Supplier withdraws from £2.3bn NHS IT plan because risks are too high.
Lockheed Martin’s withdrawal from bidding for the NHS national programme for IT has highlighted concerns that electronic medical records due to be rolled out from 2005 will contain inaccuracies that could hinder the care of patients or affect their health.
The firm, one of three key bidders, pulled out from the £2.3bn programme only weeks before contracts were due to be awarded because it believed the cumulative risks of the project were too great.
Lockheed’s concerns about the NHS requirements to make it accept responsibility for identifying and resolving inconsistent data entered by medical staff were a key element of the decision, Computer Weekly has learned.
It has emerged that Lockheed executives regarded the transfer of risk from the public to private sector as unrealistic because they believed that IT suppliers could not guarantee the integrity of data entered by doctors and nurses.
In theory, under the draft contracts, Lockheed and other suppliers could have been liable to pay the NHS more than the original value of their contracts for any serious breaches.
Doctors and NHS IT specialists said Lockheed’s underlying concerns about being responsible for inaccuracies in information entered by doctors and nurses reflects a wider anxiety among hospital clinicians and GPs about the credibility of electronic records.
Inaccuracies in records have raised concerns among doctors that patients will be left with the final responsibility for checking that information in the national system is correct. In the most serious cases, doctors say inaccuracies could compromise the health of patients.
Trials of electronic patient records in North and Mid Hampshire found that the recording of information by clinicians was “rarely” accurate or consistent.
A trial in Cornwall concluded that inaccurate data created a risk to the healthcare process for patients. A trial in Devon said the accuracy of electronic records could not realistically be assessed without the help of patients.
GP Paul Steventon, an IT specialist, said, “Lockheed’s withdrawal was the result of its gaining an understanding of grass roots issues. No supplier can guarantee that it will deal with data quality issues that are the responsibility of doctors.”
Some paper-based records are unstructured or written by consultants on the equivalent of Post-it notes that cannot be reliably transferred into electronic records unless doctors oversee the process – which they do not have time to do, he said.
Angus Goudie, IT head of Sunderland Teaching Primary Care Trust, said that although inaccurate or inconsistent data will usually be no more than irritating, “It is possible to see how it could be a risk to patient health if, say, there is a lack of recording of an allergy or a condition which could cause an adverse reaction to medications.”
National programme officials have indicated that suppliers will be expected to only ensure that fields in databases are completed properly.
But after weeks of tough negotiations, Lockheed staff concluded that the requirements for consistency of patient data was an unquantifiable risk.
The national programme for IT argues that electronic records will be more accurate than paper-based records.
It has responded to concerns that suppliers would be expected to take on the risk for the integrity of data and pay liquidated damages for problems caused by inaccuracies by giving assurances that contracts between the NHS and the suppliers would be fair.
“The national programme is confident that it has terms and conditions on which bidders, after negotiation, can make best and final offers that will reflect a fair distribution of risk and reward between the NHS and successful bidders, given the need for systems and services that meet the demanding needs of NHS staff, clinicians and patients,” said a spokesman.
Goudie said the fact that paper records are sometimes inaccurate is widely acknowledged but there is a danger that people would put more trust in electronic records.
NHS drops EDS from key project
The national programme for IT has withdrawn EDS from a shortlist of three suppliers for “e-bookings” – a system to give patients the ability to book appointments with doctors and consultants online. Some staff at EDS are mystified by the Department of Health’s decision.
E-booking is one of four national projects that form the NHS’s £2.3bn national programme for IT.
The exclusion of EDS for the contract, which is due to awarded by 31 October, will leave only two bidders: Fujitsu and Schlumberger Sema. A spokesman for the national programme refused to confirm or deny that EDS had been excluded.