digital radiology works, but is generally a standalone system and poorly integrated.

GP to GP transfers - well that would have happened anyway.

Lorenzo is totally dead in the water. Involved in product testing of modules in last 3/12 - doesn't even get to first base. hopelessly broken.

Yes CERNER Millennium works, but is a maladapted dinosaur, with the same evolutionary potential.

I am a senior doctor in the NHS and am one of many trying to unravel some of this unholy mess to work out which bits are workable.

The obvious stuff - own a basic infrastructure, use open standards, manage contracts tightly and locally, encourage a diverse IT culture within and outside hospitals and use competition to drive down price and drive up performance - this just didn't happen. As the parent says - a centralised system specified by obsessive compulsive people who don't touch patients and with an irresistible urge to gold plate everything.

The NHS doesn't even own the N3 network - it rents it off BT.

We are tied down with a vast number of closed systems that will cause untold unhappiness, waste and frustration in years to come - my hospital is about to go live with CERNER, which has a Windows 3.1/ 'visual basic by a first year programmer' look and feel. It takes >30 seconds to authenticate every time you want to do anything (often)! this alone will steal many hours of medical and nursing time waiting.

They as the parent says, the contracts were poorly specified, carved up by the usual management consultancy clowns and their mates, and then just left to fester.

Unfortunately, the people running the whole thing were not equipped with the mental or managerial experience to make it work. There was one head of IT, Richard Grainger, who might have had a chance at doing it properly from the off, but was brought in too late when the carve up had taken place, and ran away as fast as he could. The rest is history.

What they could have done differently?
1. read ' the mythical man month'
2. pay someone to re-engineer VISTA in c++/ c# / java
3. get some people in who are successful doctors, not just the nearest beardy muppet who doesn't want to touch patients any more.

COI: IAANHSD

IAAMD, also national data representative for medical college.

this is absolutely right
big taxonomies are are designed by people who don't use them. There is a degree of prick measuring - 'my taxonomy is bigger than yours'
Silly to go to ICD10 when that's already out of date and SNOMED is available.

In the long term, complete EPR with native SNOMED coding is the way to go, but in the meantime give me a small taxonomy with minimal inter-coder variation.

you don't want them voting on every crappy decision. there needs to be some personal disincentive to call a vote about stuff that doesn't matter. look at the mature democracies - they don't have crappy electronic votey things.

if there is a vote, they have to get up out of their seats and go somewhere

you could have a lobby that they have to go through a yes or no channel with a barcoded badge but better (and more geeky)- how about if they have an RFID badge each and then go and stand at the YES or NO end of the debating chamber ( where a sensor picks them up)

This is a pretty vacuous vox pop study that doesn't really tell me anything I didn't know.

The problem with this approach goes back to BF Skinner and his teaching machines in the 1950s. Essentially it is that all the interaction has to be scripted, and if you think about even the large free roaming games like GTA, all the key interactions are pre-determined.
The problem with humans is that they do not act in linear predictable ways, and that is what makes them so interesting, and challenging. A VR environment can not yet portray the level of detail necessary for complex human-human interaction to be realistic.

The problem with medical students is that progressive generations of well meaning medical education 'innovation' mean that they spend less and less time interacting with patients. Only this, structured and supervised properly, is good training for what you want them to be able to do at the end - to interact with patients.

I do see a time in the future when some good learning will be possible in a true virtual environment, but for now, like other simulation based training, it is limited to the relatively few situations when the situation portrayed is adequately realistic and the stuff being taught is simple e.g. Pavlov's dog stimulus-response stuff - things like resuscitation. It is not appropriate for teaching, even less for testing, complex human-human interaction.

[CoI IAAD, have masters in MedEd, and teach in (allegedly) the top medical school in the UK]

IAAD, but an emergency physician so people generally don't have time to look stuff up. Or if they do, by definition, it's not an emergency. And the waiting room is in a Faraday cage, so their iphones don't work either, a very satisfactory arrangement.

When I talk to my GP (family physician) colleagues about this, they say you have to work with it, and this phenomenon always occurred to a certain extent, it's just that in the old days the nutters had to go to the medical libraries, and so were easier to identify. Nowadays, quite rational people look up their symptoms and get things right, and this is good.

There are real medical problems with the internet and increased accessibility of information, but far more than increasing anxiety, I would say worse problems are:

• Astroturfing by pharmaceutical companies - pressure groups, patient groups with suspiciously slick websites
• quack cures
• aggressive libel laws stifling scientific debate which in the old days would have been shielded from lawyers.
• looneys can find each other and associate more easily, and act aggressively to those who do not share their very strange view of the world - e.g. 'Myalgic Encephalitis sufferers' (an alleged condition that is neither myalgic or encephalitis and it is everyone else who does the suffering).
  
  Patients usually give you a clue that they are a looney though, which is very helpful. Favoured tell-tale signs are wearing tinted glasses, a soft neck collar or making notes in purple ink or with RANDOM capitalised words, or using one of those obesity scooter things. But if they seem relatively normal, I listen carefully and explain, because quite often they are right.
  
  BTW, I presume you were referring to this? Although some other conditions can do this as well.

As a doctor, I suggest that your navicular bone is more likely to be found in your foot than your wrist. I'd stick to cars!

the problem is that we then end up with a monoculture, whereby the only IT people hired are Microtards, because they are the cheapest and sheepest.

Now we have a hospital that is riddled with malware because the Microtards don't know what they are doing.
i.e. we spend loads of cash encrypting everybody's hard disk, and then install conficker etc. on all the workstations.

And this is not a small hospital - it is a world famous name that this is happening in.

I think the OP is in NZ as they have district health boards there.

the reason to harvest cord blood rather than anything else is because it is free, easy to collect, and has more than average stem cells.

if in the future one of these people needs a bone marrow transplant, they have a perfect match. Research causes are also in there, but I very much doubt the legal/forensic side of things was considered in all this, and usually medical databases are quite thoroughly tied down in this respect.

When Google released Buzz, it was a reminder that if they wanted to break gmail pretty badly, they'd be able to, and we'd have no recourse. With software on your own computer, you can at least refrain from running the upgrade.

It's worth mentioning, however, that Google unfucked the situation in less than 48 hours. Complete with deployment to everyone's Gmail account.

When Microsoft fucks you, you stay fucked until it's more profitable to pull out.

Yes, but this time they have CONCLUSIONS! Which is more newsworthy than an unbiased study by honest researchers who caution people not to overreact to their results. It is always this way, which is why even after that study linking vaccines to autism has been completely demolished, a depressing amount of people still run around thinking that autism is caused by vaccines. That study was poorly done, and the results were announced to the world as final proof rather than something that would merit at most one or two repeats of the experiments before it was taken seriously.

If you want to get a lot of attention and don't care that all of the serious professionals in your field will immediately see that you are a quack and will eventually prove you wrong, then make a quick study and shout your results as the word of God for all the public to hear.

""We can now say with utmost confidence that regardless of research method -- that is experimental, correlational, or longitudinal -- and regardless of the cultures tested in this study [East and West], you get the same effects,"

Yes, you can say that, Mr. Anderson. You should also point out IN THAT SAME FUCKING BREATH that regardless of research method, YOU COULD STILL EASILY BE WRONG. As you're promoting this as infallible truth, based on research you didn't even do, I'd say that increases the chances that you're wrong, because you're a complete moron.

I'm actually a bit surprised he actually says policy needs to be changed, rather than "Elect me to be supreme overlord and I'll have this whole violence thing sorted out in a month." I mean, if you're going to boldly overstate your results, then by God, overstate your results, don't pansy out at the end and suggest someone else be empowered to deal with it.

I think the respondent's point is that many error messages are nonsensical and thus hard to remember. Often, I read an error message only to forget it 5 seconds after I've clicked Ok. Sure, a puppy dog or a baby would help with this (personally I like the colour and number system). What would also help is if the error was informative (and not written in binary).

Great advice, but for my family's safety, I'd want a professional survey and a report with a PE signature on it, not an amateur survey.