This comment is from the EHI thread to the above...

This comment is from the EHI thread to the above story.....

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We need to consider the longer term advantages
[email protected]

10 Aug 09 15:32
There is little doubt that the wait for Lorenzo has been far longer than was acceptable or necessary, or that, along with earlier/other acute EPR product issues, this exercise has seriously undermined the original and laudable NPfIT objectives, possibly to the point where the current mission is salvage rather than progress. But having learned such a hard lesson, having spent so much money and having waited so long, we should be careful not to cancel a product just as it becomes usable.

Of course I may have misread the article or its implications, but I would argue against a call for scrapping the programme outright. Learn and build rather than slash and burn. Sharing data from local NHS IT systems doesn’t necessarily mean monolithic central IT systems, but it does require good local systems, at affordable costs, not just to feed the beast but to deliver the sort of local healthcare you want for your family.

Like many Trust’s we, with valuable support from our SHA/CfH, invested in Interim Solutions, so we are not is a desperate position, far from it. We, like others, now have several years of project and operational experience of working with CSC, so we know the value of planned, realistic development and that the pace of implementation is sometimes a slow learning exercise. Getting Lorenzo to a point where it replaces our PAS, Order/Comms and ER systems and is interfaced with the couple of dozen other clinical/business systems we run, will be more challenging than most realise. But the NHS has loads of quality experience to share with our LSP colleagues, many been here before, so it is an entirely doable joint project.

“Dismantling the infrastructure” (as the article says) needn’t necessarily mean a total demolition job. I like many, have only seen presentations of Lorenzo, but “if it does what it says on the can” it will be worth waiting for a little longer, before considering any terminal action. From the presentations of Lorenzo, it is not just a PAS Order/Comms replacement, it puts the patient and quality of patient service at the heart of Hospital patient care administration. Some would say long overdue (I couldn’t possibly), but this will entail procedural and cultural change on a scale not often seen in the NHS. If, in the world of politics, product functionality is compromised for contract expediency – what would have been the point of all the pain - just another PAS and lost opportunity.

I doubt Lorenzo’s future is entirely dependant on the NHS anyway. Regardless of what future political administrations decide to do, I would think that Lorenzo will continue to be developed and marketed world wide by the suppliers, probably quite successfully. It would be a shame for the NHS to miss out on such success, especially having contributed to and funded so much of its development. Also we need to ask ourselves; “what else is there”, “how would we afford to buy it” and “how long would it take”? Perhaps it is the contract and delivery mechanism that needs reviewing, adopting a more pragmatic and realistic approach to the flaws and pressures of the famous contracts”, find a win-win position.

But it’s not all roses, a major flaw in the NPfIT programme is that local health communities have to fund the substantial project implementation costs, which in the current financial climate looks hard to do. Of course it would be handy not to have to find that money, dump NPfIT – dump those costs, but where would that leave us, where would that leave the joined up principles of Lord Dazi?