Evaluation of IT modernisation in the NHS - NETSCC

Report to SDO for NCRS ProjectSupporting Literaturewhat Klein has coined the ‘Martini factor’; once found they can be used any time,any place, anywhere. 40,41This potential advantage of paper records may be onereason why the authors concluded that, although EPRs were in certain casesbeneficial, on balance time saved versus time spent was at best equal. Theauthors propose that future EPR systems will have to do considerably better inrecognising and balancing the potential conflicts between time saved and timespent. They also warn that current euphoric claims regarding the effectiveness ofEPRs are likely to result in widespread disappointment amongst NHS staff andpatients. 42Whether this prediction will be realised when implementation of the NPfIT iscompleted is unknown. A report by the Institute for Public Policy Research 43described how the benefits of EPRs to health services could be huge, but therisks could also be substantial, because of the failure to provide evidence ofimpact. The research, based on examining large EPR pilots in the NHS,concluded that public and political support for unprecedented spending on ITinvestment in health services will not be realised without better planning andevaluation. Trials of electronic patient records failed to demonstrate that theywould lead to more flexible services, cost savings or improvements in treatment ofpatients. In addition, pilots of electronic appointment booking systems failed toshow clearly that they helped to facilitate greater choice for patients about where,when and by whom they are treated. A more recent National Audit Office reportalso raised concerns, with the current roll out of NPfIT reported as less thanoptimal. 44The report highlighted that the programme faced significant challengesin delivering systems to agreed timescales, ensuring involvement of NHSorganisations in implementation and, importantly, gaining the support of NHS staffand the public.2.6. ConclusionsOne aim of this study is to determine which organisational factors impact on theimplementation of electronic patient records in the UK NHS. Current researchreviewed offers some useful insights, in suggesting that factors such as having anorganisational culture of trust, plus good teamwork, supportive leadership, systemcustomisation, flexibility, userability and speed, will aid success. However, as22