Leatherhead Matters

I’ve not posted about the NHS for some time. It was making me too angry. I’m calmer now and my anger is directed at the incompetent, economic architect of Britain’s Boom to Bust. However, the NHS appears again to be climbing the political top 10 list of dysfunctional, state institutions.

This view of the NHS accords with actual experiences shared by friends & family of poor hygiene, medically incompetent nurses,  and a culture where targets are more important than the patient (particularly when elderly patients require NHS care) and a culture of denial when things go wrong.

But, in reality it’s worse than that. The real cost of the NHS is not transparent. The nation is probably not getting a good deal from the extra billions which New Labour has poured into the NHS over the last decade.

Just one example is the I.T. project “Connecting for Health“, intended to deliver computer systems and services to improve how patient information is stored and accessed. The new system is supposed to link 30,000 GPs to nearly 300 hospitals across England, providing NHS staff with instant access to the medical notes of 50,000 patients at every stage of diagnosis, treatment and discharge. It’s already 4 years late but, most non NHS observers believe this is fantasy. The Government claim to have spent £12.9 billion on the system though some MP’s assess it to be closer to £20 billion.

A Committee of MPs politely says:

The programme is not providing value for money at present . . . Unless the position on care records system deployments improves appreciably in the very near future (ie within the next six months), the Department of Health should assess the financial case for allowing [hospital] trusts to put forward applications for central funding for alternative systems.

“Not providing value for money” is code for:…..£12.9 billion has been poured down the NHS drain!  It’s an IT system designed around a centralised NHS organisation model. Critics talk of abandoning this centralised model and letting local NHS Trusts organise their own I.T. requirement.

But there is an alternative model: Google Health & Microsoft Health Vault are both Personal Health Record Systems (PHRs) which put the individual in charge of their own medical data. It facilitates sharing relevant data with whoever you wish but, that’s your choice and no one else’s. Microsft Health Vault & Google Health were released in the USA in beta test stage in October 2007 & May 2008 respectively. I posted last year on the Google Health system launch but, a more recent review of PHR systems by the Robert Wood Johnson Foundation says:

These first-generation PHR approaches represent significant progress in using health IT to empower consumers, but they also present several key limitations. Generally, current PHR offerings provide people with access to health care records stored at health care institutions or to freestanding collections of personal health observations. Those that are derived from institutional records generally become inaccessible to patients when they change providers, and those that are freestanding rarely integrate effectively with institutional records. Because many of the current offerings are proprietary in nature, few opportunities exist to build on or customize them to meet the highly diverse needs of different individuals and families.

If PHR products and services are to realize their potential to help people lead healthy lives and become engaged participants in their care, they must evolve in ways that maximize opportunities for innovation in meeting the varied needs of a population that has increasingly diverse health needs and goals. Ideally, PHR systems also should be responsive to patients’ different levels of self-efficacy, health literacy, familial supports, technological fluency and other factors. For any individual, a personal health record in the years to come might encompass the medical records that result from care delivered by multiple health care providers, observations such as weight or glucose readings that a person records directly, and data collected passively in the home and/or work environment by sensors and other biomonitors.

The development of these PHR systems almost guarantees that, even if the NHS system is finally completed by say, 2014, it will be technologically obsolete and modelled around a highly centralised form of governance, inappropriate to the 21st century. By 2014 up to £20 billion will have been flushed down the NHS toilet!

If you want to know more about PHR systems and how the Microsft & Google systems compare read more HERE.