Dr Anderson) Well, there are actually a number of separate things happening when we talk about the](https://iiif.wellcomecollection.org/image/b32218631_0013.jp2/full/800%2C/0/default.jpg)
