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Dispatch from London

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I’m in London today with Bob Wachter, Dave deBronkart , Julia Adler Milstein, David Brailer and others working on healthcare IT planning for the National Health Service England.


The actual report will be crafted from now to June, but in general my impression is that the UK is exploring exactly the issues the US has tackled over the past 5 years.

Applicable US lessons learned include

1. Investment in people is even more important than technology

2. Interoperability needs to use case based with requirements crisply defined

3. Digitizing existing workflows is not very helpful - future state planning needs to envision the possibilities created by automation instead of “electronic paper”

4. Policies must be created and culture must be changed before disruptive technology is implemented

5. Scope, time, and resources are inexorably linked.    You cannot have infinite scope in zero time with few resources.  Haste makes waste.

My sense is that European economies  including the UK are struggling economically and government is looking for quick wins based on technology return on investment.   Unfortunately I’ve never experienced an IT project with a  measurable return on investment.

The UK is wonderful country with a rich history and amazing people.    Our group will do everything in its power to share the HITECH/Meaningful Use experience so that the UK benefits from our successes and avoids our failures.


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