Manpreet Pujara, chairman of the Emis User Group, offers his
interpretation of answers given by the national programme on how
and if GPs' systems will be integrated
As health officials try to reduce the number of different systems
used by GPs, they face opposition from one of the biggest IT user
groups in the health service.
The scene is set for a protracted conflict between the £2.3bn
national programme for IT (NPfIT) in the NHS and the Emis User
Group, which represents 5,500 GP practices.
Manpreet Pujara, chairman of the user group, is concerned that his
members will be pressurised into giving up their proven Emis
systems for unknown technology from local service providers which
have been appointed by the national programme.
Computer Weekly put GPs' concerns to the national programme - whose
responses are intended to be reassuring for GPs. We reproduce the
NPfIT statements here with Pujara's comments. In general, said
Pujara, the national programme's answers "allow many different
interpretations".
Statements and comments
NPfIT All GPs will be offered a choice of IT
systems to access the NHS Care Records Service [a system to be
rolled out over the next six years which includes a national
database of summarised patient records].
Pujara Choice is limited to the system offered by
the local service providers and, in some areas, it would appear
this is limited to one system now and one system in the
future.
NPfIT In the long term it is expected that the
majority of the current plethora of existing systems will have to
be replaced or integrated and it is likely that, owing to the large
number of existing systems, some will not be integrated.
Pujara The fact is that three suppliers cover more
than 90% of all [GPs'] practices.
NPfIT Properly planned implementation and close
work with GPs will manage and minimise any potential disruption and
ensure this investment in IT brings about significant benefits for
patients and GPs, ensuring care is delivered more safely and
effectively than ever before.
Pujara How is the NPfIT planning to do this
without a full understanding of what the current systems can do and
what information they provide to clinicians?
Surely it would be better not to have the disruption in the first
place, and enable integration and ongoing funding of existing
systems that are already working with the programme?
NPfIT The national programme has been working with
Emis and other existing system suppliers to ensure their GP and
patient administration systems are NPfIT-compliant for the roll-out
of Choose and Book [a system to be rolled out between now and 2006
which enables GPs to book hospital appointments online].
Emis has been testing its systems in the national programme system
integration testing environments with full support from NPfIT staff
and co-operation from NPfIT contracted suppliers.
Pujara This proves the ability [of Emis] to
integrate and further demonstrates the nonsensical decision to then
rip and replace with all the subsequent disruption.
NPfIT All local service providers are contracted
to offer GP practices within their region a choice of IT systems
through which they can access the NHS Care Records Service.
Pujara Choice is severely limited. There appear to
be no commercial drivers for local service providers to offer wider
choice.
NPfIT The national programme will be ensuring that
sufficient systems are made compliant to allow for the principle of
choice to be maintained.
Pujara There is no evidence of this and it is
contrary to the latest guidance.
NPfIT The majority of existing systems will need
to be replaced or integrated within a local service provider
solution.
Pujara The implementation of open standards and
the use of integration seem to be contradictory to this
statement.
NPfIT It is expected that some existing systems
will not be integrated to local service provider solutions.
Pujara It is clear there is no intent to integrate
Emis to local service provider solutions and no actual reason why
this would be necessary if open system standards were
implemented.
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