Posted by: Tony Shannon | January 14, 2011

An Information Revolution … for the NHS?

The National Health Service in England has been in existence for over 60 years now and is generally well regarded by the population that it serves.

My experience of the difficult transformation of emergency care in the NHS suggests that it delivers a very good service all free at the point of care. As the NHS has developed in recent years the importance of process improvement and information technology has been increasingly recognised .

Lean Thinking for the NHS highlights that the NHS has taken a leading position on process improvement internationally.

Equally the importance of information as an enabler of change in the NHS has been recognised for many years.
Back in 1998 the Information for Health paper heralded an increasing emphasis on Electronic Health Records.
This was followed in 2002 by  Delivering 21st Century IT support for the NHS: national Strategic programme which heralded the arrival of NHS Connecting for Health/National Programme for IT.

While the NHS may be amongst the international leaders in primary care informatics, progress has been much more difficult in the complex hospital sector. In this area, it has received considerable criticism for lack for progress and poor value for money.

So with a change of political administration has come some new thinking into the NHS.

The recent 2010 “Equity and excellence: Liberating the NHS” white paper has heralded major changes in NHS service delivery. This paper called for an Information Revolution in the NHS.

In recent months the “Liberating the NHS: An Information Revolution”  paper has been out to consultation.
The paper reiterates once more the critical role of information in improving healthcare.
The key paragraphs from the Executive Summary is;

Transforming the way information is collected, analysed and used by the NHS and adult social care services will be critical to achieving this information revolution. This Government is committed to moving:
-away from information belonging to the system, to information enabling patients and service users to be in clear control of their care;
-away from patients and service users merely receiving care, to patients and service users being active participants in their care;
-away from information based on administrative and technical needs, to information which is based on the patient or service user consultation and on good clinical and professional practice;
-away from top-down information collection, to a focus on meeting the needs of individuals and local communities;
-away from a culture in which information has been held close and recorded in forms that are difficult to compare, to one characterised by openness, transparency and comparability;
-away from the Government being the main provider of information about the quality of services to a range of organisations being able to offer service information to a variety of audiences; and
-in relation to digital technologies, away from an approach where we expect every organisation to use the same system, to one where we connect and join up systems.

It goes on to explain that key to success will be standardised records and interoperability.
While the strategy is ambitious and well meaning, the means of achieving these aims is missing while out to consultation.

One of the key questions (and related responses) in the consultation exercise was;

Question 4: Given the current financial climate, how can the ambitions set out in this consultation- to make better use of information and technology to help drive better care and better outcomes – be delivered in the most effective and efficient way?

Our reply ..(on behalf of Leeds Teaching Hospitals)
“Given the current financial climate, the clear solution lies in the Jan 2010 “Government ICT strategy; Smarter, Greener, Cheaper.”
This well developed strategy outlines an Open Source, Open Standards and Reuse Action Plan and the DH should explain how the NHS will address this important plan.
The international progress of open source software relates to its ability to offer a collaborative approach to tackling diverse and complex challenges. The ongoing challenge of reconciling international and national standards with local innovation could be tackled with greater use of open source software and collaboration across the NHS.
Leeds Teaching Hospitals is piloting a related approach.

While most/all healthcare systems are working to improve with information supporting and driving those changes,  given the economic climate that prevails, there has never been a better time/greater need for increased collaboration in the health IT field.

In response to this change in landscape,  the early work of an eHealth Open Source EcoSystem is steadily getting under way..


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