Below is my list of reasons why I think NPfIT failed. NPfIT was the NHS National Programme for IT in health, starting in 2002, with Richard Grainger appointed as NHS IT director. A timeline is published here. NPfIT is generally conceded to have spent £10.7bn by the government in 2013, when it was definitively shutdown. Claims have been made that slightly more than this was delivered in value. Realistic analyses such as the one linked to from the image at the top of this post show that the realised benefits are miniscule. Right now, the benefits for ‘Choose and Book’ can probably also be written off, as it is no longer generally used. I would guess the only benefits that those in the industry would agree were actually realised are N3, the secure NHS network and possibly NHS mail. The Spine supplies some benefits, but is so badly designed and over-complicated that it will undoubtedly be completely replaced in the next 5 years.
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Every so often I get bored of what I am doing and start trying to draw one of those ‘services roadmap’ kind of diagrams for e-Health. These pretty pictures appear in slide presentations, standards, whitepapers etc, but are not often used as a tool to help map out the road ahead, mainly because (I think) they mix too many conceptual levels together. We do however need some sort of vision of the future for defining services. I like my latest version enough that I thought it would be worth putting up publicly to get reactions and input. Please comment and/or add content to the wiki page.
Some readers may have read my previous post FHIR compared to openEHR. If not, I recommend you do, it is available in Spanish, Japanese and Chinese as well as English. Here I aim to clarify some of the concrete differences which are increasingly common sources of confusion, particularly with the FHIR hype wave preventing coherent thinking in many places. It seems that the human psychological pre-disposition for uncritical silver bullet thinking is as strong as ever, but I still hope (perhaps vainly) that in e-health we can soon get back to real science and engineering. Continue reading →
For decades, most of us working in health informatics and e-health have lived on the assumption that ‘interoperability’ is one of the main things we are trying to achieve, and that it is the most important because the lack of it blocks progress on nearly every other priority. In the last decade, the gold version of interoperability has become ‘semantic interoperability’, a fabled Nirvana in which today’s sewers of recalcitrant proprietary data are magically transformed into a sea of pure Evian whose meaningful molecules will be ‘understood’ by drooling next generation apps that will instantly discover what is wrong with each of us, and tell us how to fix it.
The openEHR Basic Meta-Model (BMM) that has been in use in some form for nearly 10 years now was recently upgraded to version 3.0.0 (from 2.x), with the persistence format (now called P_BMM) being backwards-compatibly upgraded to version 2.3. The purpose of the upgrade was to improve the separation of class and type, and to greatly strengthen the semantics of generic types and classes.
I just returned from Heidelberg, where another very successful ‘openEHR day’ was held, this time by the HiGHmed research consortium, with 100 attendees. HiGHmed is funded with 20m€ by the German Federal Ministry of Education and Research (BMBF) under the “Medical Informatics” funding scheme, and has as its goal (my bolding):