One step forward in engaging clinicians in IT

Editor—We read with sympathy the experience of setting up and maintaining a database.¹ As rheumatologists in a district general hospital, we went through a similar process, but with a more positive outcome.

We initially explored standalone databases, which were costly, not guaranteed to link with our hospital systems, and requiring the expense of annual back up. One of us (MEL) sat on the hospital information technology (IT) committee (which, unsurprisingly, had plenty of vacancies for clinicians). We worked with our hospital IT department to set up a system based on the hospital patient administration system, a surprisingly powerful data storage tool. It took several months to complete but resulted in a robust and well supported system that has survived to the dawn of the national programme for IT in the NHS (NpfIT).² We have been lucky to have adaptable and dedicated secretaries. Although the system is more cumbersome to type in, time is saved by pulling all demographic data automatically via hospital number. It worked so well that the diabetes clinic also adapted it.

We learnt some lessons:

• You can't underestimate the lack of knowledge IT departments have about clinical practice and process

• IT departments can't underestimate the lack of knowledge that consultant rheumatologists have about computing

• If your hospital IT department didn't install your system don't expect them to be able to back it up when it goes wrong (and it will go wrong)

• If there's a hospital committee that has a major impact on your work try to get a seat on it.

The electronic patient record will make our database, and others like it, obsolete. However, the effort was worth it. Our department and IT understand each other a bit better, and we have a more realistic view of what can and can't be achieved. We're still talking to each other, and to the IT department.