Review of a Spartan Healthcare Computing 2007

I have great respect for the organisers of the event, the British Computing Society (at least, I think they're involved somewhere along the line) and the exhibitors who made a brave stand, but that was the problem with Healthcare Computing 2007- it felt like the last stand. Having two posts in a row about the stiffling of innovation in the health care sector and I'm starting to sound like a broken record, but the event really depressed me.

Most annual shows for any industry sector worth billions of Euros are showcases of the latest and greatest technologies with all the buzz that goes with it. It simply wasn't all that. Harrogate was not ringing to the beat of deal making and new product launches. It was like stepping back at least 5 years. Perhaps more. I was going to have a harrumph at Cerner for emphasising the divide between the have (...an NPfIT contract) and the have nots (...an NPfIT contract) because their stand dwarfed most others... but at least they supported the event. BT, iSoft and the other big contract holders didn't even show up. Having been a supplier in another sector not too long ago I really appreciate the costs associated with exhibiting at such an event and therefore the valiant efforts of those who showed.

I spotted suppliers at the event who had chosen not to exhibit. They, and some of the exhibitors who could be frank with me, lamented the fact that of the thousands of people who pass through the depleted halls, only a handful of people are buying. The rest are not as they've no decision making power.

Still, with 90 minutes of my time there to go, I finally found a couple of tech nuggets. They were well hidden, reflecting the lack of recognition of anything new, but that makes the opportunity all the greater for us.

Tags: technology, health care, innovation, UK, healthcare IT, health care IT, Cerner, exhibition, Harrogate, Harrogate Computing 2007

Can Gerry Robinson Fix the NHS?

Essential viewing starting tonight in the UK for all healthcare industry professionals is "Can Gerry Robinson Fix the NHS?" on BBC2 at 9pm. This British Business Guru spent 6 months in Rotherham General Hospital and the sneaky preview at The Telegraph suggests that he found it a very frustrating (but rewarding) experience. He cites the considerable challenges in the public sector and the difficulty in motivating consultant doctors to work more hours/more productively in coming to the conclusion that all is not lost. What is needed to manage these "brilliant, extraordinary people" are really excellent managers.

I agree. I think there are other ways to motivate the consultants too but I'll be interested to see if the programme covers these.

I'll be interested in seeing what the local press reaction to the programme is. So far the Yorkshire Post has been quite non-committal.

Tags: Gerry Robinson, health, health care, NHS, Rotherham General Hospital

Keep it Simple with Healthcare IT

In healthcare IT you hear alot about interoperability and integration of systems. Whilst this is extremely valid, I and my peers often lose our colleagues in technical jargon and presume that the sector is more mature than it really is. Some problems are more immediate than that.

If you watch how a retail assistant, waiter/waitress or bar tender interacts with their terminal, it is very quick and rapid fire. Tokens often allow near instantaneous log on. Then they punch some buttons and walk away. Do they put time aside at the end of their shift to reckon up? No. How long do you think it took to train new joiners? Not long- they probably picked it up on the job.

Now look at how clinicians access healthcare IT. Ouch.

Add that to the list.

Tags: technology, information technology, IT, health, healthcare, health care, healthcare IT, user experience, retail IT, hospitality IT, hospital, clinician

Does IT Matter?

In May 2003, Harvard Business Review published a paper authored by Nicholas G. Carr titled “IT Doesn’t Matter”. A business partner of ours sent it too me and yes, it was thought provoking, and yes, it nearly made my blood curdle.

A Technorati search shows that the article has been widely reported on by AccMan and Navarik. The title isn’t a total red herring designed to hook you in before it makes some clever ironic play. The paper really does make the case that at a strategic level “IT Doesn’t Matter” because it is approaching commodity status. Quite simply- I disagree, especially in health care IT.

1. The article paints a static picture of any company’s IT investments. This is a war of continuous evolution rather than a battle between individual systems.

2. I would argue that the commoditisation of IT provides the opportunity for organisations to construct orchestrated solutions disruptive to markets and their competitors. Customers can apply technologies in ways that the creators of the building blocks had not imagined. This is a highly competitive capability which depends on organisation competence and agility.

3. The investment in IT is being painted in black and white. Because the customer was not intelligent, IT investment was focussed on features that solve problems without consideration of how the problems are solved. The “how” has become crucial because for features from many suppliers to work together requires an understanding of this architecture. I would agree there was overinvestment in features- but only now are we looking at the architecture.

4. You cannot compare, as Nicholas Carr does, IT to electric power or railways by analogy at almost any level. Information simply does not conform to the First Law of Thermodynamics. If the physics don’t stack up, nor will market comparisons. We’re talking about tools for knowledge workers, not core utility services.

5. Technology as a competitive factor in health care is only just beginning. We are along way off a sector with the characteristics this article is describing. Technology is still widely seen as a necessary evil in this sector which is amazing as few other sectors would benefit from computerisation more than healthcare. It is such a complex sector that control of information will make the controllers very competitive. The status quo suits only the incumbant. Managing vulnerabilities is important, but there is an opportunity for a health care IT company to be created out of the current climate who will lead us into the next phase of IT maturity.

*ClickRich’s New Rules of IT Management would therefore be:

Spend wisely, but large investment in health care IT is required to catch up.
Follow on core technologies, lead in how you apply them.
Focus on Opportunities if you are an emerging Health care provider.

Tags: technology, information technology, IT, healthcare IT, health care, Harvard Business Review, IT Doesn't Matter, IT strategy, IT architecture, Nick Carr, Nicholas Carr, HBR, IT management

PACS is dead. Long live PACS

It is my prediction that the days of the acronym "PACS" are numbered. Picture Archiving and Communications Systems are the hospital systems that store all those digital diagnostic images- X-ray, mammogram, MR, CT etc.

They need phenomenal storage capacity (Terabytes) and distributing those images (usually of the DICOM format) from the imagers to radiologists is therefore non-trivial.

When did you last hear an application based IT system have to define itself as a communication system? That's inherent in the fact that it is information technology. It feels illogical to make a big deal out of that, reflects challenges largely in the past and aspires to monolithic systems. I try and use the terms "DICOM Storage", "DICOM Viewer" and "Radiology Writer" to describe the constituent parts and apply as appropriate. Processes are being reengineered such that these elements are being reused in ways the inventing technologists hadn't imagined and the PACS term will itself be reengineered.

There's a lot of inertia in the acronym by virtue of the intellectual capital (deals, research papers, products, implementations) invested in it, so I don't expect a change any time soon... but watch this space

Tags: technology, medicine, medical, health, health care, healthcare, healthcare IT, Health care IT, PACS, Picture Archiving and Communications System, acronym, CT, MR, radiology, etymology, hospital, x-ray, xray, diagnostics

Abuse of Chatham House Rules

I was pleased to meet with Richard Granger, the Director General of NHS Connecting For Health, (aka NHS IT Chief) earlier this week. I have to say he was very impressive and it was a good opportunity to hear about the GREAT progress being made in many areas of the National Programme for IT. Clearly, all things the press is not interested in printing.

However, I can't say any more because the event was Chatham House rules. That is, people can take away what was said in the meeting, but it is not to be referenced in a way which makes it attributable to any individual present. This encourages openness and enables us all to learn from mistakes as well as successes.

Richard Granger suffers much at the hands the media. You could argue that's just part of the job- and that is fair enough. My point is that comments which he made last week in a Chatham House rules governed event are now splashed across the pages of the New Statesman and have been picked up by all the usual healthcare IT publishers. We have to lose this rapcious appetite for sensational headlines if we can have reasonable discussions we can all learn from.

Tags: technology, IT, CfH, Connecting for health, NPfIT, National Programme for IT, Chatham House rules, Chatham, health, health care, healthcare, Healthcare IT, NHS, Richard Granger, Granger