Crompton Paul
Cardiff and Vale NHS Trust, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW.
J Vis Commun Med. 2007 Jun;30(2):72-7. doi: 10.1080/17453050701496334.
The National Health Service (NHS) in England is in the middle of an Information and Communications (ICT) revolution. The NHS National Programme for IT (NPfIT) has been described as one of the world's biggest IT projects, costing pound6.2bn. 'Over the next ten years, state-of-the-art computer systems will be installed across the NHS. Once the work is complete, those systems will, for the first time, connect more than 117,000 doctors, 397,000 nurses and 128,900 other healthcare professions in England'. The improvement of services through the application of ICT surrounds our everyday life, whether at the bank, in supermarkets or in the entertainment industry. Whilst major technological advances have taken place in medical imaging, diagnosis, treatment and surgery, the same level of advancement in information and communication management, across the whole organization, has proved far more elusive. The concept of the Electronic Patient Record (EPR) in the NHS was first introduced to readers of this journal in 2000. The idea of using information management and technology to ease the burden on NHS staff had been developing for years, with some success in what Brennan described as 'pockets of excellence', but on the whole these initiatives had not achieved the revolutionary change sought and were regarded as a 'frustrating failure'. The Department of Health (DH) therefore seconded Frank Burns from one of the successful EPR sites, Wirral NHS Trust, to develop a strategy to take the NHS towards the vision of an integrated, computer-savvy health service. Three years later, Brennan was back in these pages with an update. The vision of Information for Health and its spin-offs had led to disappointment, missed targets and, ultimately a major re-think. Apart from the failings of Information for Health, the DH was also having to respond to a number of other influential publications; Building the Information Core: Implementing the NHS Plan, Jan 2001; Delivering the NHS Plan; and Securing Our Future Health: Taking a Long-Term View, April 2002 (commonly known as the Wanless Report).
英国国家医疗服务体系(NHS)正处于一场信息与通信(ICT)革命之中。NHS国家信息技术计划(NPfIT)被描述为全球最大的信息技术项目之一,耗资62亿英镑。“在未来十年里,最先进的计算机系统将在整个NHS体系中安装。一旦这项工作完成,这些系统将首次把英格兰超过11.7万名医生、39.7万名护士以及12.89万名其他医疗行业从业者连接起来”。通过应用ICT来改善服务围绕着我们的日常生活,无论是在银行、超市还是娱乐行业。虽然在医学成像、诊断、治疗和手术方面已经取得了重大技术进步,但在整个组织的信息与通信管理方面,要达到同样的进步水平却困难得多。NHS的电子病历(EPR)概念于2000年首次在本刊向读者介绍。利用信息管理和技术来减轻NHS工作人员负担的想法已经发展了多年,在布伦南所说的“卓越典范”方面取得了一些成功,但总体而言,这些举措并未实现所追求的革命性变革,被视为“令人沮丧的失败”。因此,卫生部(DH)从成功实施电子病历的机构之一威尔拉尔NHS信托基金借调了弗兰克·伯恩斯,以制定一项战略,使NHS朝着整合的、精通计算机的医疗服务愿景迈进。三年后,布伦南再次在本刊上发表了最新情况。“健康信息”愿景及其衍生成果导致了失望、目标未达成,最终引发了重大反思。除了“健康信息”的失败之外,卫生部还必须回应其他一些有影响力的出版物;《构建信息核心:实施NHS计划》,2001年1月;《实施NHS计划》;以及《确保我们未来的健康:长远视角》,2002年4月(通常称为《万利斯报告》)。