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NHS IT: A plan for the future

We all know what a mess the NHS IT project is in. Billions overspent; one of the major partners currently being investigated by the FSA for suspected “accounting irregularities”; another announcing a profit drop due to the project and then subsequently pulling out. Most recently the government has threatened to scrap the agency in charge of the project". So much, so known, and yet nothing seems to be being done publicly to fix the project. The press pundits complain about a waste of tax payers’ money and typical government IT project cock ups but I haven’t yet seen anyone put forward a plan to fix it.

In the past, back when the NHS IT project was but a glimmer in the eye of the various consultants that persuaded governments that monolithic IT solutions were The Way Forward I spent a time talking to doctors about their requirements. Here is what I learnt: before government woke up to the enabling aspects of technology the Doctors realised pretty quickly that they could make their surgeries far more efficient. They either looked at off the shelf packages or talked to developers for more bespoke solutions. The Doctors got systems that they and their staff liked with user interfaces that they then got used to over many years. Generally the systems worked the way that they wanted and had specified. Unfortunately the systems didn’t work well with each other and were not compatible with the systems that hospitals and other NHS resources had.

So, how to rectify this situation? I am a great believer in loosely coupled systems which offer many advantages. At this point in the NHS IT Project the large collection of different software platforms that existed should have been seen as building blocks, not a hindrance.

In 2000 Tony decided that the UK should become the best country in the world for e-commerce. This seeded some ideas in my head about how these sorts of large government projects should look. Rather than creating large, monolithic and effectively unmanageable projects, why not ask some technical experts (say, the W3C) about data transfer technologies and then set up a working committee to look at a resilient and extensible data standard for transferring data between medical systems?

Once this standard is produced all government needs to do is mandate its use across all NHS platforms. You keep a free market in software; doctors, nurses, physiotherapists, hospitals, you name it, all get to use the software that they want to use, rather than software that is forced upon them which requires vast swathes of tax payer’s cash as well as retraining. The more technical able would even be able to write their own applications. You also get the benefit of then having created a standard that medical systems can use across the world. Imagine how useful it would be, in the modern travel hungry world, if doctors in foreign countries being able to find out about your medical history if you are unable to communicate it to them for what ever reason.

There are obvious hurdles here but none of them are insurmountable, and a few of them are solved problems in other industries. Here are some of the challenges that this would face off the top of my head:

  • Data Security
  • Authentication and Access Rights
  • Data location
  • Data synchronisation
  • Data redundancy

IT these days should be about enabling people to improve how they and the processes that they interact with work. Lets work towards that in the most flexible way possible.

Published on 2006/11/08 at 15:30 by Toby, tags , , , ,

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