A Christmas Carol, in Bytes, Being a Ghost Story of Healthcare IT
Iain Marsland, a former NHS chief information officer, gives up his regular column to tell a strange tale for the festive season.
As E.S. sat at his desk, the lights flickered and died and the room went shiveringly cold. A spectre with a grey beard and dark suit stood by the door. E.S. had been expecting him. His PA, Marley, had emailed that a chief information officer called Christmas Past was scheduled for 12 o’clock.
Stave one
“You could have knocked,” said E.S. “Which strategic health authority are you from?” The spectre silently pointed to his laptop. The screen went grey and then the haze cleared to show a scene of bright lights and laughter.
E.S. looked and remembered. This was Christmas Eve 2003. In the corridors of Princes Exchange in Leeds, CIOs and staff from the National Programme for IT in the NHS were celebrating; cheerful and full of hope. After three long months, the programme’s local service providers had been selected. Each of the five clusters was celebrating its choice of IT partner. Soon they would go home and celebrate Christmas with their families.
The young E.S. returned to his office, pleased with his efforts. “We have the best opportunity for decades to save lives, now let’s see if we can save some money as well.” He picked up the phone to the first LSP. “Tomorrow, my office,” he barked, “and no mince pies!”
“It’s not over yet, E.S! I am the CIO Christmas Future and you have one podcast still to see.”
Stave two
The screen faded back to grey. The room remained cold and dark but the spectre was now clean shaven and had grown considerably in size, almost filling the small office. “Where’s Christmas Past?” asked E.S. “He had to leave,” the spectre wheezed. “I’m his colleague, the CIO Christmas Present.”
He pointed a large, pudgy finger at the laptop, and again the screen cleared. Only this time there were no bright lights, no laughter and no-one to see. “What’s this?” cried E.S. “I don’t recognise this.” A phone was ringing but there was no-one to answer it. A sign on the door read “Fujitsu”. Further down the corridor, another dark office bore the sign “Accenture” and another office the sign “IDX”. The phone stopped ringing and the screen faded back to grey again.
E.S. turned again, but the CIO Christmas Present had left. “What sort of meeting is this?” he cried. “Blasted CIOs keep coming and going!” He hadn’t noticed a small, tanned spectre in shorts and a Hawaiian shirt sitting in the corner. “It’s not over yet, E.S! I am the CIO Christmas Future and you have one podcast still to see.”
Stave three
E.S. sighed and sank back into his chair. His screen flickered blue, then white, then blue. A cacophony of noise followed a trolley into the bay of an Accident and Emergency department. Nurses and doctors quickly set up drip lines, oxygen and a cardiac monitor. The single, high pitched whine galvanised the team further; intubation and bagging, then defibrillation. The monitor continued to whine.
As the crash team withdrew, someone asked: “Who is this?” And someone replied: “His iPhone has his name as Timothy Small and his GP is Dr Cratchit; but without access to his notes we know nothing about him. The post mortem will tell us what we should have known before he got here! ” “Ok, time of death is midnight, December 24 2010. Thank you everyone.”
Refrain
E.S. shook himself awake and made a mental note never to drink at lunchtime ever again, not even on Christmas Eve. “Well that was an old episode of Casualty!” he smiled. “Thank God we had the chance to turn things around and we have the Care Records Service now.”
“Data from the patients’ hospital, GP and community care was instantly available [while] their pseudonymised data would contribute to the trust’s statutory quality account.”
He walked out of his office and into the main reception of the polyclinic. The few patients waiting had all been checked in and had given their consent for their demographic, activity and clinical details to be used by properly authorised staff. The data from their hospital, GP and community care was instantly available and would contribute to clinical decision support; making their care safe and effective.
Data collected during their present consultation would be analysed by the local team to assess and improve the quality of their care, benchmarked against the best in Europe. Pseudonymised data would also contribute to the trust’s statutory quality account.
E.S. thought the thought he thought every night when he walked through reception: “A lucky time to be ill.” Only tonight he added: “God bless us every one!”
About the author: Iain Marsland has been in the NHS for 34 years, most recently as chief information officer for Essex Strategic Health Authority and previously as director of IM&T for acute trusts in Brighton, Sussex and Bristol. He is now an independent consultant.