Frectally speaking

The month of September saw two interesting developments in the worlds of healthcare, change and IT.

Firstly and not all together surprisingly the UK Goverment called time on the end of the NHS National Programme for IT,  with the Department of Health moving to accelerate the dismantling of the programme.

As I spent 5 years within the programme, this came as no surprise in the end, indeed it was interesting that it took so long for the recent change in government adminstration to come to this conclusion.

While some of the successes  of the programme have been recognised (N3 broadband network for the NH, PACS Picture Archiving and Communication System for radiology in the NHS), the very slow progress made within the acute hospital sector was one of the reasons that the programme came to this formal end.

Of note, the change in approach emphasised is worth highlighting …”we need to move on from a top down approach and instead provide information systems driven by local decision-making.  This is the only way to make sure we get value for money and that the modern NHS meets the needs of patients.”

What is less clear is what will change within the significant NHS IT contracts still agreed, yet the move towards local change and innovation is welcome. There has been an implicit move from connect all to replace all for some time now in NHS IT circles, yet this is predicated on the availability of usable health IT standards for interoperability such as the NHS Interoperability ToolKit.
Yet is been my experience that detailed standards are not enough on their own, so open source is a necessary part of the recipe.

On that theme, the beginnings of the new approach to Health IT developments by the US Veterans Adminstration and Department of Defenc took more shape during the same week in September. In this new joint effort they are taking a commendable user centred design approach to their next joint record.. the iEHR.

While they have just released an Request For Information, the related documentation gives a nice overview of their thinking on their future, including thinking on portal, a common user interface to their EHR, integration of legacy systems, an enterprise service bus and a common information model.. I’ve placed a copy of this paper here and related architecture slide here.