Electronic patient records can drive healthcare innovation without compromising privacy

Nuala Moran, News Editor

The prognosis is grim. The patient has been in steady decline for years. Despite periods of remission new procedures have failed. Health professionals cannot agree a way forward.

The ailing patient analogy for the world’s biggest civil IT project is disturbingly neat.

After years of false dawns, political cowardice, technical complications and system redesign, contractor fall-outs and management convulsions, the most politicised project in the history of computing, UK’s £12 billion electronic patient record system has stalled.

The significance of this goes way beyond what it means for the efficient operation of the largest public sector organisation in Europe – the UK National Health Service.

The merits of a comprehensive electronic system are self-evident. You don’t need to have been a patient, who has taken a day off work for an out-patient procedure and been sent home because paper records were in the wrong part of the hospital, to understand the simple virtue of providing on-line access to up-to-date, consistent patient records.

The benefits of a single electronic patient record system to the delivery of healthcare are transparent – in efficiency, in cost savings, in improved patient (for which read customer) service, in health outcomes.

But there is more at stake here. Failure to deliver the electronic patient record system also strikes at the heart of innovation in healthcare and threatens to compromise a sector where Europe senses a global market opportunity.

The fact is that interoperable electronic patient record systems could underpin waves of innovation, fostering the development of translational medicine, supporting epidemiological studies, freeing up drug development resources and leading to the development of new services for monitoring those with chronic disease, or helping elderly people remain independent.

As we report this week, the European Commission is beefing up innovation policy and putting more flesh on its Lead Markets Initiative. The aim is to remove obstacles to the growth of new markets in six sectors including electronic healthcare. The Commission has been forming steering committees, identifying regulatory initiatives and starting work to create new technical standards.

One of the first concrete moves is a recommendation for interoperability standards for patient record systems, as a first step towards making it possible to share health data electronically. The Commission believes that if Europe was the first market to devise standards for electronic patient records it would create single market incentives that have never existed in the sphere of healthcare – one of Europe’s biggest single areas of expenditure.

In identifying the need for standardisation of patient records, the Commission has rightly grasped how the current lack of standards is holding back innovative healthcare technologies.

From its inception, the UK electronic patient record system has faced hostility from an unholy alliance of Luddite medical vested interests, civil liberty lobbyists, and libertarian politicians simply happy to see another government IT project fail.

They have found common cause by uniting behind the privacy fig leaf, and the news that the European Commission is getting involved in the action will no doubt lead to redoubled protests.

Of course there are huge privacy and security issues around the computerising of personal medical files, and these have to be managed sensitively, both from an organisational and a technology perspective.

But to be clear – setting European standards for electronic patient records would in no way undermine the way privacy issues are handled, or remove the responsibility of each country to create its own privacy rules.

No one doubts the importance of standards in building markets – whether advanced technical standards like GSM for mobile communications, or the more mundane 60cm X 60cm footprint for white goods.

So let’s hope the UK electronic patient records project can be roused from its coma and reactivated as a showcase for the contribution that standardised systems can make to healthcare.