Mozrat, over at Beer And Speech wrote about the NPfIT, which is the National Programme for Information Technology in the NHS. It's a good post, in which he explains that the the cost has soared to Â£30 billion pounds which will make patient care suffer.
The idea behind the programme is that modern computers, networking and databases will enable GPs and hospitals to become more linked, allowing GPs and hospitals easy access to the normally separate medical notes. It will also mean that operations and consultations over an electronic booking system. It will also provide an centrally managed email and directory service and will eventually mean that GPs can electronically send prescriptions to pharmacists.
But there are problems…
A lot of GPs are unhappy with the system, in fact only 7% of the 500 GPs asked felt they had been adequately consulted.
As mentioned before, the original cost was estimated to be Â£6.2 billion, now the cost is expected to rise to between 18 and 31 billion pounds. It has gotten so expensive, the National Audit Office is to investigate the way in which the contract was awarded.
I am personally worried about the security of the system, and my personal experience in the new system at Newham hospital doesn't inspire me.
Newham has currently implemented an EPR system (Electronic patient record from Cerner. This means that when the patient enters through the doors of A&E they are booked onto the computer, and all treatments, tests, x-rays and the like are recorded on the computer system. Instead of having to manually track the patient through the department there is a huge monitor on the wall that lets the nursing staff know where each patient is.
This was the first thing that I noticed, that the computer screen in the main area had the patients name, and what was wrong with them, which isn't too good for patient confidentiality. I told the nursing staff this, and a little later that day the 'complaint' field had disappeared.
I'll not mention how it is taking over a month for the nursing/medical staff to get used to the new system, for the first two weeks after it was implemented our Control were so distressed at the amount of ambulances sitting outside the A&E, they kept calling us up to make sure that we were 'alright' (for 'alright', read 'ready for another job'). We had to keep telling them that it was taking us much longer to hand our patients over to the nursing staff because the staff were unfamiliar with the new computer system. Extra trainers have since been brought in, and things are running a little smoother.
Finally, there is the thing that amuses me the most… Security for such a system must be high, mainly for patient confidentiality reasons, but also because you don't want some bright spark hacking the system so that they get seen out of order. The system has a number of laptops, so a wireless network has been used to link the various systems together. Admittedly I'm no hacker, or even a wireless network expert – but a little investigation with Ministumbler and my Pocket PC has shown that they aren't broadcasting their SSID, and I can only assume that they are using WEP. But, and this is the problem with any system where non-geeks are expected to use it. Every computer has magically grown a sticker, upon which is the Username and Password to log into the system.
Hardly secure, and the implementations for patient confidentiality is terrible – can you imagine this system rolled out across the UK, with the full functionality of the NPfIT system up and running? Break into a GP's office, use the password that is conveniently stickered to the monitor, and gain access to nearly anyone's medical records. I mentioned this to the staff in the department, but they seem happy to let this huge security flaw continue.
So I'm now sending a letter to the hospital directors – hopefully they will get the message.