Re: Database design.

["Michael Simpson" <mikie.simpson () gmail com>]

On 6/8/06, Dude VanWinkle <dudevanwinkle () gmail com> wrote:
> On 6/7/06, Drsolly <drsollyp () drsolly com> wrote:
> > I've had a few xrays in my lifetime, and quite a lot of dental xrays,
> and
> > I still think that my text records would go on 20 kb. 60 million people
> > then means 1.2 terabytes..
>
>
> I found out that the 1gb is an actual amount, but that they include
> everything: notes, ideas, advice to other doctors.
>
> Also, most of the notes are gif'ed and pdf'ed. Apparently OCR'ing an
> american doctor's handwriting isnt possible even with todays most
> advanced technology :-)
>
> -JP
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Sorry about the late entry to this thread.

I'm having a slow day in the addictions field so going back through mail,
you'll know how it is.

Let me tell you about some situations that i have been party to in my years
in the good ole NHS.

Me and a fellow A&E (ER) doctor (in the days when i was an A&E doc before
escaping into the community to work with our drink and drug addicted
brethren) had a great idea about using high quality video conferencing to
allow the virtual presence of a consultant during resuscitations which
happened at times when only junior docs were manning the shop floor
(5pm-9am/weekends).

Off we toddled to the scottish telemedicine action forum (part of the
scottish executive) with our idea.

They loved it but unfortunately had already spent their £5million for that
funding cycle.

Their top spending project consisted of this:
1 broadband link from aberdeen royal infirmary to 1 consultant's home
1 webcam in 1 room of the emergency department
the quality was described as barely adequate to allow a nurse assistance
from the consultant in treating minor injuries when the department was full.

cost of project = £1.1million (in 2003)

We costed it out with gold plated uber-boxen, top spec cameras, hot and cold
running russian whores, &c and couldn't get to >£100,000.

Next

Scotland is about to spend £40million on an app for emergency department
administration.
One thing that this app does is force the doctor to specify a diagnosis for
the patient on discharge from the department.

When we asked if it could include all the ICD (International Classification
of Diseases) codes (12000 in total) rather than the paltry subset that it
contained we were told that it couldn't happen because it would "slow the
database down too much".

Next

Where i work at present we have a suite of apps from a company who won't be
named by me. They have 2 data entry/storage apps that do similar but
slightly different things. Both use oracle as their backend. The company
can't get data from one app to propagate into the other because both apps
were developed by different teams within the company and it turns out that
even though we are their only source of income, the contract we have with
them doesn't allow us to tell them what they have to do re functionality. So
the workers just have to enter the same dataset into each app (using 2
windows and the joy of copy'n'paste). The contract is worth millions

The whole thing is fubar

So the current costs of the NPfIT in England doesn't surprise me as i have
yet to meet anyone within NHS IT that is capable of finding their bottom
with both hands, let alone have any IT skillz/kloo.

and don't get me started about the managment.

-hint for you
200,000 beds with 275,000 managers yet nurses, cleaners and technicians are
the first to get fired.

In order to cut costs in the NHS i propose a nationwide game of musical beds
all hospitals will be linked by speakers to a room with me and a gramophone
with a copy of "how much is that doggie in the window" on vinyl.

When the music starts each manager has to go and find a bed to stand next
to, when it stops any manager without a bed next to them is fired.

-sort out the slightly more hungry chaff from the chaff.

I blame thatcher with her "NHS to be like M&S" idea.

/rant

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