When advertised, the position of NHS IT tsar recently filled by Richard Granger was described as the biggest IT challenge of the decade. That description, say those in the know, seriously underestimates his task.
Medical IT is complicated: much more complicated than, for example, banking IT. It needs more than money thrown at it: the whole NHS systems it underpins first need fundamental reform.
Health service IT is widely acknowledged, at least in private, as a can of worms. In business terms, a significant part of the job is to create, from huge fragmentation, the biggest customer relationship management implementation in the UK.
The task is to achieve sharing of accurate, well protected yet accessible patient medical information by 2005. The main challenge facing the NHS is not technical. It is cultural, institutional, managerial and political. This is a core conclusion of a draft report on medical records issued recently by industry lobby group Eurim for internal consultation. Among key tasks the NHS faces are to:
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- Ensure the quality of data input where 10%-30% input error rates have been noted
- Move to direct data entry by healthcare professionals without increasing their net workload
- Move to standard and compatible technology in a sector where different terms mean different things to different people
- Align coding structures used in primary and secondary care
- Provide trusted policy frameworks that reconcile the need to share information with pressures to protect that information. Securing the infrastructure to do just that is not an IT job but the UK's biggest political change challenge yet.