I am often asked why software projects are canceled. The answer is pretty simple: you can't afford them anymore. The British government is finding that out in regards to creating a national electronics health record system.
The BBC reported over the weekend that Britain's National Health Service's (NHS) National Program for IT (NPfIT) aka Connecting for Health, will be significantly cut back to save money, and because it probably will never work properly unless huge amounts of taxpayers' cash are poured into it.
Chancellor Alistair Darling said that the national electronic health record (EHR) system being built was "not essential to the frontline" in terms of healthcare - a complete u-turn in what the government has been strenuously claiming for the past 7 years. He added that, "It's something I think we don't need to go ahead with just now."
It is estimated that about £12bn have been spent on the EHR system already since it began in 2002 under highly dubious circumstances.
What is unclear is how this decision would save money. The two remaining primary main suppliers of the NPfIT EHR systems to the National Health Service, CSC and BT, will likely have to be paid for contract breaches by the government.
CSC and BT (and their shareholders) might actually be very happy if this happens - their current contracts require them to only get paid when their EHR systems are installed and working acceptably (the criteria of which were just recently defined). If the government reneges on their contracts, both may be able to recoup their investments, which has looked at risk for a long time.
Local UK hospitals might be happy too, if - and this is a big if - they can find the money to replace the EHR systems that were being foisted on them. Continual "teething problems" have been experienced by hospitals using the NPfIT mandated systems.
Because of these problems, in May, Christine Connelly, the NHS chief information officer, told the main NPfIT suppliers that they have until the end of November to demonstrate real progress in installing the systems in big acute-hospitals. Latest reports indicate they haven't.
An article in Computing in October for instance reported that only about 175 clinicians were using the Lorenzo EHR software (supplied by CSC) across the five early adopter trusts. The estimated cost per user was about £57,000 according to a ComputerWeekly estimate. The Computing story also said that another hospital now facing fines of £400,000 a month for missing patient care targets as a result of problems with the Cerner Millennium EHR system that BT supplies.
This has been a fiasco in the making since the beginning, with political hope and spin triumphing over good systems engineering, program and contract management (not to say common sense) at every opportunity.
If the British government is smart, they would kill this beast immediately, but that is politically not viable given the upcoming election. So the government will let NPfITslowly bleed to death, to the detriment of the British taxpayer and NHS patients, both which deserve better.
Robert N. Charette is a Contributing Editor to IEEE Spectrum and an acknowledged international authority on information technology and systems risk management. A self-described “risk ecologist,” he is interested in the intersections of business, political, technological, and societal risks. Charette is an award-winning author of multiple books and numerous articles on the subjects of risk management, project and program management, innovation, and entrepreneurship. A Life Senior Member of the IEEE, Charette was a recipient of the IEEE Computer Society’s Golden Core Award in 2008.