Bill Aylward: Open source advocate
This post is part of our series of stories from clinicians who have made a difference in digital health.
My interest in computers started in the 1970s when, as a socially compromised teenager, I played around with microprocessors and was amazed by their potential. I started writing software for the venerable Acorn Atom to help with my university studies, and have rarely been far away from a computer since then.
I did mathematics and physics at university for one year before changing to medicine, and had many happy times in the early hours of the morning accessing the university mainframe using punched cards. As a junior doctor, I witnessed the disconnect between computer systems that hospitals provided, and the needs of clinicians, particularly in the area of clinical research. Writing important clinical information on paper was fast, but had no other advantages, so frustrated clinicians were creating their own clinical databases using spreadsheets, simple databases or sometimes more sophisticated systems, despite the implicit duplication of data entry.
On my appointment as a consultant at Moorfields in 1994, I set about eliminating paper records and replacing them with modern information systems encouraging clinicians to enter structured clinical data in realtime. I thought that this would take maybe 5 years (..yes I know!). The first attempt was partially successful, but failed commercially largely due to the lockdown created by the National Programme. The second attempt used an open source approach which makes perfect sense to clinicians who already ‘open source’ their clinical ideas within the NHS.
Progress has been made, but it is immensely frustrating that informatics innovation within healthcare is so slow, difficult and painful. This is particularly the case when we are surrounded by other industries who have not only benefited from IT, but in many cases have been completely transformed!
If there is one lesson that I have learned, it is that the IT future that clinicians want can only be brought about when clinicians are leading the process. This takes time and effort on their part, but will ultimately deliver.
