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April 29, 2007

To Go and To Come?

In its editorial the Health Service Journal of the 19 April 2007 says Mr. Richard Granger, the Director General of NHS IT is "expected to leave soon". Now how many times have I heard that in the last 2-3 years? Nonetheless, the recent mostly critical report on NHS National Programme for IT by the House of Commons Public Accounts Committee (PDF 4.5Mb) cannot have strengthened his position.

The HSJ also refers to a report by Professor Sir Ara Darzi, the national advisor on surgery and one of the medical profession's rare technological innovators. In Saws and Scalpels to Lasers and Robots Professor Darzi suggests 80 percent of local surgery could be carried out in health centres and large GP practices.

It seems if anything is going to drive NHS modernisation it will be public expectation combined with the march of technology--with or without a centrally led IT programme.

April 15, 2007

Improving IT Better?

As reported here more than a year ago, the NHS National Programme for IT is being reorganised. As part of the National Local Ownership Programme, responsibility for implementation is being devolved from NHS Connecting for Health to England's ten fledgling Strategic Health Authorities. Staff are also being transferred.

E-Health-Insider reports the process is delayed. Given the NPfIT's turbulent past, that isn't surprising. What is surprising is we seem to think that transferring the same staff and same suppliers to SHA's will make NPfIT different.

We need more change than that. It seems only a matter of time before NHS trusts are free—within reasonable constraints and complying to reasonable standards—to create their own care record with their own choice of supplier.

Robotic Physiotherapists

A picture of handsA nail-pierced hand catches a man falling from a rooftop and hoists him to safety: just one potent image from Ridley Scott's Blade Runner which I recently watched again. The hand is that of the fearsome genetically engineered replicant Roy Batty who mercifully saves Rick Deckard—the blade runner who has been pursuing him through a rain-sodden Los Angeles in a 2019 dystopia. After the encounter Deckard looks as though he could do with the services of a physiotherapist—but even in 2007 s/he may not be human.

New Scientist reports the use of robots in helping patients to recover from strokes. In the US 700 000 and in the UK 130 000 a year suffer a stroke making it the biggest cause of severe disability in both countries.

The US Department of Veterans Affairs (often ahead of the rest of healthcare) is running a clinical trial of MIT's wrist robot. Studies have shown patients prefer robotic therapy to home-based exercise, which could make them more likely to complete programmes of rehabilitation.

Will mechanical physios replace human ones? With 4000 unemployed and many of them heading for Canada, Australia and New Zealand to find jobs and experience, let's hope so.

April 07, 2007

Who is Sick?

Given healthcare's dilatory acceptance of IT it may be customers who force the pace. I received an email about a newly launched website: www.whoissick.com. It uses Web 2.0 technology to generate user content displayed through a simple Google Maps interface.

The website started in 2006 after the founders' poor experience with health services in the US with a mission to "provide current and local sickness information to the public - without the hassle of dealing with hospitals or doctors". The founders believe in the power of user generated content about local sickness.

Note: FHIT is not accountable for the content of other websites.