Britain's National Health Service is significantly scaling back its National Programme for IT, a decade-old initiative to implement electronic health records across the nation of about 60 million.

Changes in the program come after spending about $10 billion on the $18.6 billion initiative. The program has been harshly criticized as heavy-handed and even dictatorial: A government agency selected teams--run by prime contractors without core competencies in health care--to implement government-selected EHR products in five regions across the country. The contractors rarely delivered products or services on a timely or quality basis, some contractors were fired and providers rebelled.

On Sept. 22, the National Health Service announced the obvious: "In a modernized NHS, which puts patients and clinicians in the driving seat for achieving health outcomes amongst the best in the world, it is no longer appropriate for a centralized authority to make decisions on behalf of local organisations."

Now, providers may select their own EHR products and vendors, and the government will work with a technology trade association "to explore ways to stimulate a marketplace that will no longer exclude small and medium sized companies for participating in significant government healthcare projects," according to NHS.

While the EHR mandate failed, there have been successes in the National Programme for IT that will continue. These include a national core health information network, an appointment booking system, e-mail exchange of records between general practitioners, and implementation of picture archiving and communication systems.

A recent story in The Guardian newspaper further explains changes to the program and how it seems destined to survive.


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