Friday, April 20, 2007

What can go wrong with eHealth?

The British Parliament's Committee of Public Accounts has published a report that is very critical of the NHS' National Program for IT. It identifies many issues which are captured in our eHealth Risk-Opportunity Report Card. This is a list of their conclusions and recommendations [words in square brackets are mine]:

  1. The delivery of the patient clinical record, which is central to obtaining the benefits of the programme, is already two years behind schedule and no firm implementation dates exist. [project risk]
  2. The Department has not sought to maintain a detailed record of overall expenditure on the Programme and estimates of its total cost have ranged from £6.2 billion up to £20 billion. [business risk]
  3. The Department's investment appraisal of the Programme did not seek to demonstrate that its financial benefits outweighed its cost.[business risk]
  4. The Department is maintaining pressure on suppliers but there is a shortage of appropriate and skilled capacity to diliver the systems required by the Programme, and the withdrawal of Accenture has increased the burden on other suppliers, especially CSC. [project and business risk]
  5. The Department needs to improve the way it communicates with NHS staff, especially clinicians. [project and business risk]
  6. We are concerned that the leadership of the Programme has focused too narrowly on the delivery of IT systems, at the expense of proper consideration of how best to use IT within a broader process of business change. [benefits realization risk]
  7. The Department should clarify responsibility and accountability for the local implementation of the Programme. [business risk]
  8. The use of only two major software suppliers may have the effect of inhibiting innovation, progress and competition. [project and business risk]
  9. At the present rate of progress it is unlikely that significant clinical benefits will be delivered by the end of the contract period. [benefits realization and project risk]
It would be interesting to see what grade the NHS would get for their Programme.