HC 2008: News from Harrogate

This year’s Healthcare Computing conference was a relatively subdued affair, with the outcome of the NHS informatics review and appointments to key positions put off until the summer.

NHS IT managers were urged to focus on the basics; to sort out their infrastructures, improve their asset management and clean up their data ready to receive new systems. However, there was also room for a little futorology. Jon Hoeksma reports. 


Anyone who went to Healthcare Computing 2008 hoping for a revelation on national strategy or big changes to the National Programme for IT in the NHS (NPfIT) will have gone away disappointed.

The biggest healthcare IT news of the week arguably came from London, not Harrogate, when it was announced that the Department of Health’s medical director, Professor Sir Bruce Keogh, will take over as interim chief information officer.

Gordon Hextall will continue to act as the interim head of the NHS Connecting for Health agency. The DH is advertising both permanent positions.

Data cleansing

HC 2008 was more a case of business as usual - with occasional glimpses of the potential of modern IT when applied to health in its widest sense. “Get on the front foot, engage with your staff, ensure that you know how we use data and prepare to receive new systems…” Matthew Swindells.

So the DH’s departing chief information officer Matthew Swindells urged NHS IT professionals to grasp the importance of information as an asset to their organisations and to start the hard work of preparing them for changes ahead.

He said all those involved in healthcare IT needed to “get on the front foot, engage with your staff, ensure that you know how we use data and prepare to receive new systems. The sooner you start, the cleaner the data, and the better the transition will go.”

Mr Swindells had little to say about the detail of the informatics review that he has been leading. He did, however, say that the next steps review led by Lord Ara Darzi, of which informatics now forms a part, will not be a single review but a whole series of reviews; one for each strategic health authority.

How these local reviews will mesh into a national whole, and how local freedoms can be squared with a standardised national IT project remains to be seen.

Infrastructure optimisation

While such big questions are being decided, Mark Ferrar, NHS CFH’s director of infrastructure, told the conference that trusts needed to look to the effective management of their own IT infrastructure and assets.

He warned that that many NHS organisations are failing to keep up with best practice in other industries, even though infrastructure and operations account for 20 per cent of the £2.2 - £2.3 billion that the NHS now spends annually on IT.

Dr Ferrar said research from other industries showed that savings of up to 30 per cent could be achieved on infrastructure costs by following best practice. But he said the gap between the best and worst NHS performers was growing.

To help NHS organisations to improve, NHS CFH has developed the NHS Infrastructure Maturity Model (NIMM) to help NHS organisations assess their infrastructure requirements and prioritise future investments.

NIMM draws on best practice research from Gartner, Microsoft and others – and it maps fairly closely to Microsoft’s own Infrastructure Optimisation tool (although this is company specific, where NIMM is vendor neutral).

Asset management

Dr Farrar said that another of the basic steps that trusts need to be taking now is to find out what IT assets they have and to manage them more effectively. “We don’t know what the total cost of ownership is across the NHS, despite being the 800lb gorilla in IT purchasing...this translates into real money...” Mark Ferrar.

He said proper asset management is vital to understanding the total cost of ownership of assets, so their purchase, use and redundancy can be planned to deliver best value. But he warned that too many trusts could not even produce a spreadsheet of their complete IT assets.

Dr Ferrar also said that proper asset management was vital to the health service as a whole. “We don’t know what the total cost of ownership is across the NHS, despite being the 800lb gorilla in IT purchasing,” he said.

“I don’t want to have to sit down with Microsoft and say I don’t know how many PCs the NHS has or how many copies of Microsoft office. This translates into real money.”

Meanwhile, NHS CFH’s clinical safety lead, Maureen Baker, outlined how the agency has been working with the National Patient Safety Agency to put clinical safety at the centre of its work.

“We now have safer IT projects,” she said. “A clinical safety group administers a clinical risk management system at each site.” In addition, NHS CFH now runs a certificate of authority scheme before any system can be implemented.

Show time

Although the conference’s exhibition was smaller than in previous years, it served as a reminder of how diverse the IT requirements of an organisation as complex as the NHS really are. "HealthVault is a platform that provides secure storage for patient data, connectivity for telemedicine devices, and search functions to applications and services developed by others."

Products and services on offer included: hardware, networks, data migration, project consultancy, radio-frequency identification (RFID) services, digital imaging, mapping systems, data security services, reporting tools, together with a wide range of business and clinical system vendors.

For suppliers, the biggest subject of interest was the Additional Supply Capability and Capacity (ASCC) framework procurement for clinical systems – Lot 2. Suppliers have been selected and are due to be announced soon.

However, it is unclear whether any NPfIT money will be committed or how the framework deals, which are designed to fill gaps unmet by NPfIT, will work in practice.

Case studies and presentations also highlighted the breadth of innovative work and projects that are underway across the UK. Particularly impressive were the small but growing number of uses of Web 2.0 technologies to deliver training and education, interact with patients and even deliver services in innovative new ways.

HealthVaulting into the future

On the final day, delegates heard from two harbingers of the future, wider world of health IT. Nick Hunn, chief technology officer for wireless specialists Ezurio Ltd outlined a near future of cheap, wireless telehealth devices linked to new online health platforms.

And Bert Van Hoof, Microsoft’s director of consumer health solutions, told his audience about Microsoft HealthVault and the company’s vision for it.

He explained that HealthVault is a platform that provides secure storage for patient data, connectivity for telemedicine devices, and search functions to applications and services developed by others. What HealthVault is not is a personal health record; “the core focus is a platform to drive connectivity.”

Mr Van Hoof said there had been huge interest in HealthVault since it was launched last October, with 15 partners already live and many more actively working to go live. He said the initial focus was on the US market, but made it clear that Microsoft was already engaged in discussions with parties outside the US.