Any hopes of 2010 becoming the year in which healthcare IT moves on from the trauma of NHS Connecting for Health and the English National Programme for IT may be in vain. In the first half of the year at least, painful changes in scope, together with cuts in central administration and contract renegotiations will continue to generate heat.
In the second half of the year, however – regardless of the result of the general election – the agenda may move on. For many in the industry, that move could be over the Atlantic.
The first major event in the diary will be the NHS Management Board's decision on whether "significant progress" has been made in acute hospital implementations. The larger of the remaining local service provider contractors, CSC, said last week that it is "in the early stages of discussions with the Department of Health on the reshaping of our contract to meet the future needs of the National Programme for IT. We expect these discussions to conclude in due course to the satisfaction of both the NHS and CSC."
The first half of the year will also be a critical time for the introduction of the Summary Care Record (SCR) in England. Assuming the London deployment goes ahead successfully – a big assumption, given the capital's dismal track record in healthcare IT – implementation across a significant part of England will follow.
A more difficult decision will be over whether to combine the SCR with the Healthspace personal health record. Officially, an announcement on Healthspace's development is expected in January, but this is highly likely to slip. Given the lack of public enthusiasm that has so far emerged for the scheme, Healthspace must be a prime candidate for postponement or outright cancellation in the quest for chancellor Alistair Darling's IT project economies.
The same must go for the delayed and still embryonic national electronic prescriptions service – unless a rock-solid business case is forthcoming.
Known unknowns
A big unknown for 2010 is whether Google and Microsoft will introduce their respective personal health record services in the UK. These have been talked about with enthusiasm by Conservative leader David Cameron, so much will depend on the general election outcome.
And, despite its status as one of the "big three" government websites, the long term future of NHS Choices must also come under scrutiny in 2010. The announcement in the Smarter Government strategy that underlying site data will be available to all raises the possibility of NHS Choices being replaced by initiatives from the private or voluntary sector.
However the current portfolio of centrally funded IT projects is by no means the only game in town. A significant challenge that will emerge in the year will be creating an IT infrastructure to support "total place" initiatives, or whatever a new government chooses to call projects that link up services in a locality. As the Conservative-sponsored independent review of health and social care pointed out, NHS and social care organisations will need to work together more closely to meet the challenges of the future: "Information-sharing will need to become the life blood of this relationship."
Whoever grasps this nettle will face an onslaught from the privacy lobby – especially if the NHS suffers more headline-grabbing IT security breaches.
On the brighter side, 2010 will be the tenth anniversary of the HL7 healthcare data standard in the UK, and a chance to show that, where the local will is there, different arms of the health service can be linked up, especially for the benefit of the chronically sick.
But developments in the UK are likely to be overshadowed in industry circles by the rising profile of President Obama's $19bn (£11.7bn) healthcare IT pledge. All eyes will be on the first real test of the Nationwide Health Information Network (NHIN) by the Department of Veterans Affairs and healthcare provider Kaiser Permanente. The Department of Defense is due to join the next phase of the pilot programme early in the year.
If all goes well, the US programme will create a strong temptation for US-based IT suppliers to wash their hands once again of the troublesome NHS market. But as we have seen in the NHS – which began with the advantage of having an integrated health service to computerise – success is no certainty.
But making predictions is a dangerous business. Back in 1998, this writer contributed to a research-based work of fictional futurology called Healthsmart 2010, produced by Smart Healthcare's publisher Kable. In it, we proposed that, by 2010 the NHS would have been transformed by the "information revolution... in ways that affect everybody." We said that 2010 will be the age of the "informed patient – at least among those social groups that have access to information technology." And we warned that "security is a serious issue".
So we got part of it right.
Staff
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