[JusticeJuice]

The UK government tried this, wasted 12.4 billion pounds over 10 years, and ultimately wrote most the project off. The dream of an EHR is just deceptively tricky, so many smart, well-funded, well-connected teams have tried and failed.

ref: https://barnett.surge.sh/welcome/intro.html

[Flibble21]

I have a friend that has worked on this project for over a very long time and the issue is not that the UK tried to implement EHR records from scratch but rather that GPs (General Practitioner, think local doctors surgeries) had mostly all implemented EHR systems already. The issue is that these systems are created by several (6-8 if memory serves) different private companies and the UK Government can't force the GP to change or adopt a standard system.

The different GP EHR systems record patient information in their own ways. Think of a database entry for chemo medication, one EHR provider having a db column labeled "Drug X" with the patient entry listed as "Yes" with separate columns for dosage, frequency etc. Another will list the drug, dosage and frequency in the same field. Even if they have the same column e.g. frequency, different EHR's may list "5d" or "5 Days". There are also spelling errors, doctor's personal shorthand abbreviations etc.

The problem is that the UK interoperability system has is to implement a safe translation layer that will allow records to be transmitted between these systems that doesn't kill anyone. The astonishing amount of different types of information that are used and all the oversight needed to ensure that information is accurately transferred has made this project way more costly and time consuming that originally thought.

There is, of course, waste and profiteering, both internally to the Government project (huge contract salaries) and also with the private EHR companies (overruns and re-builds are all handsomely paid for).

[pjc50]

> The issue is that these systems are created by several (6-8 if memory serves) different private companies and the UK Government can't force the GP to change or adopt a standard system.

Yeah, the UK healthcare system is only mostly nationalized.

I do think these IT issues could be fixed, but only if there was someone at Cabinet level who knew what operations management was, which we're unlikely to get in the forseeable future.

[penteract]

Following the sources listed there, "wrote most of the project off" seems like an overstatement.

> The MPA found that there have been substantial achievements which are now firmly established, such as the Spine, N3 Network, NHSmail, Choose and Book, Secondary Uses Service and Picture Archiving and Communications Service. Their delivery accounts for around two thirds of the £6.4bn money spent so far and they will continue to provide vital support to the NHS. However, the review reported the National Programme for IT has not and cannot deliver to its original intent.

Of the rest of the £12.4bn, £3.4bn is "expenditure by local NHS organisations, for example on local IT and training and ensuring compliance of local systems with Programme delivered systems", which probably isn't entirely wasted either.

[dieortin]

If I’m not mistaken, the Spanish healthcare system has a fully electronic medical record.

[mcosta]

In reality it has several

[dgellow]

Germany too

[Naijoko]

hahahahahahahahahahahahahahahaha

This is a joke. We want to have this but its like everything in germany if its about something digital. Its a fucking mess. Everyone can read it. Most doctors dont use it and even many insurance dont use it... its a fucking mess

[dgellow]

Ok, but it’s digitalized, I didn’t say it was good. You can now directly go to an Apotheke with your insurance card and get your medication, even the prescription is digitalized.

[Naijoko]

ok thats true and that does work. But the system in the background is a mess.

[FwarkALark]

Again, this can't be worse than private industry—that profit margin will guarantee this. I guarantee there is some other disease to blame for the waste—probably politicians of some sort invested in industry.

Of course, this does demand citizens give a shit, which seems hopeless at this point.