Thursday, January 24, 2013

They Consultants Sometimes Really Can’t Help Themselves. I Wonder What The Assumptions Were?

This appeared a little while ago.

Hunt wants paperless NHS in five years

16 January 2013   Lyn Whitfield
Health secretary Jeremy Hunt has set out a tight timetable for making all records and communications in the NHS paperless.
In a speech to the right-wing think-tank Policy Exchange on Wednesday, he said that all records and communications in health and social care would be electronic by 2018.
There is no central funding for the plans, but a report commissioned from consultants PriceWaterHouseCoopers has estimated that more ambitious use of IT would save the NHS £4 billion.
Hunt took over from health secretary Andrew Lansley in the last government’s reshuffle. The new team at Richmond House has continued Lansley’s interest in IT.
Junior minister Dr Dan Poulter told EHI Live 2012 in Birmingham that IT was essential, not just to make savings but to pursue the government's choice and transparency agendas.
To date, however, the coalition’s firmest promise had been to give patients online access to their GP records by 2015, although the NHS Commissioning Board has been given some important IT imperatives in its 'mandate' from the government.
The mandate indicates that the NHS CB should develop electronic health records that work across the health and care system by 2015.
The 'planning guidance' issued by the organisation in December also indicated that it will run a consultation on patient access to these records later this summer.
In Wednesday's speech, Hunt reiterated the GP pledge and a commitment made by NHS CB national director of patients and information Tim Kelsey to make referrals paperless by 2015.
He also added to the IT sections of the mandate, by setting a 12 month deadline for hospitals to computerise their records “in such a way that they can be shared."
Lots more here:
All one can say to this enthusiastic Minister is ‘Good luck with that’!
No funding and a PWC report saying there is 4 Billion pounds to be saved just fills one with that sense of ‘I have seen this before somewhere and it did not quite turn out like that’. An ambitious time table and an optimistic consultant report are not a good mix!
There is also coverage of the report from PwC here:

PwC finds 'even more' IT savings

16 January 2013   Lyn Whitfield
A report from consultants PriceWaterhouseCoopers has concluded that the NHS could save billions of pounds a year if “ambitious, proactive NHS organisations” improved their use of information technology.
In a report published ahead of a speech by health secretary Jeremy Hunt this evening, which will call for a paperless NHS by 2018, PwC says the NHS could save £4 billion more than the government’s estimate in its NHS information strategy.
It argues that around half of this - £1.7 billion - could be generated from four actions, including the roll-out of e-prescribing in hospitals and the Electronic Prescription Service in primary care.
This paper might inject a touch of sanity.

The Real World of Cost-Benefit Analysis: Thirty-Six Questions (and Almost as Many Answers)

Cass R. Sunstein

Harvard Law School
January 10, 2013
Some of the most interesting discussions of cost-benefit analysis focus on difficult problems, including catastrophic scenarios, “fat tails,” extreme uncertainty, intergenerational equity, and discounting over long time horizons. As it operates in the actual world of government practice, however, cost-benefit analysis usually does not need to explore the hardest questions, and when it does so, it tends to enlist standardized methods and tools. It is useful to approach cost-benefit analysis from the bottom up, that is, by anchoring the discussion in specific scenarios involving trade-offs and valuations. Thirty-six stylized scenarios are presented here, alongside an exploration of how they might be handled in practice. Open issues are also discussed.
Full paper here
This really shows how hard it is to get a real and accurate handle on costs and benefits. Must read material!

1 comment:

Bernard Robertson-Dunn said...

The most certain way of saving money with IT is not to do the IT project.

Based upon the IT industry's track record anything else has at least a 50% chance of failure.

Until information systems are developed using better approaches, this is most likely to be the case.

More 0.02c