As health officials try to reduce the number of different systems used by GPs, they face opposition from one of the biggest IT user groups in the health service.
The scene is set for a protracted conflict between the £2.3bn national programme for IT (NPfIT) in the NHS and the Emis User Group, which represents 5,500 GP practices.
Manpreet Pujara, chairman of the user group, is concerned that his members will be pressurised into giving up their proven Emis systems for unknown technology from local service providers which have been appointed by the national programme.
Computer Weekly put GPs' concerns to the national programme - whose responses are intended to be reassuring for GPs. We reproduce the NPfIT statements here with Pujara's comments. In general, said Pujara, the national programme's answers "allow many different interpretations".
Statements and comments
NPfIT All GPs will be offered a choice of IT systems to access the NHS Care Records Service [a system to be rolled out over the next six years which includes a national database of summarised patient records].
Pujara Choice is limited to the system offered by the local service providers and, in some areas, it would appear this is limited to one system now and one system in the future.
NPfIT In the long term it is expected that the majority of the current plethora of existing systems will have to be replaced or integrated and it is likely that, owing to the large number of existing systems, some will not be integrated.
Pujara The fact is that three suppliers cover more than 90% of all [GPs'] practices.
NPfIT Properly planned implementation and close work with GPs will manage and minimise any potential disruption and ensure this investment in IT brings about significant benefits for patients and GPs, ensuring care is delivered more safely and effectively than ever before.
Pujara How is the NPfIT planning to do this without a full understanding of what the current systems can do and what information they provide to clinicians?
Surely it would be better not to have the disruption in the first place, and enable integration and ongoing funding of existing systems that are already working with the programme?
NPfIT The national programme has been working with Emis and other existing system suppliers to ensure their GP and patient administration systems are NPfIT-compliant for the roll-out of Choose and Book [a system to be rolled out between now and 2006 which enables GPs to book hospital appointments online].
Emis has been testing its systems in the national programme system integration testing environments with full support from NPfIT staff and co-operation from NPfIT contracted suppliers.
Pujara This proves the ability [of Emis] to integrate and further demonstrates the nonsensical decision to then rip and replace with all the subsequent disruption.
NPfIT All local service providers are contracted to offer GP practices within their region a choice of IT systems through which they can access the NHS Care Records Service.
Pujara Choice is severely limited. There appear to be no commercial drivers for local service providers to offer wider choice.
NPfIT The national programme will be ensuring that sufficient systems are made compliant to allow for the principle of choice to be maintained.
Pujara There is no evidence of this and it is contrary to the latest guidance.
NPfIT The majority of existing systems will need to be replaced or integrated within a local service provider solution.
Pujara The implementation of open standards and the use of integration seem to be contradictory to this statement.
NPfIT It is expected that some existing systems will not be integrated to local service provider solutions.
Pujara It is clear there is no intent to integrate Emis to local service provider solutions and no actual reason why this would be necessary if open system standards were implemented.