“The NHS has quite an expensive IT system that, frankly, is not essential for the front line” (pt 4)
How will this be achieved?
Let’s cut to the core of the matter and lay out what is truly needed to sort out the mess that we’ve got ourselves into.
1. A redefinition of the ‘open’ market place
A single set of open standards must be defined and used for the exchange and storage of medical data. There are too many precedents to name for this but everything from the VA system in the US to the CALIOPE system in Europe. Data formats exist, they must just be used and adhered to.
To some extent, we do have this in the UK, but it is redefined every 6 months as it is in continual development (or so it seems) and the implementation and specification lag each other meaning it is often not possible to get ‘compliant’ with the latest specification. The compliance process also takes so long that you can easily find yourself building something on one standard only to find it out of date by the time it is deployed – by which time you have to begin compliance again as there is a change in ‘scope’ of the product. In other words, we did not start this project with a fixed specification, but we are making it up as we go along…
All this costs money (in our case tens of thousands of pounds in internal costs annually and we are a small company working with consultants who do most of the work for us) and this prevents the small companies with the big ideas from delivering (assuming they can get an invite to the closed party in the first place)
2. Don’t try to deliver everything for everyone.
Define the standards, make them fixed, and let the market do the rest. If there were one set of standard methods for data interchange then providers could make great tools, people could buy them and the market would sort the wheat from the chaff.
The best thing about this is that it could then enable healthcare providers to get on with delivering healthcare. This would allow them to innovate in their service delivery which would then improve the quality of their care.
3. Make it easier for companies to get on board
This is really the key to solving this mess. With a dynamic marketplace built on standards and robust rules, we will see a rush of innovation coming from companies large and small, all of whom wish to get on board. We, as a society, are not short of ideas, but we are actively prevented from realizing them in this sector by infrastructure that simply cannot meet the demands of the industry, even 5 years after it was put into place.
By all means vet companies, by all means make hoops for people to jump through, but make them reasonable and make the standards fixed so that the effort that people spend on coming up with great ideas are not wasted.
What’s next?
There are a number of genuinely good ideas in both the political parties and in industry I genuinely hope the next government have the courage to implement some of the more radical proposals they are coming up with, but this continual separation of medicine and technology has got to stop. We long ago passed the point where we could justifiably say that IT was a niche. Technology is not a toy – it runs our stock markets, our power stations and our system of government.
Technology allows people to be great at what they do by making their lives easier. Technology doesn’t have to cost the earth and when it does, people don’t buy it so long as they have a choice.
