Why GPs use computers and hospital doctors don’t (as of 2002)

Reading a couple of articles from 2002 giving an insight into the origins of computer use in the NHS. They are: Why general practitioners use computers and hospital doctors do not—Part 1: incentives (BMJ 2002;325:1086) and Why general practitioners use computers and hospital doctors do not—Part 2: scalability (BMJ 2002;325:1090).

I’m sure the situation has changed in the last 20 years. When I last visited a hospitals I’ve seen computers on trollies, possibly tablets, and definitely computers behind desks. But also clipboards and whiteboards.

I’m old enough to remember visiting a GP as a teenager and seeing paper records — called Lloyd George envelopes, I learned from these articles. But for a very long time, it’s been computers on desks:

Uploaded image — Figure from a paper from the same author: Benson T. Why British GPs use computers and hospital doctors do not. Proc AMIA Symp. 2001:42-6. “Comparable data was never collected about the use of clinical systems in hospitals, but in 1993 consulting room use in outpatient clinics was almost certainly below 3% […]”

The historic differences between GPs and hospitals are summarised as:

GPs were incentivised to adopt computers in consultations, and hospitals were not (rather, they were a cost to hospitals)
The needs of GPs and hospitals are different, with hospital needs being more complex.

The articles also describe the origins of Read codes / SNOMED and HL7 for data interop.

Fun stuff.

health-tech