| Hubris | Satisfaction and the dated interface - a problem? |
The Exeter GP System was designed at the dawn of time. Its philosophical and political antecedents are impeccable, its users are conspicuously satisfied with it's function and development, but it's interface while entirely functional has now been rendered very non-standard - by IBM and Microsoft. (2001: and also by the march of X11 and Linux GUIs)
2001: eVolve is the project by which the Exeter System is leap-frogging in the way predicted, and sensibly making use of the Open Source and Free (libre) software Apache on Linux to deliver an interface which can be integrated with other information sources and delivered over any browser.
EMIS is a more recent system, the company although not owned by the users does appear to show a degree of responsiveness which may actually be beyond the capacity of a company with more pure commercial aims, it's users are predominantly satisfied with most of the tools provided, but its interface while entirely functional has now been rendered decidededly non-standard - by IBM and Microsoft.
Does this matter?
I think it does.
Neither system has captured the entire UK NHS GP market, and even if they had there should be severe doubts whether the GP community is sufficiently large, united, and influential enough to withstand the pressure from the rest of the world's software suppliers to expect a common user architecture (CUA) design of interface.
The coming integration in one form or another of secondary sector and other organisation's information services with those of primary care compounds the problem - administrators of such systems face the task of training all users in the interface of each system involved - a daunting task, or persuading each system to present information in a manipulable lingua franca, and then displaying it in the form they are used to. The latter is a large task and grows exponentially larger as more connections are made. Experience of this is one of Reuters' main stocks in trade, and certainly something with which Torex are acquanted.
2001: Reuters left the market, and Torex failed to fulfill their potential due to the distractions of acquisition.
Meanwhile, the second reason most of business adopted Windows is that it means a secretary trained in Word for Windows (say) by corporation A can be put immediately to work by corporation B using the same software, or even a different word-processor with only occasional confusion.
2001: Microsoft of course messed up hugely, and as a result have incurred criticism they could and should have avoided. Recommending Microsoft or Windows as the standard interface is no longer possible, not least since GNOME and KDE provide similar functions in a similar fashion. All are of course derived from the Xerox PARC work.
One File per Document Again - a Digression
There is something to be said for applying this principle to the file format of the medical record, and certainly it would be in the interests of GPs and probably their patients.
But, back to the interface.
The costs of retraining every entrant to general practice - which will soon include the doctors and nurses as well as the traditional typing trades - away from the interface they are used to and into a maverick system will rise, and represent a drain which is theoretically unneccessary but may be fixed upon us by now.
Both Exeter and EMIS have windows front-ends to their legacy systems, and quite reasonably these look very similar to the old interface, random changes in shortcut commands can irritate users considerably and GPs have never been keen on falling into line with the rest of the world. EMIS' forthcoming NT version which is assumed to migrate away from MUMPS toward SQL is also forecast to show the same interface.
However, can we look forward to seeing a browser front end, running over a TCP network, perhaps even an NHS wide intranet, which displays a picture of the old text-based screen?
It may even be the best way to go, but to the world outside general practice in the UK it is going to look increasingly dated, insular and odd.
Looks best with whatever browser you prefer, as should all Web pages. I like Opera browser
Service problems -SWIS | Remarks on content or suggestions Version date: February 2001
Original: 5 August 1998top of page | AKM Homepage |