E-health record failure blamed on top-down approach
The failure of the UK’s e-health program has been blamed on rushed implementation, failure to engage clinicians and a top-down government-driven partnership with private contractors.
A review of the UK’s program, similar to the $500 million PCEHR planned in Australia, concluded that it was “time consuming and challenging, with as yet limited discernible benefits for clinicians and no clear advantages for patients.”
Researchers who reviewed five areas where the IT system was implemented through partners such as Cerner and iSoft, blamed the program’s ‘top down’ approach which led to an “unrealistic, politically driven timeline from the outset”, with “multiple tensions” between the creators and NHS staff.
In their review (link) the authors suggest there needs to be a clear vision and realistic timescale from the start with more “user involvement” of local clinicians and health staff in decision making.
They say a key lesson is the need to “move away from technology driven models of implementation,” and to “consider the merits of participating in the development of open source systems as opposed to the purchase of commercially developed systems.”
Large scale procurement projects were used in an effort to save money, but these often resulted in the ‘tail wagging the dog’ and programs being influenced by the particular type of software implemented.
Comments
Yet another monumental waste of taxpayer funds. With all the privacy restrictions placed on the EHR by well-meaning but misguided people, it will only serve those who don't cause problems within the health system but would potentially generate a lot of wasted time and effort - if doctors had the time to actually do what is being asked. The drug dependent patients and doctor-shoppers where this initiative could be useful will just restrict their EHR access. What's the point of such a system? As in the UK, no benefits, just cost and effort. Why can't we learn from the experiences of others but be doomed to repeat them? Count me out. I'll give my patients a one-page summary where necessary.
Dr. Igor Jakubowicz | 18 October 2011 at 15:43
