大象传媒

Why would Google and Microsoft touch the NHS programme with a bargepole when we've witnessed IT giants like Accenture and Fujitsu walking away from it in frustration and BT's IT services division brought to its knees?

They wouldn't. The NPfIT programme may have to be abandoned. As I understand it, Google and Microsoft have existing health records platforms used in the US which could possibly be adapted to accept UK data. Microsoft technology may be used in NPfIT - but only as components in a proprietary system. What needs to be looked at is whether the same job could be done using more 'off the shelf' type applications and the Internet as a backbone.

Is the 大象传媒 allowed to call them Speedos? The Today programme quoted Milliband as saying that it is hardly a national secret that the head of MI6 wears swimming trunks on holiday.

On that occasion, I fear that the 大象传媒's need to avoid brand names changed the entire quote. I, personally, am very afraid about a man so stuck in the seventies that he wears tight swimwear to the beach.

#3. Fear not, they look like ordianary trunks not Speedos.


I'd like to read exactly why these national database projects are hitting the buffers? Is it that the companies bidding don't have the expertise, that the DBs are asking too much of current tecnology (surely not), a badly thought-out initial brief? What are the problems?

As for using off-the-shelf cloud technlogy; if it works, is economic and secure then why not use it?

The fact is, Accenture, Fujitsu and BT have all failed to meet the NHS's requirements, arguably because these requirements have been ill-defined. It sounds now as though the NPfIT Programme might be abandoned and a new set of requirements articulated in order to accommodate Google's and Microsoft's technology. Won't the result be that we have a a fully working solution, but to the wrong problem?

This project was dead before it started. For years our government as had this database mentality in solving all kinds of problems without first thinking the most important - the quality of the data being input into the database. In the case of the NHS, may a draw your attention to "Little Britain USA", where one of the characters works in a hospital with a computer that always says "No!".

In truth, few one size fits all systems work. The NHS does a fantastic job of providing healthcare for the amount of money invested, but still it has problems with overfunding and underfunding in key areas (and parts of the country) because the bureaucracy (which is I am afraid necessary for an efficient system) cannot easily see objectives from cost savings. These problems are not due to the front line staff, but to adopting a tick box culture to record decisions as they are made, rather then to actually use the expertise and specialism of the staff to actually do something that makes the patient better or at the very least stops them from dying before the correct treatment can be administered.

My fear, is not the computer healthcare system that leaks private information, it is a system that physically prevents the correct action from being taken. If the computer system had been designed with this premise in mind, it might be for example that sensitive personal information be purposively kept of the database. With the political emphasis on keep costs low, how do you know whether the system is fit for purpose? 拢12 billion sounds like a lot (it is), but when lives are involved you want to make sure the system works don't you?

I remember a number of years ago an article in the Worcester News about a computer system introduced at my local hospital. This caused a number of inconvenient issues as the computer had problems with inviting people whom had deceased for appointments (upsetting the relatives) and couldn't arrange appointments correctly. That was just one hospital, not a large organisation.

At the end of the day I will be glad if this project fails. If anything it goes to prove that NHS does not really need such a system and that money of this nature would be better off spent of the people that matter the doctors and nurses that save lives.

Why Microsoft or Google? What about Open Source?

#5 wix4ever
Why would it require "technology" from Google, Microsoft or anyone else? We could all save a simple text file plus a few x rays on an online storage service. My GP seems to have my records computerised. Why can't I keep a copy? On a USB drive even.

This comment was removed because the moderators found it broke the house rules. Explain.

There are two reasons why it has become so expensive.

1. There is so much that needs to be done to ensure accuracy of data alongside the strucvtures being flexible enough to allow for searching and trending. This needs doing regardless fo who does the work.

2. NHS staff have largely been unhelpful or shown downright resistance. Every step has been extended by nitpicking and infighting.

The second problem is always an issue in any company but seemingly more so in the public realm as people dont want the changes regardless of what they say in public.

My health records in the hands of Microsoft?

"You need to take a perscription medicine now or you will die next week, but don't worry, I can print one for you now... Oh, the system won't let me in because Windows could not find 'C:\Health' and apparently I need to update the printer drivers..."

I have said it and I say it again. The way to carry our medical records around is to use personal Smartcards - or even dare I say it the ID card? Technology is such that today you could easily make a card with enough memory to store all your medical records, and you could carry this around to any doctor or hospital who would have a low cost reader (e.g. just a PC with a card reader, or since they all have PCs, just a card reader - say $20 max)).

I would like to be able to choose who I trust to hold my medical records which can be updated by my doctor and hospital but anybody else would need my consent to see different levels of my medical records.

I'm not sure I would want to have the responsibility fo keeping them on a smartcard. Although using a smartcard to access the online data might be an idea.

Having more than one Vault for medical records would be more secure and would be trusted more than one huge store. It would of course then need agreed interchange standards. This would allow hospitals and GP surgeries to choose their own administration software as long as it was able to interchange data with the accredited Vaults.

#7 Doh! Its not so much about who develops the software, its the fact that a software company is capable of developing what's required. Whether its based on Open Source or not, is irrelevant.

Plenty of large IT companies have shown in America that they can meet the requirements for similar systems, surely 95%+ of the software architecture and code is the same and just the scale that changes?

#12: Surely the question is why would you want to carry round your medical records when they are of absolutely no use to you? Just because something is possible, doesn't make it a good idea....

The existing project has been a complete farce, as anyone who browses the pages of the _Private Eye_ will no doubt be acutely aware of.

But why replace one massive centralised IT project (that will "end in tears") with another? We can talk about "clouds" but in reality, these will be in control of a single software firm. Replacing monopoly with monopoly.

What I do agree with is that projects need to be far more fleet of foot, albeit with well-defined parameters at the start. Furthermore, data security has to be paramount and, most importantly, held in the UK under our laws. There's no guarantee that any Google or Microsoft system would commit to that as cloud servers are often, by their nature, transnational - albeit governed by the loose data laws of the US.

Google Health and Microsoft Healthvault are not matured products. If this plan is approved, it would be an opportunity for these companies to work on their products using govt. money!

I am not saying this is a bad idea. Google products are almost always good, but why govt. paying for it? Just open it up to the public just like US, so the public can choose the the software of their choice. There are already about 50 PHR software tools available. Why limit to Google Health or MS Healthvault? Be democratic!

By the way, here is a good primer on PHR tools and the providers -

Whilst a centralised record system like this is a good idea for national monitoring and reporting (similar to what is in place in Scotland with the Scottish Morbidity Record system), rolling out such a project across England could prove difficult due to the even more disparate nature of requirements at local levels.

Further, local and regional managers and directors tend to be so protective of their own systems and needs (due to govt pressures) that resistance to change is a significant obstacle...hence poorly defined requirements documents and projects running over budget.

Google & Microsoft would both crumble if they took on a project like this because everyone in the NHS is running around in different directions in a technical time lag of -10 years. Google operates with the future in mind, NHS with the past. Maybe Apple should take on a project like this, they're past masters of waiting for the competition to do all the work then trumping the market with a masterpiece...

As someone who has spent more years than I care to mention in IT solution delivery - the problem with the NHS delivery, and why most of these projects end in tears is simple - it's the suppliers.

They paint a picture of nirvana with interlocking systems, that bedazzle how much they will transform the business they affect. Essentially the bigger the project - the longer term it is - the more the business changes during deployment - the more change notices get issued - it's a dog chasing it tail.

The suppliers then work out how much money they will make, and how much change management they can force through - on an ongoing basis with armies of consultants built in a pyramid tree structure.

The answer is to not to think of the big grandiose - but do smaller more achievable bits - and using ready software like Google has achieves that.

The staff in the NHS do not live in the past - they have the most demanding clients in the world - people die when it goes wrong - so they insist on solutions that work - it's a shame the IT suppliers involved did not take the same risk-managed approach to this solution.

I worked on the NHS Program very soon after its inception for one of the major suppliers. And the frustrating thing to me is that the systems component of the program really isn't that difficult. Sure, data volume is a challenge but the functionality is pretty straightforward.

From my point of view, the problems that the program has are driven by poor planning in the first place (from NPFIT - probably driven by politics). Any IT professional, if asked, would tell you that the original timescales to get cross dependent systems out at the scale that was originally contracted for was a pipe dream... in fact I would speculate that all of the providers signed up to the original government contracts with the intent to re-negotiate them when one of the other providers failed in its obligations (e.g. late delivery of the central records system). Which is a real shame. I could go on and on about the problems I saw but I'll spare you all!

Really, my point is that I would not be suprised if Google or Microsoft took this over and made a success of it from a technology perspective. In fact, I'm not sure that the technology is really the biggest problem anymore. The challenge from where I see it is now is really going to be in deploying it to the user groups and enabling them to adopt it - which is where we are right now.

If I had to choose between the two companies, I'd choose Google to protect my data - but to be honest, I'd choose either over our Government managing it!!!