NHS study damns electronic patient records systems

Large scale electronic patient records systems can make healthcare less efficient, according to a major study funded by the NHS.

After a global study, researchers at University College London concluded that of electronic patient records systems helped hospitals with billing but often did not aid clinical work.

The findings will be an embarrassment to government as the NHS begins the multibillion pound rollout of these systems after completing early adopter trials.

The UCL study comes as a Harvard Medical School study that looked at some of the “most wired” hospital facilities in the US found that computerisation has not saved them any money or improved administrative efficiency.

Researchers at UCL argue that that in many situations, paper is preferable and more flexible to any computerised records system currently available.

Some £12.7 billion is being spent on the NHS National Programme for IT. But the UCL researchers warned that up to eight in 10 health record projects have failed because it is difficult to introduce such complicated systems into diverse, highly complex environments.

The NHS assumptions, that records could be easily transmitted between different stages of care, were “flawed”, the report stated.

Smaller programmes with local systems work better, it found. This model was originally suggested by many clinicians prior to the start of the programme, but the government pressed ahead with a national rollout.

The new UCL study found that large scale programmes “promise much but sometimes deliver little”. It assessed hundreds of health records programmes including the NHS scheme, in a report sponsored by the Medical Research Council, the National Institute for Health Research, and NHS IT programme co-ordinator the Department for Health.

Ongoing integration between different record systems was “unlikely ever to happen”, the study found, because human input is required to “re-contextualise” the data.

The report, published in specialist journal Milbank Quarterly, also cautioned Barack Obama, US president, against his own plans for an electronic patient record for all US citizens in five years.

Professor Trish Greenhalgh, the main author of today’s UCL report, said it was time for policy makers to “move beyond simplistic, technology-push models” and to consider “the real world”.

Last year academics at UCL said patients should not be automatically opted in to records.

The NHS, however, stuck to its guns, making patients continue to have to opt out if they do not want to be part of the system.

In a small concession, the NHS introduced a model whereby clinicians will have to ask patients to view the record. The doctors’ industry body the British Medical Association said it disagreed with that approach. It argued that patients should have the choice of opting in and be “treated like adults”.