Hope for a new partnership in health and care IT

Bob Wachter - a leading physician from the USA - is today presenting his recommendations for the digital future of the NHS in England.

I spent an hour talking to Bob about what he believes is necessary for us to see real benefit from information and technology in health.

Bob's interest in health and information stems from his experience as a physician in the hospital environment. This led to a major exercise in the study of, not only what can go right and wrong in introducing tech into hospitals, but also how other sectors handle similar problems.

Having undertaken that journey, he was well-placed to provide a viewpoint on how we can improve in the UK.

It's important that we maintain a sense of perspective and truth. It has been an incredibly traumatic couple of decades in the English part of the NHS. The National Programme for IT (NPfIT) did deliver, in some ways, but the wounds it inflicted on relationships and on collective confidence are not yet healed.

Bob's judgement on this was pragmatic but harsh: this not only failed to deliver but has made us fear trying.

What's interesting - and encouraging - about Bob's attitude is that he is very clear about the risks and pain of introducing technology, yet he is still a purveyor of hope. It will be difficult, but it is too important to avoid.

Government policy is only one element of what's necessary; Bob was very clear that successful change requires partnerships. Everyone involved in delivering care: clinical professionals, technologists, record managers, and organisational leadership all need to work together, sharing goals and understanding.

These partnerships - at all levels - are what's going to make it different this time. They will make it work for patients, for people, and for those that provide for all of us.

This is not, in practice, something that can be delivered by the Department of Health. Government must be as much a partner as every other element.

The partnerships need to be at the coalface where care is delivered. That's why the endeavours to found clinical and technical partnerships, and to support a new cadre who bridge both, are so important. This will only work if people step outside their professional and organisational silos and comfort zones. And they must do so with a sense of hope and with a shared purpose.

Having observed more than a decade of NHS IT misery, I'm used to half-baked ideas and delivery that won't deliver. There is no law that states that any good in the Wachter report cannot be transduced into another round of misery.

However, what I took away from my discussion with Bob is a strong belief that things can be different this time. That’s because there’s an open door for professional communities to make it different.

Bob himself reminds me of some of the well-motivated and determined people who are assembling in places like: BCS, the Chartered Institute of Library and Information Professionals (CILIP), Institute for Health Record and Information Management (IHRIM), the Society of Information Technology Management (SOCITM), and in the Faculty of Clinical Informatics - people who want the right thing to happen and aren't willing to tolerate failures that are a consequence of inaction.

There is hope and an open door. What more do we need to get started down a different, better path? Everything else is simply detail...

Comments (2)

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  • 1
    Dr Richard Turner wrote on 15th Sep 2016

    In America every item of data is financially relevant and is therefore properly logged, classified, coded, and analysed at great expense. This is just not the case over here so American experience should be treated with enormous caution.

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  • 2
    Matt Durcan wrote on 15th Sep 2016

    Your comment may have factual merit - but:
    1. Free at point of need doesn't mean free, and there is a real moral, financial and operational need to account for public money
    2. Isn't it rather sad that accuracy of data may be driven more by financial relevance than patient need - don't patients gain enormously by correct data?
    So I do take your point, but I fear we no longer have the luxury of acknowledging it.

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Thoughts on membership, the profession, and the occasional pseudo-random topic from the BCS Policy and Community Director.

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November 2017