Supplier withdraws from £2.3bn NHS IT plan because risks
are too high.
Lockheed Martin’s withdrawal from bidding for the NHS national
programme for IT has highlighted concerns that electronic medical
records due to be rolled out from 2005 will contain inaccuracies
that could hinder the care of patients or affect their health.
The firm, one of three key bidders, pulled out from the £2.3bn
programme only weeks before contracts were due to be awarded
because it believed the cumulative risks of the project were too
great.
Lockheed’s concerns about the NHS requirements to make it accept
responsibility for identifying and resolving inconsistent data
entered by medical staff were a key element of the decision,
Computer Weekly has learned.
It has emerged that Lockheed executives regarded the transfer of
risk from the public to private sector as unrealistic because they
believed that IT suppliers could not guarantee the integrity of
data entered by doctors and nurses.
In theory, under the draft contracts, Lockheed and other
suppliers could have been liable to pay the NHS more than the
original value of their contracts for any serious breaches.
Doctors and NHS IT specialists said Lockheed’s underlying
concerns about being responsible for inaccuracies in information
entered by doctors and nurses reflects a wider anxiety among
hospital clinicians and GPs about the credibility of electronic
records.
Inaccuracies in records have raised concerns among doctors that
patients will be left with the final responsibility for checking
that information in the national system is correct. In the most
serious cases, doctors say inaccuracies could compromise the health
of patients.
Trials of electronic patient records in North and Mid Hampshire
found that the recording of information by clinicians was “rarely”
accurate or consistent.
A trial in Cornwall concluded that inaccurate data created a
risk to the healthcare process for patients. A trial in Devon said
the accuracy of electronic records could not realistically be
assessed without the help of patients.
GP Paul Steventon, an IT specialist, said, “Lockheed’s
withdrawal was the result of its gaining an understanding of grass
roots issues. No supplier can guarantee that it will deal with data
quality issues that are the responsibility of doctors.”
Some paper-based records are unstructured or written by
consultants on the equivalent of Post-it notes that cannot be
reliably transferred into electronic records unless doctors oversee
the process – which they do not have time to do, he said.
Angus Goudie, IT head of Sunderland Teaching Primary Care Trust,
said that although inaccurate or inconsistent data will usually be
no more than irritating, “It is possible to see how it could be a
risk to patient health if, say, there is a lack of recording of an
allergy or a condition which could cause an adverse reaction to
medications.”
National programme officials have indicated that suppliers will
be expected to only ensure that fields in databases are completed
properly.
But after weeks of tough negotiations, Lockheed staff concluded
that the requirements for consistency of patient data was an
unquantifiable risk.
The national programme for IT argues that electronic records
will be more accurate than paper-based records.
It has responded to concerns that suppliers would be expected to
take on the risk for the integrity of data and pay liquidated
damages for problems caused by inaccuracies by giving assurances
that contracts between the NHS and the suppliers would be fair.
“The national programme is confident that it has terms and
conditions on which bidders, after negotiation, can make best and
final offers that will reflect a fair distribution of risk and
reward between the NHS and successful bidders, given the need for
systems and services that meet the demanding needs of NHS staff,
clinicians and patients,” said a spokesman.
Goudie said the fact that paper records are sometimes inaccurate
is widely acknowledged but there is a danger that people would put
more trust in electronic records.
NHS drops EDS from key project
The national programme for IT has withdrawn EDS from a shortlist
of three suppliers for “e-bookings” – a system to give patients
the ability to book appointments with doctors and consultants
online. Some staff at EDS are mystified by the Department of
Health’s decision.
E-booking is one of four national projects that form the NHS’s
£2.3bn national programme for IT.
The exclusion of EDS for the contract, which is due to awarded
by 31 October, will leave only two bidders: Fujitsu and
Schlumberger Sema. A spokesman for the national programme refused
to confirm or deny that EDS had been excluded.