NHS standardisation failed, says London CIO
'Pragmatic, rather than dogmatic'
London's programme for IT has succeeded by dumping the National Programme for IT's standardised model, according to the chief information officer for the capital's health service.
"Without a doubt, we haven't delivered the systems envisaged in 2002," said Kevin Jarrold, chief information officer of NHS London, told the Smart Healthcare Expo in London on 10 June 2008.
The original model had been a single database with the health records of eight million people: "Never been done anywhere in the world, didn't happen in London," Jarrold said.
When IDX was replaced as the main software provider to London, the capital moved to a 'best of breed' approach. Jarrold called this "pragmatic, rather than dogmatic", under which different care record software is used by different types of health organisation.
Jarrold said this has produced success, with the Royal Free Hospital going live with the new LC1 version of Cerner's Millennium software this weekend.
Three acute trusts are using the R0 version of Millennium, with two more using existing installations of the software. Jarrold said he expects that 15 of the 32 acute trusts will be live with suitable software by the end of 2008-09 financial year, along with 29 of 31 primary care trusts, eight of 10 mental health trusts and all GP practices.
"The holistic approach to delivering the single patient record has never been delivered anywhere," Jarrold said, referring to the standardised model still being pursued elsewhere in England. "We decided a pragmatic approach was better than sticking with an approach that may never be delivered."
This article was originally published at Kablenet.
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A License to Print money
The NHS is a bottomless pit of money.
"Connecting for Health" are proud to state that the NPfit Contractors only get paid when they deliver, but how many payments have been made for interim software solutions installed whilst waiting for the troubled final solution and who will be picking up the bill to replace the interm software once the product is finally ready considering we have already paid once.
It is a bold project, a waste of public money and an unworkable solution and they are all to blame, the government, the CFH, the PCTs managers on the ground who grab all the money they can from the project, so they do not have to use there own budget replacing old IT equipment, they can waste their budget on something else. The LSPs who have been contracted to hold a monopoly on their area and stifle competition altogether.
Does anyone know if iSoft as an LSP actively promote Emis software, or vica versa? I would doubt it very much. This project was supposed promote competition by splitting up the country into sections, all that it has done is provided a monoply for the LSPs in the areas they have been given.
Now heres an idea, the NHS develops a backend system, but the patient holds their own data at all times, where ever the patient goes the data goes and can be read by the NHS backend. This needs to be worked on, give me 6 billion and I’ll get right on it.
Unique NHS number eh?
Speaking as someone who used to work in healthcare IT but escaped before the current fiasco started...
In the beginning was the NHS number.
And it came in 23 different formats, and there were duplicates which had been issued historically.
So a project was created to allocate everyone a New NHS number.
And it ate a lot of time and effort for everyone.
And when it was rolled out... d'you know what happened?
In the early stages... the systems managed to issue duplicates again.
And as far as I know they are still there.
I also used to work in interfacing healthcare IT systems with one another, and was involved in one of the earliest EDI projects in the NHS, to send pathology results from Hospital path labs to GPs.
And just at the point where we had a few pilot hospital sites sending results electronically, using a standard message, to a few GP practices...
Someone at the Department of Health got a bee in their bonnet about the European Standardisation Effort for medical messaging...
...and suddenly started mandating that everyone should implement a new, different set of standard messages - without any additional funding of course - which set the cause of healthcare EDI back a good couple of years.
Then just as that was sorting itself out, some idiot at the Department of Health realised that all this old-fashioned EDIFACT stuff was rather old hat, and there was this new thing on the block called XML, and another argument started over why everyone was using EDIFACT and we should all move to XML as the encoding scheme, quietly ignoring the fact that no message schemas had been defined in XML yet, and we had already changed horses once causing great upheaval.
So the current balls-up is basically just the logical conclusion of that sort of stupidity, with the addition of Tony Blair behaving like an idiot, compounded by the fact that there is now no in-house NHS IT capability since the organisations which used to provide in-house NHS developments were all outsourced to the likes of EDS and CSC many years ago when Virginia Bottomley was the Health Secretary.
Oh So True
I've only heard 2nd hand about the "MESS" and the moving goal posts "Fujistu" put in.
I can see what they are trying to achieve and possibly how it should be done..
But with all the multiple layers of information about each person it does get a bit more complex.
So anyone care to actually figure out how to solve it, data integrity & data security being priorities of course, although only part of the over all solution.
I mean don't we all have a unique NHS ID from Cradle to grave anyway, there is a start point.