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As I mentioned earlier this week, among the provisions of the financial recovery stimulus bill is an allocation of $20 billion to "jumpstart" efforts to computerize health records in the US. The goals is have a wide-spread system of interoperable electronic health record (EHR) system in place by 2014.

What is happening in the UK on this very subject should give the new Administration - and Congress - pause.

The UK Public Accounts Committee (PAC) released a scathing report on the UK governmentâ''s effort to create a national EHR system called the National Programme for IT (NPfIT) yesterday. I have blogged and written about the problems with this program several times before.

The NPfIT is supposed to link 30,000 doctors to some 300 hospitals across England, providing NHS staff with instant access to the medical notes of 50,000 patients at every stage of diagnosis, treatment and discharge, as the London Guardian succinctly puts it.

The scheduled date for delivery - which is now 4 years behind schedule - is 2014-2015. This date is highly suspect as well.

Edward Leigh MP, chairman of the Public Accounts Committee, says that, "The risks to the successful delivery of the National Programme for IT are as serious as ever. Essential systems are late or, when deployed, do not meet expectations of clinical staff; estimates of local costs are still very unreliable; and, despite action to secure their commitment, many NHS staff remain unenthusiastic."

Richard Bacon MP, a member of the Committee said in a London Telegraph article that, "In its current form the programme is in deep trouble from which it is unlikely to recover.â''

Two of the four major suppliers â'' Fujitsu and Accenture â'' walked away from the project, and the third, BT, is in financial trouble, in part because of its work on the NPfIT programme. The fourth, CSC, is also behind in its EHR implementations.

â''Trusts [i.e., hospitals - ed.] should not be expected to deploy care records systems that aren't working properly. If there is no improvement to this situation within six months, then the department should consider allowing trusts to apply for funding for alternative systems,â'' Leigh says.

The Financial Times reports that at least one trust - Worthing and Southlands Hospitals NHS Trust â'' is "considering ditching its new electronic patient record software in order to revert to its 20-year old system."

As has been the standard response to any criticism, NHS management claims everything is fine with the program. As reported in several London newspapers, the NHS said, "We welcome the report. New IT systems in the NHS are delivering better, safer and faster care. Current costs have declined because of the delays to implementation due mainly to adding extra functions to the system. Costs are also controlled by the contracts which only pay to providers once the service has been successfully delivered."

I am hoping the US government is paying attention to what is happening over in the UK. Leading EHR vendors, who are from the US, are highly unlikely after years of efforts to get their systems to work together in a tightly controlled environment even with defined standards by 2014 -2015.

How is the US going to accomplish the same feat in the same time frame (but without agreed upon standards) and with some 7,500 plus hospitals and 920,000 doctors? By just throwing money at the problem, and saying the market and government incentives will make it work?

And that question doesn't even address the privacy or security issues that have been so far punted, or the significant impacts on local health care of making such a technological transition, to name but two.

And if the US can't get something relatively straightforward like Real ID in place by 2014, tell me again how a national EHR system will be implemented by then?