Engage or risk failure, BMA IT chief tells NPfIT

Speaking at the IBC Informa ‘eHealth: Transforming healthcare access and delivery’ conference in London yesterday, Dr Powell said: "We need to learn the lessons from history. One of the central lessons is the you have to engage with the people who are most affected by the change. Lack of consultation with the users is a main failure of public sector IT."

"If the national programme set themselves up into opposition then that’s what they’re going to get," Dr Powell told E-Health Insider. A good move for NPfIT would be to start engagement with clinicians by formally announcing that they are aiming to set up partnership networks, he continued. The National Care Records Development Board was a good start, he told EHI, but more needed to be done.

“We believe that an extensive and genuine consultation is crucial,” Dr Powell told conference delegates. "The whole program could stand or fall with its approach to change management."

Dr Powell stressed that the BMA supported the aims of NPfIT, but cited the recent Medix online survey that revealed only 7% of clinicians believed that consulation with the national programme was ‘adequate’.

“The national programme has been slow to realise the benefits of engaging with the professional,” he said. "There seems to be an almost oppositional view of doctors in the national programme."

He cited a couple of examples of NPfIT and clinicians talking at cross-purposes; for instance, when one clinician asked a member of the national programme about how it would affect the ‘doctor-patient interface’. The consultant mis-interpreted the question as being about computer interfaces and GUIs, rather than the relationship and balance of power between clinician and patient.

Powell explained that information and change management, not technology, were the principal issues: "Doctors are information managers – we manage information all the time. People must realise how vital information is to medical practice."

Engagement would result in greater ownership, said Powell; without addressing the concerns of stakeholders, there will be a large amount of difficulty in achieving change.

Responding to comments that clinicians should be pro-active in looking to engage with NPfIT, rather than waiting for the national programme to come to them, Dr Powell said: "We would like to take a more active role, but we haven’t been asked."

Furthermore, information on IT updates wasn’t being made available enough for the BMA to explain to members what was going on, Powell claimed: "We need to be supported by the national programme. It’s not the partnership that it should be."

"Early demonstration of benefits and value for money will be important in convincing patient and healthcare works of the need for change"

The ‘I’ in IT must not be underestimated, Powell argued. "Information is central to healthcare and always has been. New developments in information management should be driven by the need to prove improve patient care."

"It’s about people, it’s not about computer infrastructure. The ones who will need to be engaged are those who have no idea about how computers work."