Results tagged “electronic patient records”

The state of IT in the NHS? Ring a random NHS trust and see if they have IT problems - it worked for us

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We'd like to let you in on a little secret.

In the past week, Computer Weekly uncovered IT problems at two NHS trusts in the north-west of London. In one, medical staff were unable to access patient information, leading to emergency cases being diverted to other hospitals. In the other, a major systems upgrade has been delayed, causing "great difficulties" for staff.

The stories originated - as many good stories do - from a Computer Weekly source. But here's the secret - having received the tip-off, we rang up the affected NHS trust and they admitted the problems and gave us the details. It was a good story.

We then realised that, due to a rather confusing website, we had rung the wrong NHS trust. The original story was true - we rang the correct trust and they admitted to their problems too. But in effect, we randomly rang a large NHS trust, only to find they had major IT problems as well.

A happy coincidence for us, perhaps. But it also came a couple of weeks after we revealed major technology issues at a south London trust too, although those were not so recent. You can't help but think that maybe such stories are not isolated cases.

The NHS, as everyone knows, is at a crossroads. Faced with an aging population and austerity budgets, it's been running out of cash and in some cases patient care has suffered. The health service needs an extra £8bn a year and the government has promised to find the money.

Meanwhile, many in the NHS are waking up to the fact that technology offers huge opportunities to cut costs and transform elements of patient care. Yet we still barely have the basics in place - patchy use of electronic medical records and patient administration systems, little or no integration of records between different trusts, let alone between GPs and their local health providers.

Much of the NHS is still suffering from the legacy of the £12bn National Programme for IT that promised so much and delivered so very little. Many NHS organisations are playing catch-up, despite health secretary Jeremy Hunt's promise of a "paperless NHS" by 2018.

If we can stumble into IT problems at one NHS trust, how many are there having similar difficulties? With so many challenges facing the NHS, technology cannot become the forgotten solution.

It is patently obvious the NHS must have online patient records

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The issue of electronic patient records in the NHS is back in the headlines after health secretary Jeremy Hunt called for the health service to be "paperless" by 2018.

After £6bn or so of taxpayer's money failed to introduce a nationwide electronic records scheme in the ill-fated National Programme for IT, it's inevitably a subject of much debate and cynicism - justifiably so, in the circumstances.

But putting aside the history, the concerns about NHS IT capability, and about privacy and data protection, the over-riding consideration here must be that surely it is patently obvious the NHS must have nationwide electronic records, accessible online by patients, if it is to function as any sort of modern health provider.

The issue cannot be whether or not we have online patient records, but how we avoid the IT disasters of the past and overcome the inevitable privacy fears in doing so.

It cannot be a sensible debate if it starts with, "Don't do it, the NHS will never get the IT right", or, "The privacy issues of nationwide digital records are too great" - both of which I have seen suggested.

Can anyone seriously claim that while we live more of our lives online, sharing our personal information, even managing our finances on the web, that somehow our medical records should not be a part of that world?

It would be ludicrous to think we could have an NHS without online patient records.

For a start, the vast majority of us already have digital medical records - they sit in our GPs' systems, lonely and isolated, unreadable to anyone but your GP practice. Remember too that we have a legal right to look at our medical records at any time, whether paper-based or electronic.

Some might say that is enough, but my personal experience is that it cannot be.

Someone very close to me has a long-term, complex medical condition. Her GP maintains the only copy of her entire medical history - but she has no idea how accurate it is. Updates from the hospital at which she is treated are sent to her GP by letter, to be typed in by a secretary at the GP practice. The hospital, meanwhile, keeps its own entirely separate digital record of the medical history she has accumulated under its care.

Parts of the NHS refuse to treat her because they don't have full access to her medical history to understand the medication she takes and the treatments she has had. For example, she has struggled to register with a dentist, because her condition affects her bones and she needs a monthly infusion to strengthen her bones - to many dentists, unfamiliar with her history, that's too much of a risk.

I hope it never happens, but if she ever has to go to A&E at any hospital other than the one at which she is regularly treated, doctors there would have no idea of her complex history - and that lack of awareness could be life threatening.

If any suitably qualified NHS practitioner had access to her full medical records, with all the necessary security and privacy controls, it would allow the health service to deliver a significantly improved service and better care.

Of course, neither she nor I want her medical records to be hacked, or accessed by anyone we wouldn't want to see them - any more than I'd be happy for someone to hack my online bank account.

And I don't want untold billions of pounds to be wasted again on big, bespoke IT systems that don't work. But there is no reason why the technology is not capable of delivering a secure, connected solution.

Tell me one reason why we shouldn't keep on trying until we get it right. I just hope this is the time the NHS finally does.

NHS IT managers finally get their chance to shine

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My leader article in Computer Weekly this week should have been easy to write. It's about the new NHS IT strategy, and it would be a simple task to cut and paste pretty much every similar article about the ups and downs of NHS IT in the 10 years or so since the National Programme for IT (NPfIT) was first mooted.

There are a few key themes that would have to be included, for example:

  • In this digital age, you cannot imagine not having online access to your medical records in the future.
  • Medical professionals need to be involved in healthcare IT strategy from the start.
  • The federated nature of the NHS needs to be central to any nationwide strategy.
  • Don't underestimate the challenge of cultural change to IT-enable a huge beast like the NHS.
  • Get the contracts with IT suppliers right, to avoid costly over-runs.

At some point, every one of these has been attempted, and nobody has yet got them right.

So what about the new NHS information strategy? Well, it ticks all those boxes at least. Online access to health records by 2015, for example. "Strong contractual levers" for centralised standards, for another. Overall, there's much in the new plan that makes a lot of sense.

But we all sort of thought that every time before.

It's a statement of the obvious, but the challenge for NHS IT is not in the strategy, it's in the delivery. Delivery of the core elements of NPfIT were an unmitigated disaster, embodied by the continuing legal wrangles with key supplier CSC over a contract that has failed utterly to deliver, and which is costing the vendor itself hundreds of millions of dollars in write-offs.

The proposed combination of centrally-enforced IT standards, with local decision-making and implementation, is clearly the best way forward given the greater maturity of technology now compared to 10 years ago, when big centralised systems felt like the right choice.

But now the delivery rests not on a Department of Health agency, nor on a central CIO, but on every IT manager in every NHS trust. That's how those IT managers would want it to be, but now it's time for them to become the real drivers of change to create an information-led health service.

The time for politics and strategizing is over. NHS IT managers have been finally empowered to deliver, as they have always wanted. The task is no less difficult, but this is their opportunity.

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