Evaluation of IT modernisation in the NHS - NETSCC

Report to SDO for NCRS ProjectSupporting Literatureaddition, the researchers in Ohio suggested that the elimination of alternativemethods of ordering, and the abolition of all paper forms is useful; clinicianscannot revert to manual ordering if it is not available. 36The findings from this body of work are generalisable to our study, whenevaluating the impact of EPR implementation in the NHS, in highlighting potentialprecursors for success and suggesting potential obstacles. However, asdiscussed earlier in relation to the New South Wales study, it would be a mistaketo assume that these factors will automatically translate to a different context.There are important differences between North American health care systemsand England’s current NHS EPR strategy. Some of these differences are aquestion of organisational configuration, such as private and public sector financeand cost allocation, and the more rigid demarcation of clerical and clinical roles inthe US and Canada. 9organisational structure and strategy. 37Other differences concern fundamental transformations inThe CPOE studies involve implementinga single form of electronic function across 7 or 8 hospitals. The NPfIT is likely toimpact on, and transform, every part of England’s current health care system.The research reviewed tends to ignore wider issues of organisational andtransformational change, preferring to concentrate on the utility of the innovationto the individual consumer. Research addressing innovation on the scale of thecurrent NPfIT is simply not available anywhere because the national program isthe largest and most ambitious public sector IT project ever undertaken. Nothingon this scale has been attempted before. 102.5. Research examining implementation of IT in the UK NHSCurrent research specifically concerned with the evaluation of implementation ofEPRs and IT in the UK NHS is limited. A review of this literature undertaken in1999 generated over 2000 citations, yet few instances of independent externalevaluations were identified, with comparative quantitative studies virtuallyunknown. 38 The authors concluded that few reports gave a full account of thecosts involved, and that many evaluations were ‘simplistic, inadequate orprecipitate’. The messages that emerge are again general; most problems relateto human rather than technical factors, work processes must adapt as IT isintroduced, realistic expectations and timescales should allow for greater benefit20