Granger promises summary care record pilots by Easter

Connecting for Health’s chief executive, Richard Granger, has revealed that the first pilots of the national summary care record project should be ready to begin by Easter.

Speaking at the London Telehealth Symposium yesterday, Granger said that the delayed project summary record will be ready to begin rollout to initial pilot trusts by Easter. Dr Patrick O’Connell, managing director of BT Healthcare, which is currently developing the summary record system, agreed the deadline would be met.

Granger was addressing the audience on the importance of driving change in healthcare by using technology. He talked of the difficulties of getting trusts to take the systems currently on offer.

Echoing his comments to the Financial Times in November, he said that the challenge of deploying systems was hard to meet at present, because of the weak demand from many trusts for the systems currently on offer from NPfIT sub-contractors iSoft and Cerner.

Granger said that while ‘greenfield sites’, which had relatively little IT in place, have been quite receptive, those ‘brownfield sites’, that had already invested in and were using more sophisticated healthcare IT systems were less receptive.

“In greenfield sites, it is easy to put in new systems whereas in Brownfield sites, it’s not so much. For example, in the north-west of England, it is hard to get more than one Patient Administration System in a month due to the different fields of hospitals in the region. The cost of integration and interoperability is a big factor.”

He warned that past technology, even systems that were deployed as recently as 2003, only operate fully in proprietary mode. He urged trusts to switch to NPfIT systems as soon as they can.

He said that as well as delivering immediate benefits, national programme systems were non-proprietary allowing for future upgrades and migration. "With the National Programme, we are getting a lot of money to put new systems in and it’s important to me that the replacement costs later are not higher than the original implementation costs.”

Turning to telecare, Granger said that the Department of Health’s pilots now getting underway were “new scope”, beyond the original NPfIT programme. He said that there were particular concerns over where the data goes once collected from a patient’s home and how it is kept confidential.

“The mass of data in the health environment now is pathology data, soon it will be data collected from the home. So what so we do with it? Will it be sorted by machine or human intervention?" asked the NHS IT director general.

He added: "There are ongoing discussions relating to identity and confidentiality, but with data collected from people’s homes there is a different intimacy then from data collected in hospitals.” Granger said that personally, he would like to see the mandatory use of the NHS number to be used by trusts.

He said that the mass adoption of telecare pilots in England will be a "very telling moment", one which he predicted will be of most appeal to staff who work in hospitals by relieving some of the service pressures they currently face.

The NHS IT boss again stressed the vital role common standards and interoperability had to play in creating a joined up digital health service, and detailing the work that CfH are doing to create set standards with HL7 and SNOMED CT, in particular.

“Standards of data are essential for the work we want to do. I’ve championed the creation of a SDO [standards development organisation] group, which I hope will soon get up and running.”

Granger revealed that CfH are working closely with Microsoft to construct new common user interfaces for NHS staff, to ensure that different systems in use across the health service will in future share a common look and feel for all NHS staff. “We are trying to develop standards for interfaces with Microsoft so that back end engines can be different but fundamentally the systems used remain constant, it has been very difficult and slow, but we are moving forward and we have managed to publish a style book available now.”

Summarising technology’s role in the future health service, he said: “In the not too distant future the NHS will not just be about buildings and staff, but about information, particularly clinical information and not just financial information. Our challenge has to be to put in information systems which share information very easily without cost or inconsistencies.”