Claim of censorship over Cerner system

The Sydney Morning Herald and ZDNet in Australia report that the University of Sydney removed from its website – temporarily – a negative essay about a Cerner system which had been installed at hospitals in New South Wales.

The author of the essay is a medical IT professor, Jon Patrick, who is reported to have claimed that NSW Health, which is part of the government of New South Wales, put pressure on the university to take down the paper.

If true, it would tie in with what’s been happening in England where mentions of Cerner in a negative context are being officially discouraged.

Cerner is due to be installed at hospitals across London as part of the National Programme for IT [NPfIT] but several trusts that have already gone live – including the Royal Free and Hampstead, Barnet and Chase Farm, and Barts and The London – have run into serious problems, including the losing of patient appointments and patients not being treated.

A showcase Cerner site at Homerton ceased mentioning Cerner in its public board papers after doing a deal with NHS Connecting for Health and the Department of Health. Homerton also rejects FOI requests related to its discussions on Cerner.

Homerton told me: “We are unable to share documents relating to these meetings as ourcontract with Cerner includes a confidentiality clause and as suchdisclosure of the information could give rise to an actionable breachof confidence.”

More recently, another Cerner site, Barts and The London, has refused to answer Computer Weekly’s questions on the role of Cerner in its problems. Several weeks ago we submitted an FOI request to Barts – and have had nothing more than an acknowledgment so far. [Please see “PS” note on Barts at end of this article]

In Australia, the Sydney Morning Herald reports that the University of Sydney removed from its website “an extremely critical essay abouta new multimillion-dollar emergency department IT system after pressure from theNSW Health Department”.

The newspaper reports that “Doctors, nurses and administrators at four area health services heavilycriticised the system – which tracks patients – as posing an ”unacceptably highrisk” to patient safety because it was so slow, cumbersome and inefficient”.

Some hospitals have boycotted Cerner FirstNet and reverted to paper to recordclinical notes because it is too difficult and too time-consuming to retrievecritical patient information from the system, the essay by professor Jon Patrick said.

The essay was published late last month but NSW Health asked that it beremoved, Professor Patrick said on his website. The university then published itagain two weeks later.

“I have been able to establish confidently that NSW Health phoned my head ofdepartment and asked him to remove the article without giving a specificcomplaint,” Professor Patrick wrote on November 5.

Last Wednesday, he wrote: ”The university has affirmed my right to publish mycritical essay and the attempt to censor me has been mitigated.”

The Deputy Director-General of NSW Health, Tim Smyth, told the Sydney Morning Herald that the acting chief information officer contacted the universityabout the essay but did not ask for it to be removed.

”That’s entirely a matter for the university but my personal view havingread the article is that I don’t believe it’s balanced, it’s certainly notaccurate and it certainly misrepresents reality,” Dr Smyth said.Cerner also declined to comment to the newspaper.

ZDNet reported that Patrick had said that open source could be the answer to vendor lock-in, an opinion he has previously expressed in the media, and that in the long term, the government should be spending money on research and development of clinical systems for Australia.

He believed that it wasn’t possible to know all requirements in advance of writing software because of the variety of users with autonomous behaviour which all have a limited view of how others operate.

He thought the system should be flexible in its interface so that hospitals could make it optimal for their needs. “The era of rigidly designed user interfaces that do not allow any variation for user preferences or a capacity to model the user’s needs is long gone,” he said.

NSW Health was offered the opportunity to provide comments to an early version of the essay but declined the offer, according to Patrick.


The essay in question is indeed very negative, which makes it hard to understand why NSW Health declined to provide a defence of the system. That said, there’s much material on the internet in Cerner’s favour and Patrick’s paper provides a counterview which could inform open and frank debate.

That open and frank debate isn’t happening in the UK because information about the implementations is being suppressed by officialdom.  That’s bound to increase scepticism about the system – perhaps unfairly. 



After the article (above) was published this morning a spokeswoman at Barts and The London called me to say that my criticism of Barts was unfair. I’d said that my FOI request to Barts about the role of Cerner in its problems had elicited nothing more than an acknowledgment so far. The spokeswoman said that my FOI request is being given proper attention and I will receive a response shortly.

I am grateful to Barts for this assurance.


Minister defensive over Cerner sites – IT Projects blog

Essay on Cerner by Jon Patrick, University of Sydney

When there are NHS IT problems don’t mention Cerner – IT Projects blog

Jon Patrick’s essay – his blog comment

Switch to electronic records getting mixed reviews – The Huffington Post