The Fox Report
Barry Fox’s technology column
Online health – the good, the bad and the ugly
T
he Covid Crisis has taught
us valuable lessons on the use
of IT in health care – but will
they be learned?
Public Health England (PHE) is the
back-office bureaucracy which manages
our wonderful frontline NHS staff. The
hugely expensive and much criticised
Test and Trace scheme is run for PHE
by a gaggle of highly paid private
companies and consultants.
The phenomenally successful and
world-envied Covid vaccination
scheme is run by a lean, mean warmachine taskforce under chief scientific adviser Patrick Vallance and
venture capitalist Kate Bingham. It
bypasses PHE by reporting direct to
government and televising regular
evidence-based briefings.
The bigger healthcare IT picture
Compare this to the way IT has previously been deployed in the broader
health service.
Medical reports carefully created
by one compartment of the NHS are
often not accessible by other compartments. This is usually blamed on
legacy issues, with older and newer,
and geographically spaced systems
using different data formats. Different
GP surgeries use different IT systems
which do not talk to each other or
hospital systems. The same IT disease
afflicts the private sector.
When I recently went for an eye test
at a large chain, the obviously frustrated optician could not access my
previous records because the company
had recently changed its IT system to
accommodate the purchase of a rival.
Lack of standards
When GP Surgeries started to ‘computerise’ 25 years ago they had to choose
between rival proprietary systems because (probably fortunately) there was
no NHS edict on what system to use. As
one GP said to me at the time, ‘I won’t
know what I need from a system until
I have bought it, and it’s too late’.
Getting patient data out of systems
that later fell by the wayside (like my GP
friend’s unfortunate choice) and into the
de facto standard EMIS (originally Egton
Medical Information Systems) came
with no guarantee of 100% integrity.
Diligent GPs had to check each record,
old versus new, by hand, for accuracy.
Managers at GP Surgeries often come
from an analogue age and are all at sea
with IT. My local surgery encourages
patients to save doctors’ time by checking their own blood pressure and heart
rate on an electronic ‘pod’ in the waiting
room. In theory, readings from the pod
feed directly into the surgery’s EMIS
system via a touch screen Windows
computer. But for years the computer
was frequently displaying an error
message or not even switched on. The
manager blamed patients. The computer
is now permanently dead and surgery
staff risk cross-infection by handling
paper which the pod prints out for
patients to hand to a receptionist.
Patient access
GP surgeries encourage patients to use
two different online access systems,
eConsult and Patient Access. It took
me a while to unravel how they differ
and what they offer.
eConsult is run by private company
eConsult Health Limited and aims to let
‘NHS-based GP practices offer online
consultations to their patients, ’ see:
https://econsult.net/
Patient Access is run by EMIS and
promises ‘no more hanging on the
telephone… book appointments, order
repeat prescriptions and view your
medical records when it’s convenient
for you.’ Essentially, PA hooks patients
into their EMIS surgery records, see:
www.patientaccess.com/
Although I have successfully used
Patient Access to request repeat prescriptions, all requests to book an
appointment or send a message to
the surgery generate the auto-respond
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Practical Electronics | June | 2021
messages ‘Sorry, your practice does
not currently have any appointment
slots that can be booked online’ and
‘Sorry, your practice does not offer
this service.’
Registration trauma
To register with the eConsult service
patients must of course prove identity.
This involves scanning or photographing a driving licence or passport, and
then uploading it to the eConsult site.
My first attempt, scanning a driving
licence at 300 dpi, was rejected as
having inadequate resolution.
My second attempt, after re-scanning
at 600 dpi, was successful and triggered
an on-screen request to record a video
into a black frame space shown on the
PC screen, and use a microphone to
speak (or write) a four-digit number
shown alongside the frame. Initially
this failed, apparently because my PC
was blocking camera and microphone
access to whatever requests the online
registration process was making.
After much trial and error, and changing security settings on my PC, the
camera and microphone let me record
the video. But I now have a nagging
suspicion that I may have opened
security doors on my PC that were
previously, and for good reason, shut.
Telephone access?
For those who are not sufficiently
skilled, or not well enough, to jump
through computer hoops in search of
medical help, there is of course the
good old-fashioned phone. In theory...
Surgeries are now installing automated
switchboards. Mine plays an excruciatingly long recorded message about Covid
and then automatically hangs up with a
recorded promise to call back the calling
number. It is hard to see how this can
work if the patient has blocked Caller
ID for reasons of privacy, or is calling
on someone else’s phone or a payphone.
Compare this with the Covid vaccination system of texting an offer of online
booking and then following through
with a proactive call from a real, live
and helpful human being.
The moral for anybody, or any body,
wanting real-world people to use an IT
system is simple; before going live with
the system, sit and watch a real-world
person, in this case someone old, ill
and not a computer buff, cope with
whatever instructions they are given.
Or more likely, not cope.
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tekkiepix pic of the month
Alan Blumlein (pronounced ‘Bloomline’),
a key figure in the invention of
audiovisual technology and radar.
S
tereo, the almost magical
method of creating a wide spread
of sound from just a pair of loudspeakers, was invented by a Brit – Alan
Blumlein (1903 – 1942), who worked
for UK company EMI. He was also a
key figure in the invention of television,
radar and movie stereo.
Blumlein’s life story is the stuff
that Hollywood films are made of.
Practical Electronics | June | 2021
An absent-minded genius who died
young doing secret war work, he was
an electronics wizard who couldn’t
read properly until he was 12. But for
many years only a few engineers knew
about him – largely from the 128 patents
he filed, one for every six weeks of his
short working life.
By far the most important of Blumlein’s 128 patents was the one describing his stereo technique (number 394
325). The same patent tells how to
record two channels of sound in the
single groove of a gramophone record
– or a single optical soundtrack down
the side of a reel of cinema film. That
patent has become a ‘bible’ for audio
engineers. (See Blumlein’s test film
here: https://bit.ly/3dODEik).
His work in the 1930s on television
was shelved at the outbreak of war; and
he died in a plane crash in 1942 while
testing top secret World War II radar,
which had spun off from his work on
television. There is good reason to believe that the British government had
encouraged the TV research because
it tacitly stimulated development of a
key component for radar – the cathode
ray tube screen.
Lower-right, Blumlein’s radar – pilots had
nothing but praise for the equipment.
One estimate is that Blumlein’s radar
reduced U-boat losses in the North Atlantic from 50,000 tonnes a month in
March 1943 to less than 4,000 tonnes
just three months later.
More fascinating details and images at:
https://tekkiepix.com/alan-blumlein
Practical Electronics is delighted to be
able to help promote Barry Fox’s project
to preserve the visual history of preInternet electronics.
Visit www.tekkiepix.com for fascinating
stories and a chance to support this
unique online collection.
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