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Story: Microsoft wins £500m NHS contract

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Its not as if the current system _is_ Windows, bringin in the cost of change.

In my recent extensive experience with the NHS I've seen:

Most medical notes are in paper form. XRays and CT scans are passed around as film. The patient can't have that electronic x-ray sent because at the moment it doesn't exist, and getting physical x-rays between hospitals just doesn't seem to be done. I've had repeat xrays because of this. XRays are images. Linux software handles images just fine. Lets hope the NHS mandate an open format like PNG or JPG.

Radiologist reports, and even most test results, are passed around as paper and get stuck into the big patient file. Different departments (Oncology, GP, local hospital for dealing with the side effects) have their own files with their own version of events, and the patient has to provide some communication ("So what has Dr XXX been doing with you?")

My tumour marker and blood count tests are pubished on an AIX based system, which has recently been given a web front end. This works really well. Fast results from the blood lab are essential for chemotherapy as you have to wait around before receiving any treatment to be sure that the blood test earlier that morning is good enough that it is safe to continue. With the web based system, the oncologist can get the results as they appear. A push/mail/subscription system would be even better. The sooner you get confirmation and start, the sooner you finish and go home.

Old Windows 3.1 apps, running on Windows 3.1 on standalone systems, are used for calculating things like chemotherapy and radiotherapy doses. These are double checked. The actual delivery of radiotherapy and chemotherapy is given by dedicated systems presumably running safe purpose build operating systems. Blue Screen of Death would take on a whole new meaning if these ran Windows.

CT scans are on big UNIX systems. This is a lot of data and 3D processing, which bigger iron is still needed to process and display. The amount of data in a CT scan is huge, even when processed. The NHS will need a lot of bandwidth if its going to pass this kind of data around, though an old IBM product, CatWeb (Java based online 3D vieweing), could be interesting here. Fortunately the radiologist report is generally short, maybe a few hundred bytes of plain text - another "Open Format".

Some people use Windows for typing letters and things - something that Star Office could easily provide.

The NHS certainly has a lot of scope for improvement with IT. Centralised patient data and easier communication would be great. I'd not have to repeat my medical history all the time. Results would get to doctors sooner. There'd be no need to repeat x-rays (though thats only happened once).

All this is new development though. Its a huge system and I'm not aware of anything that does this kind of thing already. There's no need for it to be based on Windows, and even the argument "Because Office is familliar to Users" is weak. The web works so well, and Office could be made to talk to an open standards based backend system. Perhaps it will.

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