[tweetiepooh]

I used to write code for the NHS many years back and we had our own patient system, had ward terminals where staff needed to swipe a barcode on their badges to login in. It didn't store patient clinical data though we were working on that. This was all in the good old DOS days. It all worked. Each month we supplied data back to a central clearing house who passed back to the sourcing NHS districts.

Each year the government changed the format for new submissions, including extra information and each year in May we ran our export for April and submitted the new data and each year big NHS areas that had expensive turnkey systems would ask us for the old format which we couldn't do as our systems no longer had the old data.

Also there were some huge manuals that defined how data items should be stored, e.g. values for gender, date formats, codes for GP. It show what information was needed for a patient, inpatient episodes, outpatient occurrences etc. It always seems obvious to me that GP's, hospitals etc can choose what ever system they want but it has to talk "NHS speak" to the outside. So the NHS/government defines how queries are made, how incoming data is formatted, and how answers are to be formatted. The developers of the various platforms have to implement the "interface", how they do it is up to them, it's irrelevant.