Once again, the same policy goals are being revived: increased efficiency, the need to take advantage of the same kind of benefits other industries are gaining from technology, greater transparency of patient data, more integrated care and so on. What's different is there's not even a whisper of any money on how to do all this. Instead, the relevant politico, Jeremy Hunt, Health Secretary in Her Majesty's Government, is framing it as a "challenge" he expects the National Health Service (NHS) to take on board.
The NHS is a huge organization -- it has 1.7 million people on its payroll, treats three million patients each week, and had a 2011-12 budget of $170 billion (£106 billion) -- that already faces its share of challenges. It is undergoing a complex internal re-organization and is already mandated to find $32 billion (£20 billion) cost savings through efficiency by 2015. It also already has had its fingers burnt by hugely costly attempts to roll out a national electronic patient record that has barely delivered working systems to any sites 10 years after the program started. As a result, enthusiasm for the Minister's latest grand vision so far has proven muted.
[ One medical record expert's opinion: 'Not One Successful EHR System In Whole World.' ]
Nevertheless in a speech recently given to a right-of-center think tank, Hunt lay out what he sees as holding the NHS back. "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 … Only with world-class information systems will the NHS deliver world-class care."
The Minister says the kind of systems he'd like to see include the very electronic patient records that have so far proven so elusive to deliver. By March 2015, he promises, citizens will have online access to their health records, while by 2018 all crucial health information should be available to staff online where needed, too, so that different professionals involved in one person's care can start to share information easily and safely.
Hunt's argument is supported by a report from consultancy PwC that says there are great potential benefits from smarter use of tech in Britain's hospitals, such as more use of SMS for negative test results. If electronic prescribing and electronic patient records were introduced properly, they could improve care, allow health professionals to spend more time with patients, and save upwards of £4.4 billion ($7.1 billion), according to the report.
Veterans of the IT scene can't help but issue a collective sigh of frustration. Yes, this is all true. The problem is that the vast NHS struggled and failed to get on board with tech last time round under New Labor when money was free; how can it manage to meet any of these goals this time, in an era of cost containment and when serious questions are being raised about its basic design? One of those design flaws, experts say, is that too much emphasis is being put on care of acute conditions in a society which seems to be moving to dealing with more long-term, chronic issues in an older, fatter world.
Hunt believes the problem is that when this was last attempted, it was all top-down; the answer is to reform bottom-up, working on local success and sharing best practice: "Previous attempts to crack this became a top down project akin to building an aircraft carrier," he said. "We need to learn those lessons -- and in particular avoid the pitfalls of a hugely complex, centrally specified approach."
Hunt's goals clearly align with the current government, which spoke on its election to power in 2010 of an information revolution for the NHS designed to boost patients' choices and raise the quality of the treatment they get.
Whether the plan has any ultimate credibility -- or funding -- remains to be seen.
Clinical, patient engagement, and consumer apps promise to re-energize healthcare. Also in the new, all-digital Mobile Power issue of InformationWeek Healthcare: Comparative effectiveness research taps the IT toolbox to compare treatments to determine which ones are most effective. (Free registration required.)