Abandoned Nhs It System Has Cost £10Bn So Far

[ChumpusRex]

So I can enter just part of a 12-digit identifier into Google, and fractions of a second later be reading the datasheets (scanned) of a part that was made in small numbers in a foreign country years ago? Sorry, I don't understand just what was so difficult about scan - OCR where possible - use a decent search engine method, at least as a stop gap.

I've just been through this - sitting with a bewildered doctor because he can't find my notes which were in his department's possession just two days before.

Even identifying a patient is not easy.

You can't use NI numbers, they're not unique, and the eligibilty criteria for an NI number do not cover everyone that needs NHS care.

You can't use NHS numbers, because they're not universal; they don't cover non UK residents (tourists, people needing care unavailable in their home country/region - e.g. Channel Islands, Isle of Man, Malta, Cyprus).

Different hospitals have different individual methods of case record numbering, so they're not unique.

You can't reliably use name, as there are too many same name people.

You can't reliably use name and DOB, as there are large population groups where many people have the same name and dates of birth are not usually known or recorded (e.g. many immigrants, certain parts of rural Wales)

Addresses are too inconsistently entered and too many people move around too often for name, address and DOB together to be reliable, not to mention inconvenient for staff to use as a primary identifier.

How do you deal with people who don't know how to spell their names, or use multiple spellings? Very common in immigrant communities where the name is transliterated from a non roman alphabet.

What about other systems?

Clients of the breast screening service are not "patients", so breast screening records are kept separately, in different recording systems with different identification systems. (A political requirement to avoid "over-medicalisation").

Similar issues exist with sexual health clinics, who often do not identify patients even by name. What happens if they suffer a complication of their illness in a different part of the country?

Even once you've solved the ID problem, how do you implement it?

Healthcare IT systems have been installed in a relatively haphazard way, with products that suit a particular institution's needs at a particular time. Typically, there will be a spearate system for each department and a global hospital information system, which is the master demographic database and appointment list for the hospital. Somehow, laboratory system from vendor B is connected to HIS from vendor A, but the lab upgrades to vendor C's system, but in the meantime HIS vendor A has gone out of business and the system is unsupported, so cannot be interfaced to C. A third party middle ware company, D, is contracted to interface C to A and at the same time builds in an additional function to have the dialysis unit's information system from vendor E to auto-sync with the lab system. No fast forward 5 years, when the middleware company has gone out of business, and various systems need upgrade or replacement.

The big problem is how do you keep such a system working, while changing the way of identifying patients, and how do you get the data from these mixed systems into a consistent format. There's no way to guarantee that vendor E's dialysis record system stores the same data as vendor F's dialysis record system.

If you want to replace the system outright, then you have a huge amount of functionality to replicate. If you want to do it piece wise, the system is very fragile, every site is different, and almost invariably has all sorts of custom-made middle-ware to hold the various IT systems together, much of it unsupported.

When you start to connect between sites, things rapidly get even harder. How do you aggregate records held with different numbering systems, if neither system supports having multiple number schemes? If you're designing region-wide internal numbering systems, then how do you manage them? How do you safely merge details, so that the manual workload is feasible, but the risk of incorrect or missed automated matches is low? How do you do this if different sites have held names and addresses in a different format? Should Site A, case number 123456, Miss Jane P Smith, 1/1/1985, Apartment 23 Dungeness mansions, Corgi road, London, NW3 1AA be automatically matched to site B's case number A763KFG, Ms Jane Penelope Fitzsimmons-Smith, 1/1/1985, Flat 23, 24 Corgi road, Hampstead, London NW3 1AA?

Of course, the easy projects have got off the ground and DO work. There is a national summary care record, and it does work; although there was a very aggressive "opt-out" campaign by various privacy protesters. This is a database, keyed on NHS number, which holds a limited set of data; diagnoses, last prescription, allergies and other important notes, current specialists, brief information about the attendance, etc. GPs have heavily embraced this, and most hospitals will submit some information to the SCR at discharge, with many GP IT systems automatically updating prescription information with the SCR when a new prescription is issued. A&E and other front line staff can search and obtain the summary record rapidly, should they need it.

The problem with the SCR is that it is a separate system and interfacing with existing systems is limited; it's worked reasonably well for GPs, as the number of GP IT solutions is limited, and most vendors have been able to deliver working interfaces. It's rather different in hospital care; if hospitals do update it, it's often done by a junior secretary or clerk, when the clinic record is sent to the GP; the quality of the data it contains is therefore somewhat variable.

Don't even get me started on the absurd confidentiality in access restrictions that people tried to put in place. However, to cut a long story short, access restrictions were to be put in place nationally. Login credentials were managed nationally, and access to every single software function had to be restricted according to role profile. These people had no idea what they were doing. If a doctor's smartcard expired, there would be no warning, it would just stop working due to an "unknown error". No one on site could deal with the credentials. Instead the doctor would have to travel to a "credentials clinic" held in a nearby city once a week, and turn up in person with 3 sets of picture ID and a current contract of employment, before the smart card credentials could be renewed. You can imagine how well that worked. Of course, no one would dream of borrowing someone else's smart card in that scenario.

Of course, that's not where it stopped. Every software tool was restricted according to the job description. So, for example if a doctor wanted to examine an X-ray using the X-ray vieweing software, but wanted to enhance the contrast, they couldn't do it. Someone in an office somewhere had decided that contrast enhancement was a system admin role only, and that was that. The local hospital could not override the premissions, except by requesting a different role (and the only role that could use the contrast tool was system admin). The national office would not offer a patch or hotfix; we had to wait for the next annual role update - really!

Edited September 20, 2013 by ChumpusRex

[Bloo Loo]

Chumpus illustrates that the IT scheme is proposed to run before it can even crawl.

The person to collect info from is the patient...He will know where his doctor is..If he doesnt, he'll have to wait for tests.

In my recent accident, there were 3 or 4 pages filled in from questions I answered...nothing was delayed through not having access to my records...The xray appeared at my surgery a few days later.

really, I think the problem they were trying solve had little to do with patient records, more like the ability to have a central track of the bills he is running up and a way to allocate them to the GP responsible.

[tomandlu]

Even identifying a patient is not easy.

...

Can every one still bitching about "I don't understand what the problem is" please read the above?

[MarkG]

Can every one still bitching about "I don't understand what the problem is" please read the above?

So what's the problem?

Oh, that the NHS want to centralize storage of all the data, rather than let people keep their own data. No-one needs to 'identify' me, if I'm the one showing them my data.

The idea of a bloated, centralized database is absurd in an era where most people carry hardware in their pocket more powerful than a 1980s supercomputer.

Edited September 21, 2013 by MarkG

[tomandlu]

So what's the problem?

Oh, that the NHS want to centralize storage of all the data, rather than let people keep their own data. No-one needs to 'identify' me, if I'm the one showing them my data.

The idea of a bloated, centralized database is absurd in an era where most people carry hardware in their pocket more powerful than a 1980s supercomputer.

Even in your scenario, they'd still have to interface with some application to collect new data and store it in a meaningful way. This application in turn would need to interface with all the other applications that are collecting and storing the data in the first place. The problem isn't storing the data - it's moving it around and keeping its context.

Take a look at a typical web-form (here's a very simple one Sample_web_form.png) - would just grabbing the data you've entered mean anything, or do you need the labels to give it context? Imagine that repeated, with each hospital running multiple applications, and each application consisting of multiple screens, often of great complexity.

[Bloo Loo]

Even in your scenario, they'd still have to interface with some application to collect new data and store it in a meaningful way. This application in turn would need to interface with all the other applications that are collecting and storing the data in the first place. The problem isn't storing the data - it's moving it around and keeping its context.

Take a look at a typical web-form (here's a very simple one Sample_web_form.png) - would just grabbing the data you've entered mean anything, or do you need the labels to give it context? Imagine that repeated, with each hospital running multiple applications, and each application consisting of multiple screens, often of great complexity.

this is the issue...give tomandlu a problem, he will ITify it...if you were a carpenter, youd want to hit it with a hammer and build a nice wooden bookcase for it.

The key is as above..the end user holds the data, and gives it to his GP..Paper is ideal for this process. It is easily marked, it needs no special reader, it can be moved and filed. If some parts are stored electronically, the NEW Unique ID can be referenced on the paper..in several places if need be...If there are multifarious other references, they can also be added to the paper host.

[tomandlu]

this is the issue...give tomandlu a problem, he will ITify it...if you were a carpenter, youd want to hit it with a hammer and build a nice wooden bookcase for it.

The key is as above..the end user holds the data, and gives it to his GP..Paper is ideal for this process. It is easily marked, it needs no special reader, it can be moved and filed. If some parts are stored electronically, the NEW Unique ID can be referenced on the paper..in several places if need be...If there are multifarious other references, they can also be added to the paper host.

Please bear in mind that my solution to this problem was not to try in the first place. As for patients having more control over their medical notes, I fully agree. That aside, you're still trying to sneak in a new unique ID, which really isn't a trivial matter.

It's not all doom and gloom - there are some excellent hospital applications out there, some of which have been developed by clinical staff, some of which have been developed by outside companies. Unfortunately, the failure of this project tends to attract more attention and give the impression that IT hasn't been useful.

[WorkingForTheMan]

I think ChumpusRex has hit the nail on the head regards the complexity of the existing system (saying everything I wanted to say but couldn't be bothered).

MarkG may well be onto something though.perhaps we could all be our own database. Hmmmm...Not gonna happen though..

[WorkingForTheMan]

really, I think the problem they were trying solve had little to do with patient records, more like the ability to have a central track of the bills he is running up and a way to allocate them to the GP responsible.

That billing system you speak of is called payment by results. It actually works well and has done for years. Hideously complex and expensive though..

The big problem that needs solving is patient identification and medical histories, which as we have determined, is a long way off..

[rxe]

The key is as above..the end user holds the data, and gives it to his GP..Paper is ideal for this process. It is easily marked, it needs no special reader, it can be moved and filed. If some parts are stored electronically, the NEW Unique ID can be referenced on the paper..in several places if need be...If there are multifarious other references, they can also be added to the paper host.

Sorry, but this is so far off the mark it is funny.

Paper is a real problem. There are huge classes of patient for which it is not at all appropriate to give them paper records - the mentally ill, the "not very bright", the careless, the senile .... the list goes on. Unless you happen to have your wodge of paper on you when you get pulled off the road and into a hospital, then none of your information is available to the doctors treating you. Hospitals literally spend millions managing paper - simply the logistics of warehouses and people scurrying around looking for paper/X-ray films, whatever. Lots of chunks of medical data don't really work on paper - a CT scan is of marginal use when printed out, and it is also very big. So it will be a load of paper and a fistful of CDs at the very least.

The other problem is increasing specialisation of tertiary care. For certain conditions, there are only a handful of centres who can treat it. You need to travel to them, and so do your notes - reliably. The doctors at these centres need to see all of your imaging, immediately, regardless of where it was taken, or you have to be imaged again. If you're treating someone with cancer, you will need to see images from every scan they've had in the last 5 years, and they will have had a lot, possibly all over the country. If you have to wait 6 weeks for the hard copy to show up, the patient will probably have died in the meantime. Of course you could argue that this is exactly what has happened in for the last 30 years, and why change it. Mainly it is because people's expectations of care have changed: in the 80s, if you got liver cancer, you were toast. Now, if you're quick, and can get the data in front of the right people quickly, it is operable in many cases.

The old system of GP + local hospital + paper worked fine in the old days, because that was all you had. The outcomes were an awful lot worse though.

[AvoidDebt]

Can we not sell it to Qatar?

Seriously, that's not a joke. The technology is pukkka and many of the technical issues outlined here: identification, security, character sets, big data have been long resolved. 70 million records with around 2.5 billion updates per year, that's easily doable in a fast and secure manner. The problem is dislodging the existing infrastructure that has been laid down over the past four decades. There are already 100's of suppliers providing IT systems to the NHS trusts. In order to replace with a central system you would need to either go down to the trusts with a kosh and dictate exactly which system they could use (obviously the one the government is developing) or lay down protocols that would allow all the other suppliers to interface with. I believe this is what happens with SPINE and associated services. Plus we've got all the legal issues around ensuring that we do not break any competition laws. Qatar would be the perfect testing ground for this: oodles of cash, small population, very much still in development mode; these grandiose technology schemes are actually easier to implement in the developing world as they can 'technology-hop' plus there is very little existing infrastructure that needs dislodging. Plus they have an authoritarian government that wouldn't be afraid to pinup a doctor against the wall and say: "I don't give a crap about that access database you developed, from Monday you will use this system or lose your licence, got it?". Much better than wasting money on consultants.

I suggest that we send in the original architect of this disaster Tony Blair with a couple of our finest consultants from the likes of KPMG and Accenture and sell this to the Qataris and recuperate some costs.

When Bill met Tony, seeds of a grandiose scheme were sown

http://www.theguardi...health.politics

Edited September 21, 2013 by AvoidDebt

[Habeas Domus]

When Bill met Tony, seeds of a grandiose scheme were sown

http://www.theguardi...health.politics

Actually the Microsoft involvement in the CFH scheme was to develop a common user interface (CUI) - a lot of usability design & testing with proven payback in terms of lower user error when entering data.

Unfortunately as far as I know not a single supplier chose to implement any part of the CUI standard, so that was £40 million of taxpayers money straight down the plughole.

Microsoft did some very good work on CUI, but it's now almost a textbook example of "not invented here" syndrome. When it became clear the standard wasn't being taken up Microsoft published the whole thing on the internet in the hope someone might pick up the ball.

NHS version: http://www.cui.nhs.uk/Pages/NHSCommonUserInterface.aspx

Microsoft (open access) version: http://www.mscui.net/

[Bloo Loo]

Sorry, but this is so far off the mark it is funny.

Paper is a real problem. There are huge classes of patient for which it is not at all appropriate to give them paper records - the mentally ill, the "not very bright", the careless, the senile .... the list goes on. Unless you happen to have your wodge of paper on you when you get pulled off the road and into a hospital, then none of your information is available to the doctors treating you. Hospitals literally spend millions managing paper - simply the logistics of warehouses and people scurrying around looking for paper/X-ray films, whatever. Lots of chunks of medical data don't really work on paper - a CT scan is of marginal use when printed out, and it is also very big. So it will be a load of paper and a fistful of CDs at the very least.

The other problem is increasing specialisation of tertiary care. For certain conditions, there are only a handful of centres who can treat it. You need to travel to them, and so do your notes - reliably. The doctors at these centres need to see all of your imaging, immediately, regardless of where it was taken, or you have to be imaged again. If you're treating someone with cancer, you will need to see images from every scan they've had in the last 5 years, and they will have had a lot, possibly all over the country. If you have to wait 6 weeks for the hard copy to show up, the patient will probably have died in the meantime. Of course you could argue that this is exactly what has happened in for the last 30 years, and why change it. Mainly it is because people's expectations of care have changed: in the 80s, if you got liver cancer, you were toast. Now, if you're quick, and can get the data in front of the right people quickly, it is operable in many cases.

The old system of GP + local hospital + paper worked fine in the old days, because that was all you had. The outcomes were an awful lot worse though.

Im not sure where you get this from..we all have paper records already...we keep them with our GPs generally.

The system does work, trying to streamline it with the expectation we will see instant results like they do on Star trek is the problem.

The same thing will have happened with the ID card computer system...gridlock in minutes and a system that could never work until reality was taken into account.

My gp got my xrays the day after they requested them.

[Lagarde's Drift]

Yes, primary care has been there for ages. Your GP's notes about you, with your blood results, xray reports and hospital clinic letters have been computerised for years.

Some parts of secondary care have also undergone this process. It's the difficulty of integrating / replacing all these systems , with a dose of corruption and inefficiency that has made this the flop it is.

[corevalue]

Even identifying a patient is not easy.

You can't use NI numbers, they're not unique, and the eligibilty criteria for an NI number do not cover everyone that needs NHS care.

You can't use NHS numbers, because they're not universal; they don't cover non UK residents (tourists, people needing care unavailable in their home country/region - e.g. Channel Islands, Isle of Man, Malta, Cyprus).

Different hospitals have different individual methods of case record numbering, so they're not unique.

You can't reliably use name, as there are too many same name people.

You can't reliably use name and DOB, as there are large population groups where many people have the same name and dates of birth are not usually known or recorded (e.g. many immigrants, certain parts of rural Wales)

Addresses are too inconsistently entered and too many people move around too often for name, address and DOB together to be reliable, not to mention inconvenient for staff to use as a primary identifier.

How do you deal with people who don't know how to spell their names, or use multiple spellings? Very common in immigrant communities where the name is transliterated from a non roman alphabet.

What about other systems?

Clients of the breast screening service are not "patients", so breast screening records are kept separately, in different recording systems with different identification systems. (A political requirement to avoid "over-medicalisation").

Similar issues exist with sexual health clinics, who often do not identify patients even by name. What happens if they suffer a complication of their illness in a different part of the country?

Even once you've solved the ID problem, how do you implement it?

Healthcare IT systems have been installed in a relatively haphazard way, with products that suit a particular institution's needs at a particular time. Typically, there will be a spearate system for each department and a global hospital information system, which is the master demographic database and appointment list for the hospital. Somehow, laboratory system from vendor B is connected to HIS from vendor A, but the lab upgrades to vendor C's system, but in the meantime HIS vendor A has gone out of business and the system is unsupported, so cannot be interfaced to C. A third party middle ware company, D, is contracted to interface C to A and at the same time builds in an additional function to have the dialysis unit's information system from vendor E to auto-sync with the lab system. No fast forward 5 years, when the middleware company has gone out of business, and various systems need upgrade or replacement.

The big problem is how do you keep such a system working, while changing the way of identifying patients, and how do you get the data from these mixed systems into a consistent format. There's no way to guarantee that vendor E's dialysis record system stores the same data as vendor F's dialysis record system.

If you want to replace the system outright, then you have a huge amount of functionality to replicate. If you want to do it piece wise, the system is very fragile, every site is different, and almost invariably has all sorts of custom-made middle-ware to hold the various IT systems together, much of it unsupported.

When you start to connect between sites, things rapidly get even harder. How do you aggregate records held with different numbering systems, if neither system supports having multiple number schemes? If you're designing region-wide internal numbering systems, then how do you manage them? How do you safely merge details, so that the manual workload is feasible, but the risk of incorrect or missed automated matches is low? How do you do this if different sites have held names and addresses in a different format? Should Site A, case number 123456, Miss Jane P Smith, 1/1/1985, Apartment 23 Dungeness mansions, Corgi road, London, NW3 1AA be automatically matched to site B's case number A763KFG, Ms Jane Penelope Fitzsimmons-Smith, 1/1/1985, Flat 23, 24 Corgi road, Hampstead, London NW3 1AA?

Of course, the easy projects have got off the ground and DO work. There is a national summary care record, and it does work; although there was a very aggressive "opt-out" campaign by various privacy protesters. This is a database, keyed on NHS number, which holds a limited set of data; diagnoses, last prescription, allergies and other important notes, current specialists, brief information about the attendance, etc. GPs have heavily embraced this, and most hospitals will submit some information to the SCR at discharge, with many GP IT systems automatically updating prescription information with the SCR when a new prescription is issued. A&E and other front line staff can search and obtain the summary record rapidly, should they need it.

The problem with the SCR is that it is a separate system and interfacing with existing systems is limited; it's worked reasonably well for GPs, as the number of GP IT solutions is limited, and most vendors have been able to deliver working interfaces. It's rather different in hospital care; if hospitals do update it, it's often done by a junior secretary or clerk, when the clinic record is sent to the GP; the quality of the data it contains is therefore somewhat variable.

Don't even get me started on the absurd confidentiality in access restrictions that people tried to put in place. However, to cut a long story short, access restrictions were to be put in place nationally. Login credentials were managed nationally, and access to every single software function had to be restricted according to role profile. These people had no idea what they were doing. If a doctor's smartcard expired, there would be no warning, it would just stop working due to an "unknown error". No one on site could deal with the credentials. Instead the doctor would have to travel to a "credentials clinic" held in a nearby city once a week, and turn up in person with 3 sets of picture ID and a current contract of employment, before the smart card credentials could be renewed. You can imagine how well that worked. Of course, no one would dream of borrowing someone else's smart card in that scenario.

Of course, that's not where it stopped. Every software tool was restricted according to the job description. So, for example if a doctor wanted to examine an X-ray using the X-ray vieweing software, but wanted to enhance the contrast, they couldn't do it. Someone in an office somewhere had decided that contrast enhancement was a system admin role only, and that was that. The local hospital could not override the premissions, except by requesting a different role (and the only role that could use the contrast tool was system admin). The national office would not offer a patch or hotfix; we had to wait for the next annual role update - really!

Sounds like madness to me. I wondered why each member of staff at the clinic I attended asked the same questions to identify me, again and again. The restricted access part is stupendously badly thought out.

A friend of ours who works in the NHS is adamant that only paper would do for her. She thinks that having the notes scanned and available quickly on screen (as opposed to archival paper retrieval in an odd selection of buff folders) simply would not work, as the staff couldn't be bothered to read them.

[MarkG]

Even in your scenario, they'd still have to interface with some application to collect new data and store it in a meaningful way. This application in turn would need to interface with all the other applications that are collecting and storing the data in the first place. The problem isn't storing the data - it's moving it around and keeping its context.

That's what we have standards for.

Take a look at a typical web-form (here's a very simple one Sample_web_form.png) - would just grabbing the data you've entered mean anything, or do you need the labels to give it context? Imagine that repeated, with each hospital running multiple applications, and each application consisting of multiple screens, often of great complexity.

So the problem appears to be:

1. You're collecting far too much information. How much of that crud they enter is ever looked at again?

2. You're storing it in the wrong place, because a bloated, centralized bureaucracy like the NHS can only imaging bloated, centralized solutions.

3. You're not using any kind of standards for applications to talk to each other.

And people are surprised that it's an expensive disaster.

[Si1]

<br />That's what we have standards for.<br /><br /><br /><br />So the problem appears to be:<br /><br />1. You're collecting far too much information. How much of that crud they enter is ever looked at again?<br />2. You're storing it in the wrong place, because a bloated, centralized bureaucracy like the NHS can only imaging bloated, centralized solutions.<br />3. You're not using any kind of standards for applications to talk to each other.<br /><br />And people are surprised that it's an expensive disaster.<br />

<br /><br /><br />

+1

[Snafu]

Start a new system, run them both in paralell. In 10 years time most if the paper stuff is obsolete.

Win.

[fluffy666]

Start a new system, run them both in paralell. In 10 years time most if the paper stuff is obsolete.

Win.

No, 2 years later you've just added another legacy system..

[tomandlu]

That's what we have standards for.

So the problem appears to be:

1. You're collecting far too much information. How much of that crud they enter is ever looked at again?

2. You're storing it in the wrong place, because a bloated, centralized bureaucracy like the NHS can only imaging bloated, centralized solutions.

3. You're not using any kind of standards for applications to talk to each other.

And people are surprised that it's an expensive disaster.

1. You'd be surprised. Okay, most information isn't relevant, say, 2 years later, but it's relevant during those two years. Audit also forms an important part. Bear in mind I work in a speciality (renal) where the patients are long-term chronic cases going through cycles of esrf, haemodialysis, capd, pd, transplant, and back to dialysis if the transplant fails.

2. I'm not sure how the 'where' is relevant.

3. There are no standards, just endless attempts to create them

I have to admit, I'm not sure if you're talking about the failed system or the existing systems.

[tomandlu]

No, 2 years later you've just added another legacy system..

[Bloo Loo]

1. You'd be surprised. Okay, most information isn't relevant, say, 2 years later, but it's relevant during those two years. Audit also forms an important part. Bear in mind I work in a speciality (renal) where the patients are long-term chronic cases going through cycles of esrf, haemodialysis, capd, pd, transplant, and back to dialysis if the transplant fails.
2. I'm not sure how the 'where' is relevant.
3. There are no standards, just endless attempts to create them

I have to admit, I'm not sure if you're talking about the failed system or the existing systems.

the where is with the patient..obvious init...the ONLY common point in the whole process.

what I think would be good and easy to do would be to put a warning list up vis a vis the patient...blood type, allergies, reactions and name of GP...serious ops and chronic conditions....no details needed, just a list of warnings.

Any wrong decisions would still lie with the Doctor treating at the time..

Edited September 22, 2013 by Bloo Loo

[tomandlu]

what I think would be good and easy to do would be to put a warning list up vis a vis the patient...blood type, allergies, reactions and name of GP...serious ops and chronic conditions....no details needed, just a list of warnings.

Well, a small optional medical card carrying such information on a chip might be a nice idea, but that's nothing really to do with a national system. If you expect such a system to be update-able in real time from all the different systems that carry this information, then you're back to square 1.

There are some nice bits and bobs around. For instance, many chronic renal patients can access their results via a web interface. It requires custom solutions for all the different lab feeds to create a common format for the CGI to handle, but it works. This allows competent dialysis patients to regulate their drugs and diet.

Edited September 22, 2013 by tomandlu

[up2late]

and who was in charge of the whole thing:

Richard Granger, the tough 42-year-old management consultant who runs the government's Connecting for Health project, initially failed his computer studies course at Bristol University - and took a year off as a result. He was only allowed to resit the exam after she appealed on his behalf, and he went on to gain a 2:2 in geology.

Granger's first job was with Andersen Consulting,which later became Accenture.

Speaking as someone who attended an Andersen Consulting recruitment roadshow, the only thing I remember other than the free beer was that a 1st or 2:1 was essential to even be considered.

It would be interesting to speculate what strings got pulled to get Mr Granger's foot in the door at Andersen...

[Bloo Loo]

Well, a small optional medical card carrying such information on a chip might be a nice idea, but that's nothing really to do with a national system. If you expect such a system to be update-able in real time from all the different systems that carry this information, then you're back to square 1.

There are some nice bits and bobs around. For instance, many chronic renal patients can access their results via a web interface. It requires custom solutions for all the different lab feeds to create a common format for the CGI to handle, but it works. This allows competent dialysis patients to regulate their drugs and diet.

but why persist with a national system idea?...we already have one...paper based in the main.

This is the question VIs rarely ask...why are we doing this...what need is it fulfilling...could the money be better spent elsewhere?

I think the money could be saved by not spending it...but that would be bad for GDP...the agenda central Government loves to keep in the Black.