Her Majesty's CIO braces US for Obama HIT

Health Info Tech? Good luck

When pharmacists go bad

Suffolk's example of how a health information system can combat larceny and fraud revolved around the NHS's national digitized prescription system. "You know the whole story about how you can never read a doctor's handwriting? Well, it's damned true," he said. "And people do die because of it. You put in electronic prescriptions, and that problem begins to go away.

"It also begins to take away all the fraud. You go to your pharmacy, you go get your prescription, and they say, 'Oh, I'm sorry, sir, I don't have that brand of drug - here's this generic one.' And they charge the government one and they take the price of the other. If you're a pharmacist - and 99.999 percent are fantastic people - but if you're slightly on the edge, are you going to rush to install that system? Of course you're not."

Installing an entirely new system will, as Suffolk put it, "flush out a whole host of things. You're going to come across problems that have been lying there for a hundred years which you've never had to address before."

Nevertheless, he said, "I believe that it's exactly the right thing to do, but it's probably one of the toughest things you'll ever do because you're dealing with people and culture in a way that's probably never been done before."

And Suffolk believes that the problems, infighting, criticism, and expense are worth it. "The NHS program gets a lot of criticism in the UK for the amount of money it's spending," he said, "but I genuinely believe that we will look back in ten years and say, 'You know, without putting in that technology on a national basis for every citizen, we probably couldn't have kept the Heath Service going in the way that we're doing it at this moment in time.'"

Will health information technology succeed in the US? The challenges are grotesque: America is lumbered with 50 jealous state governments, innumerable private insurance companies, a maze of for-profit and non-profit hospitals, and a culture that can at times be best defined as "Hell with you, Jack - I got mine."

The UK, on the other hand, has the unifying force of the NHS, a less divisive regional system, and a population one fifth the size of that of the US.

Suffolk avoided giving direct advice other than "Be realistic how tough it's going to be and manage expectations" and "Get all the issues on the table."

After all, the problem isn't rooted in IT. As Suffolk said, "We can crack the technology."

It's not hardware or software. It's that headstrong liveware.

Bootnotes

More from Her Majesty's Government CIO

On cloud computing: "People often ask me what's my definition of the cloud and what do I think of it. I have to say it's a bit like driving into fog at high speed without your lights on. Half the time, we're not quite sure what the hell is in a cloud - and if I'm meant to protect citizen data, then how can I protect it if I don't know what I'm protecting it on? But I have no difficulty using cloud in an unclassified kind of way."

On thin-client computing: "For the love of me, I can't understand why we put a big, heavy lump of tin on the desk, when all that most people do is contact-center office stuff. It's a complete waste of investment. The vast majority of the 5.5 million public servants do not need a big lump of tin."

On truth in marketing: "Tell me why you can't create a secure PC for a consumer. It's a very simple question. Well, we can't. And yet we never tell a consumer who buys a PC - it doesn't say anywhere - 'This PC is not safe.' Does it? We talk about the world's greatest inventions, and yet we never tell a consumer: 'This PC is not safe - and oh, by the way, when you put on all this additional stuff ... like firewalls, it's still not safe.'"

On the information glut: "One week's worth of newspapers - whether be it The Wall Street Journal or The Times - is greater than all the information you would have received in your lifetime in the 18th century. Take a single piece of fiber and you'll have 1,900 CDs a second - and accelerating away."

On change: "How many of you are keeping up with the rate of change? The answer is that nobody is. And therefore one of the biggest challenges for us as an IT industry is that ... we have no understanding of the consequences of the decisions that we are making. And I believe that to be true in most other walks of life as well."

On the economic Meltdown: "We're in broadly the same economic position as you good folk: we have no money." ®