Frontline innovation is free but not easy

Delaney's final conclusion on his editorial on cutting-edge information technology struck a chord with my work over the last 8 years. He suggested that in the future such IT will have to be freely available and with universal standards.¹ So far I have received no monetary grants for my work and have made my ideas and programs freely available to other like-minded GPs.

My first frontline idea incorporated the reasons for drug use on the repeat prescription screen of the IT system. This modernises the delivery of medicines and is described in detail on the website,² it is called clinical indications. The second idea (shared with my specialist practice nurse) was the development of a smoking calculator to calculate a pack-year number, that is, overall total smoking exposure for individual patients. This can be difficult to do due to changing smoking patterns and remembering the basic pack-year calculation. This calculator has been given freely to all on the web³ and there is an embedded version within general practice IT systems. This is available from Informatica Systems (Contract Plus module) and has in-built disease associations. Our names are on our calculator for standardisation purposes and this may be the first working frontline team to have their names actually shown within the modern general practice IT system! My most recent general practice program is a children's dose calculator for using liquid dexamethasone in croup. The latter is available free on contacting my email address. Fortunately, through prize money from national competitions, I have been able to set up websites and develop my ideas, but at times this can be a stressful and unpredictable way to get the necessary funding!