UK govt promises to sink billions into electronic health records for England
- Reference: 1656587832
- News link: https://www.theregister.co.uk/2022/06/30/uk_electronic_health_records/
- Source link:
The investment from one of the world's largest healthcare providers follows Oracle founder Larry Ellison's promise to create [1]"unified national health records" in the US after the company paid $28.3 billion for Cerner, an American health software company also at the heart of many NHS record systems.
In the UK, health secretary Sajid Javid has promised £2 billion to digitize the NHS in England, including electronic health records in all NHS trusts (hospitals or other healthcare providers) by March 2025.
Oracle plans US database for electronic health records [2]READ MORE
The initiative also includes recruitment, retention, and growth of the tech workforce to meet "challenging projected health and care demand by 2030." The requirements will be met "through graduates, apprentices and experienced hires, creating posts for an additional 10,500 full-time staff," according to the policy document paper, [3]A plan for digital health and social care .
Announcing the document, Javid said: "The plan shows how we will effectively create a single, life-long digital health and care record for everyone giving patients a chance to easily access their own data with these records in place universally by 2024.
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"This will build on our work to accelerate the adoption of Electronic Patient Records which will mean all clinical teams within the new Integrated Care Systems will have secure and appropriate access to a complete view of a person's health record."
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At the moment, 86 percent of NHS trusts have a form of electronic patient record in place. The government wants that figure to reach 90 per cent by the end of next year, he said.
It is unclear whether the spending is new. Last year's October spending review also [7]announced £2.1 billion (c $2.5 billion) for improving IT and digital technology within the NHS .
[8]Concerns that £360m data platform for NHS England is being set up to fail
[9]Phishing operation hits NHS email accounts to harvest Microsoft credentials
[10]Former NHS AI leader joins US spy-tech firm Palantir
[11]NHS England seeks £240m data platform to tackle COVID recovery
The new digital health strategy also includes plans for expanding functionality of the NHS App, smartphone software for accessing common NHS services. Plans include the ability to register with general practice surgeries via the app from March 2023.
The plans also include implementation of the controversial Federated Data Platform from autumn 2022. Critics [12]fear US spy-tech firm Palantir will be favored for the role, given its entrenched position in the existing NHS COVID-19 Data Store and Platform.
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Dr Pritesh Mistry, digital fellow at NHS research organisation The King's Fund, welcomed the plan as a way of bringing together years of "disparate commitments."
However, he warned that health staff would struggle to find the time to train to use new systems given their overwhelming workloads.
"The most significant risk to this new vision of digital health and care is the lack of capacity among the health and care workforce," Mistry said. "NHS and social care staff are already under intense pressure and many will wonder where they will find the time needed to learn the new skills to use technologies, change organisational culture to work better with tech innovators, and avoid the pitfall of implementing new tech without adequately consulting the staff and patients who will use it."
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The Department for Health and Social Care must deliver its plan under the specter of the [15]failed National Programme for IT , a £10 billion (c $12.1 billion) centrally delivered NHS IT project regarded as one of the biggest public-sector IT disasters in UK history. ®
Get our [16]Tech Resources
[1] https://www.theregister.com/2022/06/10/oracle_us_health_database/
[2] https://www.theregister.com/2022/06/10/oracle_us_health_database/
[3] https://www.gov.uk/government/publications/a-plan-for-digital-health-and-social-care/a-plan-for-digital-health-and-social-care
[4] https://pubads.g.doubleclick.net/gampad/jump?co=1&iu=/6978/reg_offprem/paasiaas&sz=300x50%7C300x100%7C300x250%7C300x251%7C300x252%7C300x600%7C300x601&tile=2&c=2Yr3IoTzUriej5XoQXqorzwAAAIk&t=ct%3Dns%26unitnum%3D2%26raptor%3Dcondor%26pos%3Dtop%26test%3D0
[5] https://pubads.g.doubleclick.net/gampad/jump?co=1&iu=/6978/reg_offprem/paasiaas&sz=300x50%7C300x100%7C300x250%7C300x251%7C300x252%7C300x600%7C300x601&tile=4&c=44Yr3IoTzUriej5XoQXqorzwAAAIk&t=ct%3Dns%26unitnum%3D4%26raptor%3Dfalcon%26pos%3Dmid%26test%3D0
[6] https://pubads.g.doubleclick.net/gampad/jump?co=1&iu=/6978/reg_offprem/paasiaas&sz=300x50%7C300x100%7C300x250%7C300x251%7C300x252%7C300x600%7C300x601&tile=3&c=33Yr3IoTzUriej5XoQXqorzwAAAIk&t=ct%3Dns%26unitnum%3D3%26raptor%3Deagle%26pos%3Dmid%26test%3D0
[7] https://www.bbc.co.uk/news/uk-59030945
[8] https://www.theregister.com/2022/06/13/nhs_england_palantir/
[9] https://www.theregister.com/2022/05/05/phishing_campaign_nhs/
[10] https://www.theregister.com/2022/04/22/nhs_ai_leader_joins_palantir/
[11] https://www.theregister.com/2022/04/14/nhs_england_seeks_240m_data/
[12] https://www.theregister.com/2022/06/13/nhs_england_palantir/
[13] https://pubads.g.doubleclick.net/gampad/jump?co=1&iu=/6978/reg_offprem/paasiaas&sz=300x50%7C300x100%7C300x250%7C300x251%7C300x252%7C300x600%7C300x601&tile=4&c=44Yr3IoTzUriej5XoQXqorzwAAAIk&t=ct%3Dns%26unitnum%3D4%26raptor%3Dfalcon%26pos%3Dmid%26test%3D0
[14] https://pubads.g.doubleclick.net/gampad/jump?co=1&iu=/6978/reg_offprem/paasiaas&sz=300x50%7C300x100%7C300x250%7C300x251%7C300x252%7C300x600%7C300x601&tile=3&c=33Yr3IoTzUriej5XoQXqorzwAAAIk&t=ct%3Dns%26unitnum%3D3%26raptor%3Deagle%26pos%3Dmid%26test%3D0
[15] https://www.theregister.com/2020/05/18/latest_nhs_it_revolution_is/
[16] https://whitepapers.theregister.com/
Our data, not theirs to sell
-> Javid said: "The plan shows how we will effectively create a single, life-long digital health and care record for everyone giving patients a chance to easily access their own data with these records in place universally by 2024.
And neatly wrapping up everyone's health records for sale to the highest bidder/biggest donor to the Tories.
Re: Our data, not theirs to sell
and the highest bidders will be the insurance companies we'll have to start paying, once the Tories dismantle the NHS. They'll want to know everyone's back story before offering cover.
Re: Our data, not theirs to sell
I always find this a bit perplexing: if the only people who can get affordable insurance are the ones least likely to need it, doesn't that obviate the entire point of it?
Re: Our data, not theirs to sell
An simple and effective counter-measure would be to put Dido Harding in charge of it!
"backed by £2 billion [..] in funding"
Don't worry. That will balloon into £8 billion and, in the end, it won't work.
Par for the course.
Re: "backed by £2 billion [..] in funding"
"Abandoned NHS IT system has cost £10bn so far
This article is more than 8 years old
Bill for abortive plan, described as 'the biggest IT failure ever seen', was originally estimated to be £6.4bn"
https://www.theguardian.com/society/2013/sep/18/nhs-records-system-10bn
So eight Bill would be a snip.
Re: "backed by £2 billion [..] in funding"
Those are rookie numbers! The pros can do "GBP 37 billion last we checked - and still going up": https://committees.parliament.uk/committee/127/public-accounts-committee/news/150988/unimaginable-cost-of-test-trace-failed-to-deliver-central-promise-of-averting-another-lockdown
Spyware
There's a reason I didn't put the government COVID app on my phone, not least of which is that several early versions of it were rejected by the platform's app store over privacy concerns. I got around the need to use this to scan barcodes everywhere by making the sensible decision not to go into crowded public places during a pandemic unless I really had to.
I'm told the NHS "official" app is better than the government's one, but how long before this is replaced by something "NHS" branded but wholly owned and operated by private interests (with lots of suspicious links to the Tory Party?), and with no link to, or oversight from, the NHS at all. You know, just like "NHS Track and Trace".
With the current government's fetish for derogating human rights, and willingness to weaken data protection laws, I have absolutely zero confidence that this won't be used to gather private and personal data and sell it to the highest bidder. Given their track record, this is essentially a foregone conclusion.
On the flip side, I can see the benefits of a unified electronic medical record. However, the subject MUST have complete control over how this is gathered, where it is stored, and what it is used for. There must be proper, legally enforceable oversight, and any transfers to organisations outside of the UK must be an opt-in process, with a basis in necessity. I can't actually think of any necessary cases where my medical data needs to leave the UK, except possibly for emergency treatment when overseas.
There may need to be exceptions to consent, for example in emergencies when the subject can't consent, but in these cases, there needs to be proper data governance, with the principles of limitation (only the data that is needed for the purpose), auditing (a log being kept of who, what, and when, stored with the main record), and assurance of destruction when no longer required (e.g. when discharged from that overseas hospital). There must be absolutely no scope for data collection, storage, and sale of this data.
I have no confidence in the current government to ensure any of these things. In fact, I can envision them licking their chops hungrily at the thought of just how they will spend the cash they get from selling us out.
Our Trust implemented an EPR many years ago. The clinical coders (deal with patients being coded correctly and therefore the Trust gets paid accordingly), reckoned it generated more paperwork than the old system...
Some areas are already linking together to get faster regional record updates. e.g. Great North Care Record.
Baby/ Bathwater
We have a lot of invested time and energy in EPR's PAS's Path systems, let alone Specalist Clinical systems (that I work with)
Its got to better to link these up rather than chucking out the lot and starting again with some new system.
Interfaces are what makes the systems work, not puting in the new shiny shiny every 5 years.
Priorities
"The most significant risk to this new vision of digital health and care is the lack of capacity among the health and care workforce," Mistry said
To the vision maybe. The most significant risk to the security of the data is that, given the govt's record of performance in application development, there'll almost inevitably be one or more stupid bugs in the software that allow the data to be exfiltrated or corrupted by 'bad actors'. And they will try, as it's some of the most sensitive information around.
Re: Priorities
Normally, I'd refer to the adage, "never attribute to malice that which can be adequately explained by incompetence." However, with this lot, I'd give malice and incompetence equal footing.
would be cheaper to do it with hieroglyphics
@cantankerous swineherd
cheaper to do it with hieroglyphics
But not nearly so profitable for all those conservative donors...
What kind of digital
Sometimes I wonder whether these 'digitised' records are merely scanned images of doctors' handwriting, that well-known encryption system. Not that our arts graduate government would know the difference between a scanned image and an OCR image.
Success for Google
So it is a success to give all our data away for free to the likes of Google, virtually close down the entire NHS and access to GPs and waste a fortune doing it.
No wonder they are loved by all the US health and IT companies.
"Sink" seems likely to be right although all those data brokers who get away with our medical histories won't agree.