UK health services IT chief defends project

The National Programme for IT is on track despite setbacks, says its embattled boss

The embattled chief executive of IT for the British National Health Service’s technology revamp has sharply rebuked critics of the programme, saying a withdrawal of funding would lead to “massive disruption” for patients.

Richard Granger has led the National Programme for IT (NPfIT) for the past four-and-a-half years, a £12.4 billion (NZ$33 billion), 10-year programme that includes electronic prescription and appointment booking services, a patient care records service and an x-ray archiving and electronic transmission system, among other features.

“The program gets continuously knocked,” Granger said during a keynote speech at a recent healthcare and government trade show. “I don’t think that will stop probably for another five years, and then the obituary on the programme will be ‘Well why was it so difficult? Why didn’t it get done more quickly?’ and maybe the answer to that is: if there’d been a bit less whining and more support, it might have done.”

Granger left immediately after his speech and did not address the latest crisis involving an NPfIT subcontractor — that of iSoft. The company is charged with delivering a patient-care records service for the lead contractor, CSC, which is responsible for three out of five geographic areas for the project.

ISoft, which has run into accounting and management problems, recently reached a buyout deal with Australian software firm IBA. But CSC blocked the move so it could work out with iSoft how the patient-care records system will be delivered.

The two companies remain in discussions, but the conflict has reinforced concerns about the ability of suppliers to deliver products and meet deadlines. Some of the more extreme critics of the programme have called for a withdrawal of funding.

In general, Granger acknowledged deployment problems, in part because each hospital conducts operations differently and requires different IT configurations.

He also said there have been problems integrating the 10,000 or so pharmacies with the Electronic Prescription Service (EPS), which uses an XML format, HL7. So far, the pharmacies have been using around 18 different systems to accept prescription messages from the heathcare system’s core network.

Work on the EPS has been slow, and resistance to change has been high, Granger said.

“We have found it interesting how appalling and how slow some of the big corporates, FTSE 100 corporates, have been at getting their software to be HL7 message-compliant. I might almost imagine they are not welcoming with open arms the challenge to their bricks-and-mortar business model.”

However, Granger cited statistics that indicate there has been some success.

He noted that in the 20 minutes it took to deliver his speech there were 2,250 appointments booked using electronic systems, 17,250 prescriptions transmitted electronically, 168,950 digital images related to patient care recorded and 37,500 secure emails sent containing patient clinical data.

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