Study: UK NHS IT project at risk without backing

A study in the British Medical Journal this week reports that a U.K. effort to centralize patient records on a standard IT system is at risk because local staff are feeling left out of the implementation process.

The program, called the National Programme for IT in the NHS (NPfIT), promises benefits for patients and the NHS (National Health Service) as a whole, according to the study. But researchers found that staff at four hospital trusts in the U.K. where the program is being implemented had an unfavorable view of it, mainly because of poor communication and consultation from NPfIT headquarters.

In particular, staff members feel cut off from decision-makers in NPfIT headquarters, and feel as if local needs and advice have been ignored, the study found.

“The communication has been appalling, absolutely appalling,” said an IT manager at one of the hospital trusts, according to the study. “I’ve been to some meetings where I’ve met people who are very, very good, and … they’ve been ordered and we’ve been instructed that it’s inappropriate to talk to them.”

In addition to the communication breakdown, staff was uncertain as to when new systems would be implemented in the hospitals, and what local funding would be available to support the system once it was in place.

These problems could be a threat to broad deployment of the NPfIT, a scenario that is especially troubling given the rising price tag of the program. The British government allocated £2.3 billion (US$4.1 billion) for it in 2002, but published reports estimate it could cost as much as £31 billion before all is said and done.

Researchers spoke with 23 senior managers and clinical staff involved in installing the program in their hospitals, which were chosen because they had various typical conditions, including size and financial health.

Some of the hospitals in the study reported that existing IT systems such as those for radiology and pathology were badly in need of replacement, but new implementations have been put on hold as the NPfIT is deployed across the country. “Such a delay may mean a risk of system failure, but buying a temporary solution is seen as costly,” the study says.

The news from the study was not entirely dismal, however. Local staff at the hospitals observed have shown willingness to overcome the technical problems of implementing NPfIT, the study found. However, they insist they need the help of NPfIT headquarters to get the system up and running or the deployment will not be successful.

In 1998, the NHS set a target for all hospital trusts to have in place an electronic patient record system by 2005. In 2002, findings showed that only 3 percent of trusts would meet the original target, however. The revised goal for the program is to have electronic patient records in all acute trusts by the end of 2007, according to the study.