Lessons from the UK

Points de vue | 14 Mar 2012
Points of view of Matthew Swindells Senior Vice President Global Consulting Cerner.

The UK has undertaken the largest health IT projects in the world.  Much of the criticism it has received has been simplistic, but it is fair to say that this programme has not achieved everything that it set out to do and there are lessons to be learned.

There have been some tremendous successes.  The NHS now has a secure data network that links every healthcare institution, a unique identifier for every patient, a national booking system that gives patients access to any hospital, encrypted clinical email, comprehensive implementation of primary care electronic patient records and nationwide implementation of PACs.

The major problems have been the summary patient record, which was delayed by public fears around confidentiality, and, most significantly, the digitisation of hospital medical records.  Of the two software companies awarded the original hospital contracts, one decided during the programme to completely rewrite its system from scratch, and is still trying to implement the new system in its first hospital, and the other found that they could not meet the national requirements and withdrew from the programme.

Cerner were asked to step in and pick up the pieces when the latter company had withdrawn and the programme was already up and running.  We have now successfully implemented in more than 100 hospital sites.  Based upon our experience in the UK and from implementing our systems in 23 countries around the world, here are five lessons that one could learn from:

1.    Recognise that healthcare is a changing environment.  Don’t create specifications that are so tight that you can’t respond to changing political and public priorities or so nationally unique that you can’t benefit from developments around the world.

2.    Focus on delivering benefits to patients and clinicians quickly.  If your programme becomes overwhelmed by administrative and billing requirements you will lose the support of the people who matter most.

3.    Don’t computerise poor working practice.  Remember that information technology is a tool to help improve healthcare, not an end in its own right.

4.    Ensure that there is local ownership of the new system.  Implementing healthcare is difficult, however good you are, if the local managers are not committed to the project they will “blame the government” when the going gets tough.

5.    Impose rigorous clinical and technological standards based on international best practice, this creates the foundation upon which local health systems and the industry can innovate without waste.

Professor Matthew Swindells

Matthew is a Senior Vice President and General Manager for Cerner, a global healthcare IT company.  He leads their business across 23 countries and 400 facilities outside the US, as well as their Lighthouse population health, data analytics and change management services throughout the world.

Prior to this he worked for 20 years in the English NHS as head of Information Technology at a large London teaching hospital, Deputy Chief Executive in a general hospital and ultimately Chief Executive of a large acute hospital and cancer centre.

Between 2005 and 2007 he fulfilled the role of as Policy Advisor to the Secretary of State for Health in Tony Blair’s administration.  He then joined the NHS Management Board as the NHS’s first Chief Information Officer. 

Extract from the ASIP Santé's Annual Report 2011.