UK Primary Healthcare Groups: Stakeholders, Technology and Benefits

Abstract

The UK Information Management Strategy (NHS, 1998) for the period to 2005 envisages the implementation of a Nationwide private network which will support clinical and administrative functions throughout the National Health Service (NHS). Using Web-based technologies, a wide variety of applications will enable rapid communication between professionals. Secondary, acute services and primary care services will be linked in a way that has not been previously possible. Communications concerning hospital appointment booking, referrals, discharges from hospitals, radiology results and laboratory test requests will all be mediated by the NHSnet, producing faster, more accurate communication and increased integration of services. Electronic patient records (EPRs) will be transmitted between general practitioners (GPs) and hospitals, prescription requests will be transmitted to pharmacists, even patients will be able to access information concerning conditions and treatment and communicate with health professionals from their homes. In effect we are observing the potential for technology-enabled change as ‘information powers the NHS’ (Nicholls, 1995). The UK information management strategy provides the foundations for radical changes in healthcare philosophy: shifting the focus of activity to primary care, increasing patient responsibility and involvement in the healthcare process and increasing the information available to healthcare professionals and patients. Thus, an agenda for social and cultural change within healthcare delivery is to be driven by the availability of technical infrastructure (Lenaghan, 1998). It would be naive to consider that the availability of the technology will naturally lead to its acceptance as a communication media or to the required organizational and cultural change. The management of a Web-enabled infrastructure and its Web-based information systems is as much about the management of its social construction as its physical construction. Stakeholders within the health service will have individual perceptions and expectations of the technology which through discussion and interaction within groups will determine the social construction placed upon the technology and ultimately the benefits incurred by its use. This social construction will be significantly affected by the context within which the technology is implemented. Contextual issues may include the attitude of stakeholders and stakeholder groups to the technology, economic drivers which influence the availability of the technology, and previous implementations of information and communication technology. If the implementation of a Web-based communication system throughout the UK NHS is to be successful, the needs of stakeholders and the types of application possible should be matched to produce benefits. The management and delivery of benefits requires an understanding of stakeholders’ interests and the implementation of applications appropriate to those interests. This chapter considers the following questions: Who are the stakeholders involved in a Web-based information infrastructure? What applications are possible? How do we match applications to stakeholders to achieve benefits? In each of these areas a research agenda is developed, Firstly we provide and overview of the technology which will enable a new approach to healthcare communications in the UK.