Here we go again: New NHS patient database plan sets off alarm bells
Health Sec Hunt wants your records in the cloud by 2018
A paperless NHS that stores patient records in the cloud will be floated by Health Secretary Jeremy Hunt today. His plan to get medical files into a giant database by 2018 is already stoking fears given the public sector's poor record of protecting sensitive information.
Hunt will claim in a speech to right-wing think tank Policy Exchange in London tonight that billions of taxpayers' pounds will be saved by eventually shifting records into cloud-based systems. He'll also insist healthcare services will be improved as a result.
He said in a statement issued by the Department of Health:
The NHS cannot be the last man standing as the rest of the economy embraces the technology revolution.
It is crazy that ambulance drivers cannot access a full medical history of someone they are picking up in an emergency – and that GPs and hospitals still struggle to share digital records.
Previous attempts to crack this became a top down project akin to building an aircraft carrier. We need to learn those lessons - and in particular avoid the pitfalls of a hugely complex, centrally specified approach.
The cabinet minister is expected to set a deadline of 12 months for hospitals to get their patients' records onto computers to allow that data to be shared with GPs and clinics across England and Wales.
PricewaterhouseCoopers published a report, commissioned by the Department of Health to coincide with Hunt's speech, that highlights the apparent benefits of making better use of technology: it estimated that £4.4bn from the public purse could be saved each year and funnelled into improving the healthcare system.
It claimed that measures such as sending text messages to inform people of negative medical test results, electronic prescribing of medicine and digital patient records will help cut NHS costs.
Hunt admitted that trust needed to be built with the British public, which remains dubious about the data-handling abilities of the NHS and other government services after a string of gaffes that leaked citizens' personal information. And the last attempt at a nationwide patient database turned into a multi-billion-pound fiasco.
Privacy campaigners have already questioned Hunt's plans.
"The Department of Health needs to be absolutely clear who will hold our medical records, who can access them and reassure patients that their privacy will not be destroyed in another NHS IT blunder," said Nick Pickles of Big Brother Watch.
"Detail on how patients will give their consent, who will have access and what rights patients will have after sharing is sparse."
As noted by computer security expert Ross Anderson, this isn't the first time Whitehall has pushed for the sharing of health records throughout the NHS.
"This is about the fourth time in 20 years yet its ferocity has taken doctors by surprise," wrote Anderson in a blog post. ®
cloudy flexibility meets touchy-feely
> a top down project akin to building an aircraft carrier
The first step should be to kick all the IT people off this project. Stop thinking of it as a computer to help medical people and start thinking about what those people want to do. Then apply the least amount of technology that will meet the needs of the users.
Most people in the caring professions are there because they are drawn to the personal interaction with patients, they want to do tangible stuff (like sticking on plasters) that makes people better. The ones I have met do not want to spend their days as data-entry clerks, although last time an aged relative was admitted three different members of the nursing staff sat with AR at various times during the day and wrote down on paper pretty much the same information - most of which we could have done while sitting in the waiting room, waiting to be called in.
So if this project is going to be a success - and the odds don't seem to be in its favour - the starting point must be to create a system around the way the medical staff like, or choose, to work and to make THAT JOB easier. If it starts from an IT perspective of "let's give these people new practices and procedures that will make them more productive" than it will get sidelined and ignored, just like the previous failures.
Re: The NHS and electronic patient records...
<Warning: Informed comment>
The thing is, virtually every GP practice has had electronic patient records for ages courtesy of EMIS LV (google it) even if they don't know what electronic patient records are. These records can also interoperate with a wide variety of medical software which lets the average GP practice interoperate with everybody else using software that accepts open data formats.
Having worked for the NHS at a county level, I can say that >80% of surgeries in my county are using EMIS. (it used to be >90% before generous bribes, (ahem incentives, of course) were offered to practices to switch away from it. Those that were using the government recommended solutions generated more support issues than all of the others put together, because EMIS is simply a lot better written and fault tolerant than the competition. Doctors know this quite well since they all meet up occasionally, which is why you'll pry EMIS out of their cold dead hands.
You can't force GP's to use something more useless, because they are and always have been independent for profit businesses. (screaming about privitising the NHS always somehow glosses over that little fact!)
My solution? Specify one set of open interchange formats for medical businesses and declare job done. GP's could swap electronic records 20 years ago via modem, so where is the problem?
The problem only exists at the NHS PCT level. Why? IMO: political interference in operation decisions. Your opinion might differ.
Re: cloudy flexibility meets touchy-feely
More importantly, ban all non-IT professionals from making any IT related decisions. This is the fundamental source of the problem.
Those that can - do. Those that can't - teach. Those that can't teach - administrate. Those that can't administrate - go into politics - so they can tell all the others how to do, teach and administrate. Madness.