Microsoft Excel as clinical software and other fabulous beasts

In a week that was dominated by chatter about the purchase of a smallish Aussie EMR vendor by a global EMR behemoth and the never-assuaged desire for news of all things My Health Record, it was a nice yarn about two Top Enders adapting what tools they had at hand to a job that needed doing that piqued the curiosity of many of our readers.

They have built a bespoke system that takes reports from two commercial products – CSC's MedChart ePrescribing system and InterSystems' TrakCare Lab pathology system – dumps them into an Excel spreadsheet and runs them through a series of rules. At the end is a practical and easy to use antimicrobial stewardship system that they believe has prevented many adverse events.

Whether you agree that Microsoft Excel should be used as clinical software or not, in real life it and its friend Access have been used for years by clinicians and medical researchers to capture, store and analyse data, and one suspects they will continue to do so.

Yes, there are commercial products available and yes, the Top End team is aware of them, but no they didn't suit the purpose and no, the Top End team didn't have ready access to them. They made do with what they had, and it worked. We asked them whether they emailed out alerts about drug-bug mismatches or used some other electronic means of communicating a potential adverse event, and they said yes: the telephone. The wonders of modern technology, eh.

We also had the interesting news this week that Allscripts, which is rolling out EPAS for SA Health, has bought Core Medical Solutions, which is rolling out BOSSnet for WA Health, among others. Both of these projects have come under intense scrutiny from we jackals in the media, so it was interesting to see the results of our poll question from last week: Is a big bang EMR implementation a better choice than a best of breed model? 55 per cent said yes, and 45 per cent no.

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