This article reports on the project management and Culture Change Programme adopted by the NHS Greater Glasgow Health Board to deliver an electronic patient record (EPR) to support cardiology and stroke clinical services. To achieve its vision for the EPR (;to "really make a difference" to patient care by providing to the right person, the right information, under the right safeguards') the Board recognized that attending to social and organizational issues is at least of equal importance to addressing strictly technical concerns. Consequently, an ICT Culture Change Programme (ICT CCP) was devised and implemented to assist in the management of change, and in particular to facilitate a visionary clinical and cultural environment operating in conjunction with the evolving technical environment. In this article we describe the key components of this approach, outline the benefits we believe have accrued, and describe the steps being taken to build upon lessons learned.

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The Spacelab Data Processing Facility (SLDPF) is an integral part of the Space Shuttle data network for missions that involve attached scientific payloads.The SLDPF has developed expert system prototypes to aid in the performance of the quality assurance (QA) function of Spacelab and/or Attad%ed Shuttle Payloads (ASP) processed telemetry data.The SLDPF functions include the capturing, quality monitoring, processing, aocounting, and forwarding of data frum Spacelab and ASP missions to various user facilities.The SLDPF consists of twD functional elements: the S_o_ Input P=x_i_ System (SIPS) and the S_c_ Outp_ _ing _ (SOre). The t_ _ prototypes were developed to determine their feasibility and potential in the quality assurance of processed telemetry data. The SIPS expert system, Knowledge System Prototype, (KSP), uses an IBM PC/AT with the oummercial expert system shell OPS5+. Expert knowledge (frum SIPS experts) emulating the duties of quality assurance analysts was implemented.In an interactive mode, a SIPS analyst responds to queries resulting in instructions and decisions governing the reprocessing, releasing or further analysis/troubleshooting of data. Released data is forwarded for further processing on the SOPS Sperry 1100/82. The data are edited, time ordered with overlapping data removed, d_ted, and quality checked before release to the user. The SOPS QA analysts isolate problems and select the appropriate action: either acoept the data or request the data to be reprocessed.The SOPS expert system emulates this prooess by utilizing an expert system shell, CLIPS, and the Macintosh personal cumputer.To date, these prototypes indicate potential beneficial results; e,g., increase analyst productivity, decrease the burden of tedious manual analysis, provide consistent evaluations of data, provide concise historical records, provide training for new analysts, and expedite the operational training of Spacelab analysts.The logic implemented in the prototypes, the limitations of the personal computers utilized, and the degree of accessibility to input data have led to an operational configuration to be implemented on a SUN 3/160 Workstation.This configuration is currently under development and on completion will enhance the efficiency, both in time and quality, of releasing Spacelab/ASP data.

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