WRITTEN ON November 30th, 2004 BY Richard S AND STORED IN Ideal Goverment - project

Last week, I had a pre-arranged clinic appointment at a “Foundation” hospital. The clinic was busy and the room so small that there were not even enough chairs for the waiting patients. Although there were no interruptions for special emergencies, I did not see the weary but kindly doctor until about 4 hours after my appointment time and finally reached home at 9.30 pm.

The doctor prescribed an extra medicine, largely to counteract side effects of one that I already use. He had no readily available information about satisfactory alternatives to the original troublesome medicine or about the side effects of medicines. (The paper directory seems not to help.)

Result: A whole day lost for just a brief 10 minute consultation.

Question: How could e-Government or better IT have helped?

1. Appointment Process
I received two reminder letters. (Each threatening removal from the list if I forgot to attend.)

a. Could these appointment reminders have been sent electronically?
(But with all the spam, would I trust or even read such an email or SMS?)
b. Could the clinic have made a better estimate of the real appointment time?
(But doctors seem to like having a long queue waiting?)

2. Waiting Room
The order of seeing the patients apparently depends partly on appointment time, partly on arrival time and partly on the whim of the doctors. Patients brought in by hospital transport are always seen before those who struggle in alone, regardless of distance. Most patients hate “badgering” the receptionist for information about their continuing wait, but worry about “losing their place” in the queue if they leave the room. In desperation, some even chat with other patients!

a. Are patients with “hospital transport” always the most in need of rapid attention?
b. Could the clinic reveal the waiting order and estimate the remaining waiting time?
c. Could they perhaps estimate the number of chairs needed?

3. The Consultation
This medical problem was caused largely by the side effects of a common prescription medicine. However, the doctor had no information about suitable alternatives, either to give to me or to advise my GP.

a. Could doctors have a convenient database which lists side effects and suggests other suitable medicines?
(But would such a database be free of marketing and commercial pressures from drug companies and NHS accountants?)