12 - Computer systems: practice, limitations and pitfalls

Summary

Introduction

The most difficult thing facing the clinician interested in setting up audit within his/her department must be the means of acquisition, storage and analysis of the data required to support this. Computers are particularly good at storing large amounts of data and at manipulating them, and the enormous advantages of computerisation in aiding these functions have not escaped a large number of clinicians. Many have gone ahead and developed their ‘own’ computer software to aid their ‘audit’ activities, and several commercial systems have also been developed. It is important to realise however that there are no ‘audit systems’, despite the claims of the advocates and salesmen, that will perform all the needs of audit. Rather audit requires the active input of the practising clinician and cannot be done by a computer system alone. The computer can of course be a completely invaluable ‘audit assistant’ but it is never more than that.

As usual in life whenever one finds a multitude of different approaches to the same thing it usually means that none of them are perfect and that they all have different faults. The perfect solution will be obvious if it arrives. In orthopaedic surgery we see this for example in the 60 or so different operations described for the treatment of bunions (hallux valgus), and in the audit field we see it in the plethora of computer systems aimed at the audit market.