Rocky road ahead for plans to shake up healthcare IT, say doctors and tech groups...
Plans to give NHS patients widespread access to electronic health records will not be realised without major changes to health technology, doctors and IT groups have warned.
The government has collected a wide range of views on plans to overhaul NHS technology outlined in its Liberating the NHS: An Information Revolution consultation document, one of a series of documents published by the Department of Health in the wake of the Equity and Excellence: Liberating the NHS white paper.
The Information Revolution paper sets out plans to make electronic health records available to all NHS patients, put standards in place to allow hospitals and GPs to share electronic information, make healthcare more accessible through telehealth and email, and standardise and strengthen data collection and generation to improve standards of care.
But while the goals behind the plans have been broadly welcomed, medical and technology groups have responded to the consultation by warning the Department of Health that significant technological and practical considerations need to be overcome.
Key among the warnings was the message from doctors' body, the British Medical Association (BMA), which said: "A large proportion of NHS organisations do not have IT systems in place to realise the vision set out in the consultation document, despite a sizeable investment by the previous government."
It cautions against attempting to implement the same IT systems in health trusts nationwide, citing the years of delays that have plagued attempts to introduce new hospital Cerner Millennium and iSoft Lorenzo patient administration systems under the National Programme for IT.
"Delivering electronic patient systems in secondary care has been extremely challenging and problems delivering the Lorenzo and Millennium systems have been widely reported," it said.
"To deliver the information revolution in the most cost-effective and efficient way, it will be necessary to build on what is available and continue investment in what is working well, minimise duplication and ensure lessons are learnt to prevent repeated costly mistakes."
The BMA goes on to suggest that local health trusts should be able to choose from a variety of suppliers and systems to maximise competition and minimise cost.
It adds that while releasing electronic copies of health records to patients could improve record accuracy and patient understanding of their care, it will be important to protect the quality and privacy of those records.
The BMA also raises concerns that...
...making doctors more accessible via means such as email may result in a "deluge of communication" that "may divert clinicians away from seeing patients."
The BCS, the chartered institute for IT, also stresses the need to invest in electronic healthcare, stating that "all organisations providing care to the NHS should be given notice that they will be expected to be using an electronic patient record in a meaningful way within five years."
The BCS is also keen to move away from the NPfIT model of local IT infrastructure delivery, which has ended up relying on just two main suppliers, saying there is a need to "take rapid steps to reintroduce competition into the NHS supplier market."
To ensure health bodies can share information easily, the BCS says NHS trusts must be subjected to a "rigorous enforcement of standards" by a central body.
Intellect, the UK's technology trade association, suggests NHS trusts that have successfully implemented health systems - ranging from e-prescribing to telehealth - should provide delivery and operational models for other trusts to follow.
The Royal College of Nursing (RCN) expressed concerns that nurses do not have the required level of IT skills and access to computer equipment needed to support the aims of the Information Revolution document.
It also states that nursing staff must be involved in the development of electronic record systems, to ensure records contain the information needed to support nursing.
Security was also a worry for the RCN, with its response stating that fewer than half - 49 per cent - of nursing staff surveyed by the body feel that electronic records are more secure than paper-based ones.
The consultation on the Information Revolution paper is now closed and the government will publish how it intends to put the plans into effect at a future date.