How not to introduce an IT system

This morning’s Observer column

When you walk into my GP’s surgery, the first thing you see is a screen on the receptionist’s counter. Displayed on it are the words (all in capitals) “TOUCH THE SCREEN TO ARRIVE FOR YOUR APPOINTMENT”. Being pedantic, the first time I saw it I pointed out to the receptionist that I had arrived for my appointment. She grimaced. I then asked if the medical implications of asking every patient to use the same touchscreen during, say, a flu epidemic had been considered. Another grimace. It was, she explained, “a new system”.

This system was provided by Epic Systems, a US corporation based in Wisconsin, which may explain why its software designers seem unfamiliar with the verb “to arrive”. It’s one of eight major vendors of healthcare information systems, all of which are based in the US, and it got its foot in the NHS door quite a long time ago. My doctor’s surgery has been using it for a while. At the beginning, the system’s user-interface was abysmal and dysfunctional. Now, several years on, it’s merely ugly. But at least it works…

Read on


One of my colleagues wrote, confirming my friend’s experience:

The only thing that marred our recent experience of Addenbrookes A&E (also with suspected broken foot/feet, there must be something in the water in Cambridge!), was the introduction of the new system:
there was a 20 minute wait to register once we had initially registered, because the details hadn’t come through, then the x-ray results had to be manually retrieved …and really very stressful for the staff who had to keep apologising and physically running between departments to get results.