A review of the London Hospital computer project

Abstract

The paper reviews the key decisions taken in the implementation of The London Hospital Real-Time Computer Project. The advantages of the use of real-time facilities lie in the rapid availability of information throughout the hospital. It is legible and significantly more complete than the previous manual systems; the legibility of the information makes for more flexibility in the use of clerical staff. The system is somewhat more accurate but transcription and transcription errors have not been eliminated. The system is used significantly out of normal working hours and would be even more useful if it were in operation 24 hours rather than 16 hours per day. The speed of implementation of subsequent applications has suffered from the lack of testing time after the first applications had been implemented and from the diversion of development effort into system support and maintenance. If development is to proceed, a second computer with facilities at least equal to, but preferably considerably greater than, those of the operational machine is required.

The use of tree-branching techniques on visual display units has been found acceptable and usable by the doctors, nurses and ward clerks. Considerable effort was made by the multi-disciplinary computer Executive regarding user consultation, education and support. The system has proved well used, and acceptable. In general, duplicate computer and manual systems have been avoided and the approach across all wards has proved fruitful. The restrictions regarding confidentiality have worked well without the need for codes and the use of the patient administration system as an initial framework for development has been successful.

Cet article analyse les principales décisions prises lors de la réalisation du projet informatique de l'Hôpital de Londres. La rapidité avec laquelle est obtenue l'information représente l'avantage du temps réel. Le système actuel donne une information plus lisible et plus complète que le système manuel antérieur. La lisibilité de I'information donne plus de souplesse à l'administration. Le système est plus précis, mais toutes les erreurs de transcription n'ont pu ětre éliminées. La rapidité avec laqueile s'est faite l'implémentation des différentes applications a souffert d'un manque de temps pour les tests et de la dispersion des efforts sur le developpement et la maintenance du système. Si le développe-ment doit se poursuivre, un second ordinateur avec des possibilités au moins équivalentes sera nécessaire.

Key Words:

• hospital computer
• real time
• visual displays