Let's have more connecting for health

Anyone who does not closely monitor NHS IT may regard England's National Programme as a failure, one of those great British government IT projects that has blown billions on very little, imperils civil liberties and is years behind schedule. This is, of course, only partly true of only a few parts of the programme, most importantly the Care Records Service (although there have been other problems such as take-up of Choose and Book). Westminster did bodge the plans for installing patient records systems in trusts by assuming it would be much easier than it has been, exacerbated by its cavalier attitude towards citizens' privacy in assuming that it didn't need to notify people about their records being uploaded – a mistake since partly corrected. Luckily, by paying by results it has not blown billions in doing so. NHS Connecting for Health has done pretty well on several other projects, many of which involve connecting. The most obvious is its N3 broadband network, along with applications which take advantage of improved bandwidth between NHS sites. These include N3's free on-net voice, picture archiving and communications systems (PACS), NHSmail email and GP2GP patient records transfers. These give the NHS systems from the 21st century – specifically, those from about the middle of the last decade. In consumer terms, CfH has provided the NHS equivalent of, respectively, cheap broadband deals, Skype, Flickr, Hotmail and bulky file transfer website YouSendIt.com. Given that the health service has to provide systems that are more secure and reliable than those given free to the public, this represents good work. The missing element is mobility. In the last few years, consumer IT has been about wireless hubs at home and smartphones on the move, both allowing users to take computing away from a desk. Such ideas have huge potential for health and social care, both within and without NHS buildings. Last week's Mobile and Wireless Healthcare event heard some inspiring stories – full coverage here. But such successes appear to be the rare exceptions. Why? Within buildings, short range wireless networks are the obvious technology to use. These are easy to install when new hospitals are built, and through private finance initiative schemes the NHS has been building quite a few of these recently. But retrofitting existing buildings is much more expensive and disruptive. Outside, mobile phone networks provide the connectivity. The difficulties here involve finding the right devices – powerful enough to process information, large enough to be readable, while unobtrusive enough to avoid attention from muggers. There's also the issue of patchy mobile network coverage. Currently, individual trusts have to solve these problems. They would be better handled nationally – ideally with the UK's health services banding together, as they have for the likes of N3 (used in England and Scotland) – to get the best deals from vendors which tend to be international in scale. CfH, along with National Services Scotland and Informing Healthcare in Wales, are the obvious organisations to make this happen. The ideal would be framework deals with the makers of wireless equipment and hardware providers, consultancies able to install wireless networks economically within existing NHS buildings, and network operators – the last including Airwave as well as the consumer networks to maximise coverage. At the same time, CfH would commission software (or apps, in the mobile jargon) for its existing national systems such as NHSmail, allowing them to be used in a secure and workable fashion on mobile handsets. Smartphones had been around for several years before Apple reinvigorated them as mobile computing devices. The NHS should probably avoid Apple's overhyped yet underpowered – in battery terms at least – iPhone. But for the NHS, Apple's concept of easy-to-use mobile computing represents low hanging fruit.