The facts below were taken from a seminar held on 26 March 1996 and explain the initial driving force behind the development of the Atebion software. I hope you find it interesting and we would like to know your comments.

By 1996 the DataTree costing program was used in 300 out of 450 NHS acute Hospital Trusts in the UK and over 100 hospitals abroad, mainly for detailed costing in pathology and radiology. In 1995 an orthopaedic consultant built up detailed cost profiles for each procedure using DataTree, believing the government when they stated that money will follow patients, he wanted to build a centre of excellence but he lost some major contracts that went down the road. Down the road could do it cheaper BUT price suppose to equal cost in the NHS and what was alarming was that at this time there was over sixty different types of replacement hips commercially available in Britain but British follow up data exist for only five. (Bulstrode 1995). The range of cost across these different types was very considerable..

So was the reliability

Some results of Total Hip Replacement

• Charnley  10 years 92% OK irrespective of age, sex or Diagnosis
• Howse            7 years 60-80% OK
• ICLH               5 years 2% OK

These results were taken from records kept in Sweden. The Swedes were the only people who had analysed the failure rates.

Some results of Total Knee Replacement

• LCD             10 years 95% OK
• PAC            10 years 60-70% OK
• MT11            10 years 65% OK

On looking at comparative hip and knee prices by trust for the Region, the orthopaedic consultant stated that he knew they couldn’t put in a Charnley for £2,000.

The following charts that were presented showed their trust was not doing awfully well. Why? At least one reason was that they used Charnley and LCD prostheses which make no sense if we are looking simply at current year costs.

Unfortunately at this time the Governments emphasis went away from detailed costing and over the coming years a number of scandals regarding prostheses occurred but no one seemed really interested in pain and suffering, the same in other areas like looking after the elderly that have been diagnosed as EMI (Elderly Mentally Infirm).

Only time will tell but Barry Phillips believed one day senior managers will be interested in looking at cost against quality, against outcome, with contract monitoring and resource optimization over more than a 12 month budget, Barry set about to design a program to handle all. A tall order, one that was beyond the programmers employed at the time so he sent his close colleague Angus Richardson off to Russia to team up with Russian programmers lead by Alexander Lesnikov who also had ambitions to develop a World Class Mathematical Modelling program.