England Plans Dramatic Modernization of Healthcare

In a massive information-technology (IT) project, England is planning to store every citizen's individual healthcare record in a central electronic database, which will be accessible to doctors everywhere in the country by a broadband network, taking online medicine to a higher level.

In the next several years, very doctor's office, every clinic, and every hospital will be linked to the database. The timetable calls for the medical records phase to be completed by 2010. The National Health Service (NHS, London, UK; www.nhs.uk) estimates that once the system is operational, five billion transactions a year will be processed by the system, including electronic prescriptions, appointments, and access of patient records.

The project presents a huge market for computer manufacturers. One contract is to be awarded for the national database of patient records, while separate contracts are to be awarded for the five regional networks that will link to the national database. A contract has already been awarded to build a national electronic service for booking appointments. For the project's first three years, the NHS has promised U.S.$3.9 billion for the first three years, then a further $13 billion for the next seven years. For now, the new program applies only to England, with Scotland and Wales having their own separately run health systems.

To avoid privacy problems with patient records, the NHS will use an indelible audit trail to show what part of the record has been accessed and who has had that access. Patients will be able to selectively prevent doctors from having access to certain parts of their record, particularly sensitive information such as a mental health problem.

"Patients will be able to exercise choice and experience less delay and waiting as appointments will be booked at their convenience, test requests and results transferred electronically will cut days from the current process, and electronic prescriptions will improve patient safety and provide a modern service,” said Richard Granger, IT director, NHS, UK.

Other governments will be carefully watching this program to see if it can serve as a model. While health-care computer spending in the United States rose about 10% in 2002, the use of computers in U.S. health care is small and fragmented. However, there is increasing interest there in the use of electronic systems to store patient data, in part to reduce medical errors. In a bolder move, the Canadian government recently announced the decision to create its own new system of electronic health records.




Related Links:
NHS