words of WISDAM from the Electronic Encyclopaedia of Personal Data (EEPD)

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Working towards an “Open Source” and, in future, also an increasingly “Wiki” approach to the future of Shared Hospital/Community Perinatal Care IT Systems: a Blueprint for similar shared-care specialities??


In 1979 when I first started to try to use computers to improve patient care and to reduce human errors, there was a confident belief by “experts predicting the future” a) that relatively soon clever computers a) would virtually take over much of the traditional knowledge functions of doctors and b) paper would become virtually obsolete.

So strong was this belief that a cartoon even appeared in Which with a caption “The computer will see you now.” Indeed, the whole premise of the film 2001: A Space Odyssey was that the computer HAL was capable of “thinking” and making “decision”s, and there were genuine predictions by experts that the power of computers would equal or even surpass that of the human brain by the year 2000.

Such predictions, as with almost all human predicitons, have come to naught. It needs to be said over and over again that

a) despite talk of “neural networks” and such like concepts, almost all computers currently in use are in essence nothing more than giant typewriters and calculating machines. Although sometimes decisions appear to be made by a computer, in reality all decisions are made by program writers. Such decisions may be incorporated into such programs in extremely complex ways, but computers by themselves –  certainly in medicine – have yet to make any such decisions


b) that “If computers had been invented first, and paper & pen later, the latter would probably have been regarded as the world’s greatest breakthrough in the history of Information Technology.”

These EEPDtalk discussions will try to untangle how and why things have not turned out as predicted, how the present situation in much of acute hospital IT has got into an inefficient mess, and what foundations are now needed to make more rational progress in future.

(click here for RF’s original PDF version on
(see also RF’s letter “The write stuff” in The Independent 23 January 2009)

Basic Principles

Despite a widespread belief (now fading?), even among highly trained professionals, that computers are magic; both on financial and on technical grounds, it is, in practice, impossible to adequately integrate large flow-patterned databases. Once they have been fully installed, adequate interoperability has usually proved to be unaffordable and impractical.

Numerous examples confirm that the toxic combination of gullible NHS management purchasers and plausible IT sales fantasisers has resulted, time and again, in inter-operability initiatives disastrously over-running in time and cost; with the eventual failure providing regular employment for litigation lawyers.

For this simple reason, complex Electronic Patient Records (EPRs)  will only attain their true potential to improve the quality of patient care; and to reduce the risk of human errors, (without unaffordable extra computer programming; or alternatively without clinical staff being overloaded with the re-entry of the same data into different systems e.g. maternity and theatre systems); when, in each speciality and sub-speciality – following intense, open, web-based discussions –  their detailed, logically and chronologically-arranged, flow-patterned questions and the full range of all allowable answer-options – [unlike traditional coding, always including whenever needed, “Unknown (Free Text)” and “Other (Free Text)”] – are, by stages, taking account of as many interested parties as possible, individual question by individual question, internationally standardised. (Like our classification of organisms, diseases and operations but 10,000 times more complex, and with precise flow-patterning of every question) .

from the Introduction to the Electronic Encyclopaedia of Perinatal Data
Dr. Rupert Fawdry FRCS(Ed) FRCOG – Founding Editor

Want to know more? Look at the EEPD Frequently Asked Questions.

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