Re: Coronavirus
There isn’t a "system", there are multiple Primary Care (GP) systems, and numerous different systems in Hospitals and Secondary Care areas.
https://assets.publishing.service.go...Accessible.pdf
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Computerisation and the NHS
Of course, computerisation is not new to the NHS and its associated primary care practices. In fact the GP sector is nearly 100% digitised, and both patients and healthcare professionals experience its benefits tens of thousands of times each day. NHS Choices, a comprehensive health information site, receives more than 40 million patient visits each month. Moreover, the UK has established some internationally renowned research programmes, such as the UK Biobank and the 100,000 Genomes Project, whose potential to improve care is tightly linked to their integration with clinical information systems, both for data collection and to support clinical decision making at the point
of care.
In contrast to the successes in the GP sector, the digitisation of hospitals has been far from smooth, and the patchy computerisation of this sector stands as a considerable impediment to transforming care. The ambitious National Programme for Information Technology (NPfIT), designed to digitise hospitals and trusts, was launched in 2002, only to be shut down nine years later (5). NPfIT did enjoy some successes, including the development of a national infrastructure to provide core services (the Spine); a single national patient identifier (the NHS number); and national electronic prescription and radiology programmes. But, against its primary goal of digitising the secondary care sector, NPfIT failed to deliver – largely because it was too centralised, failed to engage properly with trusts and their healthcare professionals, and tried to accomplish too much too quickly.
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digitising large, complex organisations – particularly those, like healthcare, that do not involve repetitive, assembly line-type work but rather work with substantial complexity, nuance, and decision making under uncertainty – is adaptive change of the highest order. Failure to appreciate this leads to many of the other problems: underestimation of the cost, complexity, and time needed for implementation; failure to ensure the engagement and involvement of front-line workers; and inadequate skill mix. It is thus not surprising that many health IT implementations fail, not only in England but around the world.
Since efforts to computerise a single organisation (a hospital, for instance) often fail, it is unsurprising that NPfIT – an attempt to digitise an entire sector of a massive healthcare system, operating in a resource- constrained and politicised environment – proved far more difficult than anticipated. As we try again to digitise the secondary care sector of the NHS, the question is how to learn from the lessons of NPfIT, as well as those of other countries that have traversed this path, particularly the US. Finally, there is a success story to point to: the digitisation of England’s GP sector.
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tl:dr - the NHS (and it’s systems) isn’t a huge homogeneous monolithic business, it’s a conglomeration of hundreds/thousands smaller organisations, each of which has developed its own processes & systems over the last 70 odd years.
tl:dr even more - there isn’t a simple solution to a very complex problem |
