The UK National Health Service information system, known as National Programme for IT or Connecting for Health, is one of the largest information system projects ever undertaken. The desire to have an information at the heart of the health system is linked to the aim of creating "a more modern, efficient patient-led service and to give patients more choice and control over their own health and care".
The About Us: History page provides documentation of the development of the project. Much of the documentation here is concerned with the background to the project rather than its design and implementation. A project this size for a public organisation involves a lot of public money and a wide range of people to bring on board. It is a politically driven project so government approval is required and much time has been spent considering its justification and design. The papers here are important but you need do no more than flick through them to get a sense of how much ground-work had to be done before the project could be started.
NHS Connecting for Health is the name of the NHS agency that will deliver the National Programme for IT. This will bring modern computer systems into the NHS and improve patient care and services. Over the next ten years, the National Programme for IT will connect over 30,000 GPs in England to almost 300 hospitals and give patients access to their personal health and care in for mation, transforming the way the NHS works. One of the over-arching aims is "to give healthcare professionals access to patient information safely, securely and easily, whenever and wherever it is needed".
Reasons for improving health service information systems:
"The root cause of 27% of medication errors is poor information availability".
"1,200 people die each year in England and Wales as a result of medication errors, costing the NHS £500m a year"
"10% of patients on medical wards experience an adverse event; 46% of which were judged to be preventable; 1/3 led to greater morbidity or death; while each event leads to an average of 8.5 additional days in hospital."
More detail on the evidence used to justify the new information system can be found here.
One of the central features of NPfIT is the NHS Care Records Service. This will provide a central database of all transactions that occur within the health service so that information will be more readily accessible when someone wants to access them. Starting in 2007 a Summary Care Record will be started, which will gradually build into a centralised record of all transactions between the NHS and all of its patients.
One of the justifications for developing a system on this scale is so that someone from Sunderland, on falling ill while holidaying in Devon, can be treated with full access to their medical records. (This should apply equally to a person from Devon holidaying in Sunderland!) Similarly, the various surgeries, clinics and hospitals that treat people across their home district will not have to hold separate, potentially contradictory, records but will rather use a single central source of data. What is not mentioned with the same degree of enthusiasm are the possibilities for linking one government database to another, social services to crime data and health data.
There will be an elaborate system of security to protect health records (as with other government databases) from unauthorised access. This will involve smart identity cards and passcodes (chip and PIN). A log will be kept of all accesses made to a patient's data and a patient will have the right to view this log. There is a NHS Care Record Agreement which sets out 12 commitments about how the NHS Care Records Service will collect, store and allow access to centralised electronic records. The records will be protected by "the strongest national and international security measures available...". Individuals will eventually have access to a summary of their own health care records through a secure web site called Healthspace. In some situations personal health information may be used without permission, for example if a person has food poisoning and there are public health concerns.
Some of the difficulties and controversial issues associated with the NPfIT can be found on the Computer Weekly web site (search for NPfIT or Connecting For Health).