In article ,
Dave Plowman (News) wrote:
In article ,
charles wrote:
But. A close friend has recently had treatment for pancreatic cancer.
He has nothing but praise for the NHS. And he is (or was) in BUPA as
part of his salary package from work. But it was his NHS GP who
diagnosed his rather rare symptoms, not a private one. And all
treatment was NHS.

BUPA doesn't provide GP services.

I'm not in it. He used to go for some form of an annual checkup at other
than his GP. I'll ask next time I see him.

I once had a check from BUPA - as I'd been a member for so long. waste of
time.

As regards the BBC Legionella outbreak, just how long ago was it?

1988

--
from KT24 in Surrey, England

"Nick" wrote in message
...
On 13/03/2016 18:10, Sam Crean wrote:
[snip]

I think you will find Google and Dropbox have huge amounts of data on
people.

But don’t have all that data that the NHS has on people,
or even all the data the schools have on their kids either.


No, they have more data on more people.

And can't even reliably provide the current residential address.
Let alone tell you if that individual has diabetes or not.

NHS patient data probably isn't that large by modern standards.

It doesn't wash to claim it is a huge dataset bigger than the companies I
cite.

Having fun thrashing that straw man ? I never said it was bigger.

Makes a lot more sense to have standard formats right from the start.
Open ended ones like with so many other industry standards.

Yes it makes a lot of sense. Apart from people can't agree them

Plenty of industrys have like with airline booking etc.

and when they do they change soon afterwards.

And work fine for airline bookings anyway.

Modern sensible designs decouple data formats from security, data
retrieval and data storage.

But aren't completely format free as you stupidly
propose the NHS database should be.

We have already heard explanations that agreeing standard formats in large
organizations such as the NHS is very hard work. Insisting on standard
formats means nothing gets delivered. Which is pretty much what the NHS
has achieved.

There are plenty of other operations that have done that fine.

If it were a private company it would have died a long time ago and been
replaced by companies that knew how to achieve.

Even the tax records system works with individuals.

An didn't spend all their time dreaming up excuses that they were too
special to achieve.

This is much better than what you have at present. Blood test guy says
no, I want standard formats from day one.

And that is the only sensible way to do it.

It is the sensible way to achieve nothing.

The airline booking system and the tax system are a lot better than nothing.

Which the NHS have succeeded at.

Nothing like that happens with any of Google. Dropbox, BT,
Facebook, Banks, Supermarkets, Credit Reference Agencies.

Of course it does. Google mines unstructured data. They can't use some
data at all and most they can't use fully. But they provide services
to users who can retrieve their own data instantly and can use it fully.

And that approach just isnt possible with the NHS, because
hardly anyone wants all their most private medical data
available to anyone like google to do anything they like with.

This is absolute nonsense. Security has very little to do with standard
formats for patient records.

Waffle.

And google doesn’t even do the most basic stuff like reliably
tell you where someone is currently living anyway.

What?

Even you should be able to manage such a simple sentence.

Dropbox just stores files. You appear to have got into your head that
data needs to be stored in a specific standard format, like an old style
central database.

That is the best way to handle some data like say your blood test
results. It isnt with the notes that doctors take during a consultation.

But when google can't even tell you reliably where everyone
lives, it's completely silly to claim that the approach they take
would be useful with blood tests or doctor's notes either.

I don't even know what point you are making.

Of course you do.

Patient identity and access via an NHS number is trivial?

Irrelevant to the fact that google can't even reliably
tell you where a particular person lives. So much
for how well they can mine free format data.

When I requested my X-rays I wasn't overly concerned with the format
they were in. They actually came as .dcm files, a format I had never
seen before. So after the 7 weeks I waited for the NHS to provide them
for me I had to add an additional 7 minutes searching the internet for
a program that would interpret .dcm files. What do you think was the
problem the 7 weeks or the 7 minutes?

Sure, but its different with other data like blood tests where you need
to be sure you are comparing apples with apples and not apples with
oranges because the test was done using different protocols etc.

No its not, in order to view an X-Ray you need to know the format it was
stored in. I can't not view a .dcm file as a .jpg.

It is completely trivial to work out what format its in, the
Xray tells you that.

Similarly with blood tests it is important that the format is known. It is
not essential that every blood test uses the same format.

It is however essential that the blood test be done using established
protocols so you can compare the blood test results with those that
were done in other labs, so you can work out whether that particular
individual has diabetes, pancreatitis etc etc etc.

Statistical analysis of the data may require conversion of formats and may
not be able to interpret some formats but as I explained standard formats
can be decided on separately to data storage and access technology. Data
formats can be decoupled so that an inability to decide on standard
formats for all data does not prevent or delay implementation of shared
data and instant access to records.

All completely irrelevant to the point I was making that unless the
blood test protocols are there, the data is not very useful whatever
format the data files use.

Data can be unstructured initially with structure being imposed as and
when it is beneficial to structure it.

Listening to the comments here is like a time warp back to the
eighties.

Your pig ignorance about the difference between what
an operation like the NHS needs to do and what Google.
Dropbox, BT, Facebook, Banks, Supermarkets, Credit
Reference Agencies keep in spades.

I know that the NHS could benefit from instant access to records.

Yes, but the problem is how to do that effectively.

I have explained how the issues are tackled in other industries. The NHS
seems to be 20+ years behind other industries.

Yes, but the answer to that is not to have completely format free data.

I know they don't provide it. I know how it could be achieved.

You don’t actually with your hare brained approach of just dumping
all the data into the system and assuming that whatever has access to
that data can do something useful with it with stuff like blood test
results.

The thing is that it produces usable benefits to real people at relatively
low costs. It can improve incrementally.

No it can not if the data is just dumped into the
database with no format specified at all.

An issue with one aspect of this system does not block implementation of
other aspects.

People who believed they could impose rigid system upon rapidly changing
data formats have had their time and failed spectacularly.

Yet another straw man. No one is taking about a rigid system.

A system that allows flexible formats and decouples security, retrieval
from data structure can use structured data when it is available but is
able to work and provide other benefits when it is not.

No format at all isnt flexible formats.

I know when
developing a project people try to add difficult additional
requirements which can stop projects being delivered at all. Your
requirement for standard formats is, whilst desirable, hugely
complicated to coordinate and it is not necessary in order to develop
a system for instant access to patient records.

Yes, but it is necessary when you want to do something useful with
some of the data like the blood and other test results where you
need a lot more than just a dump of the raw data into a completely
unstructured collection of data that only allows you to specify what
data belongs to what individual.

The NHS has nothing because of this attitude.

Bull****.

The system I suggested is not completely unstructured it does not require
structure.

More waffle.

Structure can be handled separately and on a case by case basis.

No it can not with test results alone.

Small steps that deliver results.

More waffle.

That very crude approach doesn’t even allow google to reliably work
out where you live, let alone whether the med currently being used
to treat your blood pressure are the best available for you.

In standard system delivery they often refer to an 80-20 rule. 80% of
the benefits come from 20% of the work. Essentially you have to say to
customers we can't give you exactly what you want at reasonable cost
but we can give you something very useful.

And you can deliver something much more useful if you don’t just
dump the raw data from blood tests and other tests into a completely
unstructured collection of data.

Clearly the NHS does not accept
this and instead chases pipe dream systems and ends up with nothing.

Plenty of other medical records systems have done a hell of a lot better
than that.

We
foot the bill and end up with rubbish.

Yes, but that isnt the only way to do medical records. Others have done
MUCH better and they haven't done that by just dumping completely
unstructured data into the system and hoping for the best.

Even the hospital paper records systems don’t do it like that.

Yes I'm sure others have done much better. The NHS seems to have a talent
at promoting and protecting incompetence.

In article ,
Nick wrote:
Yes I can imagine. I have spent my entire life listening to people
saying it was cheaper to use human staff and not automate. It was often
hard to see efficiencies as initial IT costs were high. In any company
there always seem to be a lot of people who can tell you how a job could
be done badly.

When I look back to see how the private companies that didn't automate
have done. its simple to see, they no longer exist.

In public services where it is enough to devote resources to telling
everyone what a wonderful job is being done, rather than letting them
pick, we see very low levels of adoption of even simple automation. This
is why the trains and NHS have such poor IT.

Hope you've been following the TFL fiasco reported today. Many millions
already been spent trying to modernise the signalling system on a large
chunk of the older tube system. Now cancelled with huge sums spent to
compensate the contractor. New contract issued which will cost getting on
for a billion *more* than the original estimate. But we weren't told the
total. All under the stringent leadership of Boris. And of course Tories
never waste money.

But it won't stop those on here with the engineering knowledge of a two
year old saying that the tube system could be made driverless for
pennies...

--
*Very funny Scotty, now beam down my clothes.

Dave Plowman London SW
To e-mail, change noise into sound.

"Dave Plowman (News)" wrote in message
...
In article ,
Nick wrote:
Yes I can imagine. I have spent my entire life listening to people
saying it was cheaper to use human staff and not automate. It was often
hard to see efficiencies as initial IT costs were high. In any company
there always seem to be a lot of people who can tell you how a job could
be done badly.

When I look back to see how the private companies that didn't automate
have done. its simple to see, they no longer exist.

In public services where it is enough to devote resources to telling
everyone what a wonderful job is being done, rather than letting them
pick, we see very low levels of adoption of even simple automation. This
is why the trains and NHS have such poor IT.

Hope you've been following the TFL fiasco reported today. Many millions
already been spent trying to modernise the signalling system on a large
chunk of the older tube system. Now cancelled with huge sums spent to
compensate the contractor. New contract issued which will cost getting on
for a billion *more* than the original estimate. But we weren't told the
total. All under the stringent leadership of Boris. And of course Tories
never waste money.

But it won't stop those on here with the engineering knowledge of a two
year old saying that the tube system could be made driverless for
pennies...

No one ever said anything like that, you silly little pathological liar.