HIE Library Projects

Introduction

In 1993 Quartet Software was awarded the contract to develop a bespoke database publishing system for the production of the British National Formulary (BNF). This represented a huge shift in work practices for the editors of the BNF, from using typewriters, numerous sets of galleys and trips to the typesetters, to a system using a database editor, proofing tools and a desk top publishing package for final camera-ready output.

Since BNF edition 28 in September 1994, the printed BNF has been generated from the database designed by Quartet. The tools used to edit, maintain, proof and publish the content of the database were all written by Dr Peter Johnson and Barry Thomas of Quartet.

In September 1995 the Electronic BNF was launched on CD-ROM, bringing the familiar BNF to computer screens, complete with cross references and all of the same typography of the book. Electronic Drug & Therapeutics was added to the package in March 1997 and Electronic MeReC in March 1998.

Quartet Software has now developed an Intranet version of the eBNF and eMeReC, called the IeBNF, currently on beta test and due for launch in April 1999.

Why an intranet version?

The eBNF on CD continues to sell well, but times are changing and intranets are the up and coming technology with which to deliver patient and reference data. While the current CD-based product can be networked, it is not the ideal solution for larger networks and is limited to the Windows platform. The IeBNF is served from an NT server running Microsoft Internet Information Server (IIS) and can be viewed at the client end by any web browser which supports Cascading Style Sheets (CSS), including browsers on Macintosh, Linux and assorted flavours of Unix.

Intranet technology is increasingly being used in hospitals to deliver everything from patient booking systems, ordering supplies and even prescribing at the bedside. The availability of know-how and tools to deliver HTML, plus the rapid development cycle for this type of system, allows hospital trusts to put in place wide ranging systems with a much more consistent and user-friendly front end.

It is an easy task to generate a local formulary, offer it over the hospital intranet and now even link that material directly to and from the standard reference, the BNF.

How does it work?

For the technophiles, the server has been developed as an ISAPI application which brings speed, serving HTML with CSS which runs on a wide variety of browsers without the need for slow and weighty Java applets. The database is largely the same as the CD-based product with additional indexes and data files to make sure that a busy server in a large trust will still provide fast results.

Quartet's long involvement with the BNF data has shown us that is not sufficient to provide a more or less faithful reproduction of the book in an electronic format. The key ingredient for a system such as this is fast and comprehensive searching. To this end we have taken the existing eBNF search engine and refined it, making it better suited to HTML access and providing an interface which users of Internet search engines will find familiar. Search results are presented in blocks of 10 hits, complete with the name of the record, where it is found in the publication and a couple of lines of clean text taken from the top of the record.

The printed BNF has a handy reference which gives details of serious and less serious drug interactions, but using this appendix can be a slow process. While individual drugs can be looked up, it is time consuming to look for potential polypharmacy interactions.

Perhaps the IeBNF's most powerful feature is its interactions search engine. You can enter a single drug and view the table of possible interactions, with serious interactions highlighted in red, or you can type any number of drugs to find interactions between all of the possible permutations.

When will IeBNF be available and how much will it cost?

The system is currently on clinical test at hospitals across the country and will be formally launched in tandem with the March release of the eBNF on CD.

Who is involved?

Dr Peter Johnson trained at The London Hospital Whitechapel and spent ten years as a GP. Peter has carried out consultancy on primary health care computing and written software for AAH Meditel, Imperial Cancer Research Fund and the Prodigy and Prestige projects. Peter spent ten months at Stanford University in California as Visiting Scholar, studying decision support systems for prescribing. Peter designed and wrote Meditel's Sophie protocol system.

Barry Thomas taught in London before moving into computing in the early eighties. He has written books on machine language programming and page description languages and now develops database publishing software for Quartet.

Further Information

Please contact Barry Thomas on +44 (0) 1335 370655, email barry@quartet.co.uk or pete@quartet.co.uk