The Right and the Wrong way to Centralise Services

The Right and the Wrong way to Centralise Services

In this morning’s financial review I was frustrated by the full page article entitled Doctors give tick to centralisation. On one hand it talks about the need to “consolidate the systems, and centralise patient and administrative data” – which I fully commend and wish others in the industry had this level of vision.  But it then goes on to describe a system that would seem to only cause more issues than it fixes.

The second paragraph describes one of the significant issues with providing IT services to regional centres as being that “the high-speed backbones simply aren’t available.”  This would imply that whatever solution you were looking to implement shouldn’t rely on there being a stable and fast connection.  Yet, the solution they have settled on uses Citrix which of course needs continuous connectivity back to the server.  How can this possibly work if the connection fails, like for example if the area floods….(after all that never happens in Queensland).

Reading on, apparently the system has met with such success that the vendor has been able to convince them to roll out yet another piece of their technology.  This time it is a “web-based clinical information system to doctors.”  Don’t people realise that there is something fundamentally wrong about building a responsive application using the web request-response model.  No matter how much you lube it up with Ajax, you’re still going to have a clunky interface – well at least until you shine it up with a bit of Silverlight.

Ok, so what’s the answer in both these cases – clearly a rich client, occasionally connected application.  This has all the benefits of centralised data respository, which significantly saves on administration and reporting, while not of the user-pain of either a Citrix or Web based environment.

Lastly, I’m wondering why exactly the doctors have given this system “the tick” – is it because the system is great, or just that they now have a single system.  Just because something is an improvement, doesn’t make it best-of-breed.

Disclaimer: Ok, so you might think this is a bit personal, well you’d be right.  One of the major competitors in this space is AutumnCare where I worked for a number of years.  With the right mindset it’s possible to build systems that continue to operate across a range of devices irrespective of network availability!

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