Enjoying the challenges at the sharp end of NHS
IT
Khali Itani, Medical Physics Department, UCL Hospitals NHS
Trust
I enjoyed Liz Warren's
article on working for the NHS, and I wanted to add a little
flavour to the comments about the breadth of IT projects in NHS
trusts.
I work in a medical physics department, and the amount of IT
work that we do is unimaginable. Technologies range from
infection-clean keyboards, baby-mother video monitoring systems,
and building video matrix boxes for a multitude of audio visual
systems - such as slide projectors, scanners, PCs, magnifiers and
projectors - to specifying mobile computers that are fit for
purpose in different settings with an NHS trust.
What makes NHS IT projects more challenging and interesting than
most is that we not only have to worry about the IT technicalities
of a project but also the instrumentation aspects of electrical
safety, infection control etc. Adding to all that is having to deal
with patient/staff confidentiality and consensus. It is not all
about software projects and managing records electronically.
It has certainly been a very exciting job for me for the past
eight years, and I am sure there will always continue to be
something new to keep me going for plenty more years to come.
When it comes to training, I think that the NHS is doing its
best. Let us not forget that the NHS is a huge organisation and it
needs a huge budget for training its thousands of staff.
Unfortunately, IT courses are expensive, but this does not mean
they are ruled out. You just have to present a strong case to get
them approved.
Projects aren't done until the system is
retired
Colin Beveridge, Chief executive, Hadley Grant
In Brian McKenna's piece
"CIOs' tenures are shorter
than their projects", Sean Finnan, vice-president and managing
director, EDS UK and Ireland Commercial Business, says, "CIOs are
caught in a value trap 60% to 80% of IT budgets are being spent on
keeping current environments alive. Chief executives see most of
their money being spent on just standing still."
I would suggest that there is nothing surprising in these
statistics because most IT budgets are about maintenance rather
than development. However, an interesting corollary is the
generally accepted maxim that 80% of the lifetime costs of an
information system are incurred after the initial
implementation.
Nevertheless, I can safely say that none of the hundreds of
business cases I have reviewed over the past 10 years reflected the
20/80 cost profile. At best, the sponsors usually build in a
"reasonable" - ie token - amount for a year or so to justify a
three- or five-year return on investment.
In my experience, these provisions are rarely adequate, never
extend to the likely longevity of the system, and never include
provision for eventual decommissioning.
This problem appears to be endemic, if not systemic, in the way
most IT departments operate. We should have the maturity to
recognise the seriousness of this issue and start to do things
differently. Until we do, our professional integrity remains flawed
and our customers will continue to experience unexpected costs.
We need to accept that systems development continues throughout
the lifecycle of an information system until it is finally retired.
Development is most definitely not simply a journey that ends with
a successful implementation.
Terror backlash could hit faith in patient data
plan
Rob Tweed
In view of the recent terrorism threats perpetrated by doctors
within the NHS, I wonder whether anyone in the National Programme
for IT has considered the implications for their electronic patient
record?
Control of access to and use of this personal information has,
of course, been the focus of a great deal of concern and debate,
but I would guess that, of all potential users, doctors would have
been the one group that members of the public would have felt
should have legitimate access.
I would guess that feelings may now have changed somewhat.
More on electronic patient
records >>
The National Health
Service programme for IT >>