In a sign that U.S. President Barack Obama's push for e-health records could face significant technical roadblocks, U.K. authorities overseeing a similar effort have become so frustrated with the lack of progress that they're threatening to yank contracts from contractors tasked with implementing the $19 billion plan.
U.K. Department of Health CIO Christine Connelly said outsourcers working on the National Health Services' Program for IT must make significant progress on the effort by the end of November or face "alternative approaches," including the possible termination of contracts.
"At this point, we're not ruling anything out," Connelly said in an interview published Tuesday by the Financial Times.
Each vendor on the U.K. team is tasked with providing software and services for a specific "node" on the nationwide system. The plan includes a Care Records Service that will provide an electronic record of all of a patient's interactions with the health care system, accessible to doctors, pharmacists, nurses, and emergency personnel throughout the country. British Telecom is to build a central network, or spine, that will connect all of the nodes.
The contractors include BT, Computer Sciences Corp., Cerner, and iSoft. Fujitsu quit the project last year amid mounting losses on the project, which is four years behind schedule. The project has been plagued by delays caused by everything from software incompatibilities to resistance from U.K. physicians.
"These systems don't talk to each other," said Dr. Richard Vautrey, former head of the IT committee at the British Medical Association, a group that represents U.K. physicians, in a 2005 interview shortly after the project was launched. "It's proving very difficult to link all these systems in a meaningful way; you can't start to share information."
In the United States, meanwhile, Obama has said he wants all Americans' health records digitized by 2014. The hope is that e-records will reduce costs while speeding and improving patient care. It's also hoped that e-records will allow health officials to spot emerging outbreaks -- such as the current swine flu epidemic -- while they're still containable.
The United Kingdom's experience, while providing a valuable blueprint for the United States, also shows that such a problem can pose numerous management challenges and technical difficulties.
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