Health IT Spending Is Not Working in Britain
The National Programme for IT in the National Health Service was launched in 2002 with a 2010 goal of providing every NHS patient with his very own electronic medical record. Yet in its most recent report, the British National Audit Office states that the Department of Health there has been a:
steady reduction in value delivered not matched by a reduction in costs. On this basis we conclude that the £2.7 billion spent on care records systems so far does not represent value for money, and we do not find grounds for confidence that the remaining planned spend of £4.3 billion will be different.
As in the U.S., the system was sold with claims that it would improve services and the quality of care. In fact, many of the proposed applications, like internet appointment scheduling, electronic prescribing, computerized order entry in hospitals, and a secure organizational broadband communications network are already in use, without government subsidy, in the U.S.
The project consisted of three parts: (1) the development of a Summary Care Record containing key medical information that could be accessed across England for each patient; (2) the development of a Detailed Care Record containing complete medical history with access limited to one’s physicians, hospital, or local caregivers for each patient; and (3) the development of a national broadband architecture allowing all of this information to be shared between sites that deliver NHS care.
The development of the Detailed Care Record has been far more difficult than expected. The Audit Office reports that the aim of creating an electronic record for every NHS patient will not be achieved. Of the 4,715 NHS organizations in England that were expected to receive new IT systems, 3,197 are still waiting. About half of hospital trusts will not have systems delivered. Care records for 1,243 GP practices and the London Ambulance Service have been canceled. This will save just £73 million out of the original £1,021 million because the original systems did not work.
The attempt to impose centrally managed systems on local hospitals has failed, and the Department has announced that it has shifted from its original intent of replacing entire data systems wholesale to building on existing systems and letting local groups make smaller changes in line with their local business requirements and capacity.
Trying to get people to agree on the best technology is like herding chickens. If you’ve ever gotten into an argument with someone over Mac vs. PC, you know what I mean. There are too many people to ask them all to use one type of software.
I personally am in favor of some sort of open source software where, with minimal training, clinicians can learn to modify the setup to suit their needs. It seems much better than declaring from on high what must be installed.
Agreed..The costs clearly outweigh the benefits.
I have no doubt that health IT has some definite advantages. However, I don’t believe hospitals and clinics can realize health IT’s true potential using a top-down approach.
For instance, the information technology used in non-medical offices varies depending on the needs of the firm. The information technology that is used tends to be products that have thrived in the marketplace. Microsoft Office, for example, has become ubiquitous because it has all the features most offices need. Hospitals and clinics use it because it’s useful.
Not surprised.
I predict the NHS health IT failure will continue to be trumped by the scandal at eHealth Ontario, the government agency which is supposed to maintain an EHR for every resident of that Canadian province by 2015.
Back in 2009, the CEO was fired after the media learned about outrageous salaries and “no-bid” contracts to friendly consultants.
Just last May, the media learned that eHealth Ontario’s staffers were getting substantial raises although the provincial government is supposed to be under a pay freeze (http://tinyurl.com/3m7mz6o).
Data does not equal information. EMR’s tend to conflate the two. My hospital’s EMR is swimming with data, but gleaning useful information is like picking a needle out of a haystack.
Sorry for the mixed metaphors
We have been talking about this and spending breathtaking amounts of money for at least a decade. The goal of the HIT effort in the U.S. was that everyone would have an electronic health record containing all of our medical information by 2012. Yet there is nothing — NOTHING! Not even something that might actually be useful, like a wallet card listing allergies, prescriptions, and emergency contact information.
All of the vendors should be required to return our money for non-performance. Only when the big government advocates have their own money at stake should they be listened to.