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At the heart of general practice since 1960

Ring up the savings

Dr Dick Morgan's visits to residential care homes was transformed by his new pocket computer software ­ which enabled him to find the homes more easily too

I first realised I was becoming a dinosaur in the mid-1990s. The Wellcome Foundation put on a fascinating History of Medicine exhibition at the Science Museum in London. It included a complete cardiothoracic theatre with heart-lung machine identical to the one I had worked in as a houseman at The London Hospital in 1978.

In the 1970s The London was one of the first hospitals in the world to have a custom-built mainframe computer with terminals on all wards which enabled the requesting and viewing online of laboratory tests as well as patient waiting list management ­ a houseman's boon before a consultant ward round.

General practice in the UK has been at the forefront of utilising clinical computing systems as an integral part of consultations. From 1980's green screens to today's colour flat screen marvels without which the Government's statistically-obsessed new contract could not exist, GP computing has come of age.

Ironically, just as house calls are virtually history too, most GP computing providers offer 'pocket' versions of their surgery software that will run on personal digital assistants (PDAs). These genuinely pocketable devices are capable of carrying an entire practice database (up to 10,000 patients in the case of In Practice Systems) in a form that allows both viewing of the patient data and additions to the history and prescription record while away from surgery. On returning to the practice, the PDA is docked and thereby linked to the main network where it uploads new information and refreshes its main database.

The data is encrypted and access to the patient records on the PDA requires the same password as you use on the main system at surgery. Stolen or lost PDAs won't breach or endanger confidentiality.

Access to up-to-date lab results and prescribing data has transformed my regular visits to residential care homes. At present, although you may view repeat prescription masters, they can't be edited ­ only acute prescriptions can be added.

All prevention data such as BP, weight and smoking can be viewed and added. Data entry is a little slow with a stylus and virtual keyboard, but it still beats half an hour on the PC back at surgery!

But things are even better, for after the Inland Revenue has picked up 40 per cent of the bill, the PDA is capable of things outside the surgery apart from functioning as a personal organiser.

Satellite Navigation has been with us in upmarket cars at upmarket prices for quite a while but software for PDA navigation has now matured to the point of matching expensive car-based systems for features and beating them on flexibility. It is now possible on your pocket marvel to get spoken directions with 3-D map displays that link to your PDA address book to navigate you precisely to a numbered house on any UK street.

Recent experiences with a Range Rover's Sat Nav telling me to execute a 'U' turn on a dual carriageway had left me dubious about relying on voices from the dashboard to get me safely home, but I am pleased to report that some of the latest software, for example Michelin's MapSonic, assumes if you've missed a turning that you intend to keep going straight ahead until an opportune alternative route becomes available.

To adapt your PDA for satellite navigation you require a GPS receiver add-on. This comes either as a plug-in card (my choice) or as a mouse with a lead to connect. You also need a powered bracket to secure and feed your handheld on the dashboard. I chose a suction mount holder with built-in power and speaker to amplify the voice instructions.

The software arrives on four CD-ROMs from which you load your choice of European country street level mapping on to your PC. You may then download to your PDA only the parts of a country that you need to save memory. The whole UK takes about 214Mb on the PDA so an accessory memory card is vital if you want more than your home county available.

Dick Morgan is a GP in Knowle, Solihull

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