| Some historical background, which includes plenty of personal bias: Governments, for all their posturing, love dealing with oligopolies, or even better, monopolies. They feel safer in making purchases from them. So around 2002, the UK government decided IT was so important, it was going to be done centrally for the whole NHS. They gave the job to Richard Granger, who then proceeded to divide England into five regions, each of which would have one vendor responsible for all software in the NHS for that region. As part of that deal, they licensed MS Windows and Office. At that point, it became more expensive to use open source software than Microsoft's software. Then they standardised on IE6, and many vendors began using ActiveX. When I ask departments to upgrade, they say they are going to do so, but first they need every single vendor to have signed off that their software works in the new browser. This will take a really long time. Some will install a new browser for us, but this will actually result in a worse outcome for the clinicians because they have to use IE6 for most of their existing browsing, and then the other browser for us. They do not understand the point or the difference, and new browsers mean a different user interface, and they want to get on with treating patients rather than choosing between browsers. The epilogue is that the UK government's national program wasted 12 billion pounds (about 20 billion US, ie the same amount the US government is also identically wasting to subsidise electronic health record purchases). And Richard Granger left the UK in disgrace. He is now a consultant in... Australia :) |