Hi
James Mountford forwarded the following to me BBC programme to me (http://news.bbc.co.uk/1/hi/programmes/file_on_4/5029516.stm - it lasts about half an hour), which may be of interest to those of you interested in the development of electronic health records. The programme relates to the problems being experienced with the role out of England's EHR (which, I think, will be the biggest in the world, if it gets off the ground).
My view, for what it's worth (and I don't know much about these things) is that the programme somewhat overlooks the amount of time it takes to get electronic health records fully functional. The one seemingly successful model that I know a little bit about (at the VA) took years (even decades) to achieve the success it has. That said, the BBC programme seems to indicate some worrying developments with the English case, particularly around child vaccinnation, where the introduction of the new information technology might be making things worse (also, the basic message of the development of EHRs - i.e. develop them around the needs of doctors - seems to be being overlooked).
The programme also states that the Government admitted to the Financial Times that the total cost of the IT programme could reach 20 billion pounds (almost $40 billion), which is a lot of money, particularly when it is unclear (to me at least) what the substantive benefits of the new IT programme are expected to be.
To really improve the NHS (not that I think that it does too badly as it is), it really needs (I think) to be broken up into fully independent (although still public-sector) regions, each financed by weighted allocations from the Centre, and each motivated by intra and inter-regional non-financial and non-blaming performance incentives. But this would require the elimination of politically-motivated national performance standards, which is easier said than done.
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