Thursday, February 24, 2005

HELLO ... it's for the doctors

In the latest example of clinical information technology mismanagment, this time on a national scale, the BBC has posted a story on the continued decline in confidence by the UK's GP physicians in the national electronic medical records efforts. Tens of billions of dollars are at stake because "the government (a.k.a. governmental officials and IT leaders) had failed to engage with GPs over the upgrade."

For all the non-medical officials and IT managers involved in this initiative, a word of advice: HELLO ... it's for the doctors.

I have very little else to add to what I've already written at my website on Healthcare IT failure. Except that perhaps there should be stringent educational requirements and formal licensing processes for anyone given a leadership role (e.g., just for argument's sake, control of 5 or more people and a budget exceeding $500,000) in a healthcare computing environment. Also, this license should be subject to forfeit upon findings of significant clinical IT mismanagement. In the medical world, patient mismanagement is known by the more common term "malpractice."

We follow stringent accrediting and licencing processes in medicine and in allied health professions. Why are so-called "computing professionals" in healthcare not under similar requirements? Who, exactly, has granted them this privilege?

Doctor IT upgrade support 'falls'

The £6.2bn overhaul of the NHS IT system could be undermined by declining support among doctors, a survey says.

Just one in five GPs are enthusiastic about the upgrade - down from more than half last year. Support among hospital doctors fell from 75% to 51% during the same period, medical pollsters Medix found.

The 10-year IT programme will give patients electronic health records and allow them to book hospital appointments of their choice online.

The findings come after a National Audit Office report warned last month that the government had failed to engage with GPs over the upgrade which is supposed to revolutionise the NHS for the 21st century.

And last year Computer Weekly magazine said the costs of the National Programme for IT could exceed £30bn.

The Medix poll of 900 doctors, co-sponsored by the Guardian and Computer Weekly, also found GPs felt the new system was less important than they did a year ago.

And 70% of GPs and 42% of non-GPs felt the electronic records would be less secure than paper-based systems.

And just 5% of all doctors said consultation on the upgrade had been adequate.

Medix concluded: "It will be a major challenge to overcome the distrust and cynicism that seems to be replacing enthusiasm in the minds of many doctors. That challenge must surely be addressed urgently."


Dr Paul Cundy, chairman of British Medical Association's GP's committee on IT, told BBC News the findings were "deeply depressing".

"At the end of last year GPs were given a demonstration of how the new system would work and it was clear it was not good enough.

"It was meant to be an all singing, all dancing system but it is not up to scratch. "Since then GP enthusiasm for the project has plummeted."

A spokesman for the NPfIT accepted there needed to be more consultation with doctors. "The national programme recognises that clinical engagement is essential.

"Medix says that a reinvigorated engagement programme may well rebuild enthusiasm for NPfIT which has the potential to be a success. That is exactly what we have embarked on.

"We know there has been some discontinuity in our clinical engagement.

"But we have recently adopted a new approach, appointing a number of senior clinicians to lead this engagement work."

I'm not sure what the 'scare quotes' around the word 'falls' in the title are meant to signify (i.e., Doctor IT upgrade support 'falls' ). However, the statement "we know there has been some discontinuity in our clinical engagement" is truly scary. Scare quotes belong around the "some discontinuity" phrase if anywhere.

-- SS

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