Health IT Policy in the UK: The Case of Electronic Health Records

Health IT Policy in the UK: The Case of Electronic Health Records

Wendy L. Currie (Audencia, Nantes, School of Management, France)
DOI: 10.4018/978-1-4666-4546-2.ch019
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Abstract

The challenge to provide a nation-wide integrated health service is part of a UK government policy to transform healthcare using information and communications technology. The National Programme for Information Technology launched in 2002 is the largest, non-military, non-scientific government-funded IT programme, with an estimated total cost exceeding £20 bn. This chapter is a longitudinal study of the National Care Record Service, which is the largest part of the programme, aimed to provide 50 million UK (English) citizens with an electronic health record. Using episodic interviewing techniques over ten years and secondary source material, the findings reveal a serious mismatch between health IT policy and the failure to rollout electronic health records on time and within budget. Key stakeholders, notably clinicians and patient groups, continuously question the policy and merits of the programme, not merely as a “technical challenge” but as a means of transforming working practices in healthcare. This study suggests that government agencies therefore need to extend their health technology assessment criteria to include cultural, social, and economic issues, as imposing centrist, top-down health IT policy needs to secure the “buy-in” from diverse and influential groups and individuals to ensure the successful adoption and implementation of health technologies.
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The National Programme For It In The Uk Nhs

Research on the use of IT in government organisations has increased steadily over the past two decades, particularly with the publication of reports which highlight the importance of IT-enabled transformation in public services like health, education and pensions (Department of Health, 1998, 2000). The transformational government agenda aims to, “systematically engage with citizens, business and front-line public servants to understand and then specify the transformational changes which service providers need to meet – learning from the best practice already within the public sector, from other governments and from the private sector. (Cabinet Office, 2005:7). Health IT policy is a major part of this agenda, particularly as healthcare has witnessed a shift from medical professionalism to market-driven policies with mixed success in winning the hearts and minds of key stakeholders (Blackler, 2009, Scott, Ruef, Mendel, Caronna, 2000). The literature on public sector reform suggests new government initiatives need to be contextualised in the communities of practice to understand how citizens react to change (Moore, 2006). Our interest in the NPfIT was not therefore confined to organisational and technical issues, but towards a wider health policy agenda to encourage cultural change within the medical profession and public at large.

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