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Expert’s View
Why is it important for healthcare providers to
move towards patient-personalised services?
I
n the UK, the NHS is the backbone of our healthcare
system - a place we know care will be provided
independent of wealth. When health information enters
the equation, the IT systems that have been put in place are
focussed on the system rather than what patients and health
professionals need - relevant information at the point of
care to improve care outcomes and make informed
healthcare decisions.
Today we are more than familiar with IT systems being
there to help keep us informed - the parcel that arrives from
online shopping, the carrier knows exactly where it is, and
shares that information with us. In healthcare, it’s still a
very different story – our doctors are reliant on letters sent
through the post to keep information and we can wait weeks
to know our results. The medicines we take and the notes
about our health are stored in multiple systems that often
mean we must tell our healthcare professionals what’s
wrong rather than them already knowing. It’s estimated that
in 2000, 70% of errors in hospitals are caused by not having
record at the point of care, and this hasn’t really changed.
Centralised standards rather than person-centred
standards have failed repeatedly
The National Programme for IT “NpfIT” started in 2002
with a budget of £6.5bn. By 2012 it was estimated that up
to £40bn was spent and the programme is now seen as the
biggest IT project failure ever. The objective of the project
was to build software under the direction of the NHS with 5
IT integrators. There was a published ambition to stop using
IT solutions from the open market. The NHS IT market has
still not recovered, and investment markets are now wary
about investing in IT if the NHS is the customer.
explicitly under GDPR for permission to share their data it
is not possible to do it. If however people had copies of
their health records stored and ready to share they could
offer immediate permission themselves.
People powered health - IT systems should place the
person at the heart of design
Whilst it has been clear that the national IT programmes
over the years did not listen to the clinical users it is even
more clear that they did not deliver what the people they
serve want. Over the last 20 years many successful
commercial IT initiatives were driven by serving the
suppliers of services even if the NHS failed in this way.
This is why when we compare the IT we use to shop online
with receiving letters from the NHS though the post we are
frustrated and disappointed.
Newer ways of working which have delivered companies
like Airbnb focus not on the supplier of the service but their
customer. They have a ruthless desire to deliver what we all
want from their services. This allows completely new ways
of working to be adopted and improves our lives. I would
argue the NHS needs to think this way.
If we were to improve the booking of trains by focussing on
the ticket office we would increase the number of staff and
give them better computers. The Trainline app means we
don’t need a ticket office to book a train. Apply this to the
NHS and we could see a world where there are no server
rooms and everything is cloud based. Without this drive
there will always be a need for the organisation to buy
better computers and employ more staff.
What needs to change?
The NHS is not one organisation. It is thousands of different
legal entities. Each organisation including every GP
practice is responsible independently for its own
information governance. Even if there was a central plan
that could work it is highly unlikely that every Trust in the
NHS would decide to adopt it. Unless people are asked
The latest NHS IT policy states that projects should be
focussed on the user need, so it seems that lessons are
starting to be learned. I believe we also need to consider the
following:
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