IT AND TELECOMS
Dr Justin Whatling, vice chairman of Strategy & Policy at BCS Health, talks National Health Executive through the future of health service IT.
H
ealth is one of the last major infor- mation intensive sectors awaiting
a fundamental transformation, and like other sectors before it, this cannot be ac- complished without using information and technology to reinvent both its internal op- erational functions and its outward facing business model.
An ‘Information Revolution’ can support and help drive the changes that are required in the processes and methods of care provi- sion at the start of the 21st century.
The Department of Health has now closed its ‘Liberating the NHS: An Information Revolution’ consultation to inform the forthcoming NHS information strategy. In response, BCS, The Chartered Institute for IT, has conducted one of the largest en- gagement exercises it has ever undertaken, bringing our deep expertise to bear on a holistic approach to the informatics chal- lenges.
Our response contained almost 100 rec- ommendations, but a number of themes occurred regularly throughout, including those presented below. The scale and pace of the productivity challenge faced by the NHS over the next fi ve years cannot be met without much greater and more effec-
30 | national health executive Mar/Apr 11
tive use of information and IT. The NHS is seeking to deliver a 20% productivity im- provement over the next fi ve years through better commissioning and more effective provision. This is hugely ambitious and failure will result in reduction of services offered to patients. The NHS must seize the opportunity offered by information and IT.
Creating the culture of ‘change at pace’ is vital for a world-class health service. We have recommended that a risk-based ap- proach should be adopted to allow proto- typing of new patient-centred technologies and consumer information. It doesn’t have to be right the fi rst time so long as risks are understood and mitigated.
We believe that to deliver the impact infor- mation technology has to offer, at pace, IT and QIPP programmes must be integrated and technology used as a method to rap- idly spread and enforce good practice. We have recommended that the NHS develops, with the main software vendors, standard implementation of best practice processes and places these in the public domain.
For example, the three best ways to run emergency admissions are built into the system, so a hospital can choose which to adopt and make the appropriate
operational changes, rather than either implementing the technology and worrying about the process change later or behaving as though their A&E requires a totally unique solution.
The implementation of information servic- es and IT needs to be viewed as a necessary supporting infrastructure to the redesign of service, not as an end in itself.
Successful implementation of the informa- tion revolution will involve very substantial behaviour change on the part of clinicians, patients, managers and others. Simply pro- viding the information and IT will not of it- self guarantee that the information will ac- tually be used – or even collected, analysed and understood in the fi rst place.
The opportunity is to completely rethink the way a service is delivered, starting with the design of working practices and cover- ing the whole operating model of care to determine how processes are adapted and how resources managed as a consequence of better information. Implementing mod- ern technology into old processes just makes them more expensive. A library of successful examples, with a focus on ROI delivered, would support boards in making investment decisions.
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