Memorandum submitted by Larry Benjamin
I am a consultant ophthalmic surgeon working
at Stoke Mandeville Hospital, Aylesbury.
I have a long-standing interest in IT and its
use in Medicine and although a member of the Worshipful Company
of Information Technologists, I am writing as an individual and
a consultant in the NHS for the last 16 years.
I would like these comments to be included in
the documents to be read by the Public Accounts Committee relating
to NpfIT.
My worry regarding the implementation of NpfIT
is that it has been introduced "backwards". By this
I mean that the national spine and its associated infra-structure
has received much attention whilst very little effort has been
put into useable local systems for day to day input of clinical
data—the very life blood of any clinical system.
For a clinical system to be deemed useable by
the staff using it, their involvement in its development is vital.
Clinical systems have evolved over many years to allow the recording,
storage, retrieval and analysis of data relevant to sometimes
complex clinical situations. Although the time taken to input
data into a new system does not necessarily have to be faster
than the existing systems, if longer is required then there must
be some added value. Data retrieval and analysis with plotting
of trends would be an immediate benefit which would, I believe,
stimulate staff to input meaningful information.
In my speciality, three or four software systems
already exist in clinical use, which have been developed by and
for ophthalmic units and their staff. All of these are already
able to comply with the requirements of the national cataract
dataset (which I helped to develop via the Royal College of Ophthalmologists).
An interesting project recently took place between the 20 or so
of the eye units who have installed one of these systems whereby
details of 56,000 cataract operations performed recently were
analysed. The data capture was input routinely and the retrieval
near instantaneous.
It is highly unlikely that local service providers
will achieve this level of detail and use-ability for at least
5 years. My suggestion is that more effort is put into interfacing
between the national spine and local systems such as that mentioned
above which are already fit for purpose. This will save time and
money but most importantly, will gain user confidence very quickly.
6 November 2006
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