Fully "interoperable" electronic health records - which allow patients to add information as well as simply read them - are a key part of the NHS in England's future, according to a survival plan published by its chief executive.
The NHS five-year forward view, by chief executive Simon Stevens, says that improving information is the first step towards empowering patients. 'As a first step towards this ambition we will improve the information to which people have access -- not only clinical advice, but also information about their condition and history,' the report says.
It notes a wide gap between the people who might be willing to interact with the NHS via the web and those who actually do. While 86% of adults use the internet only 2% report using it to contact their GP, for example.
In a forthright criticism of past IT strategies, the review says that the NHS "has oscillated between two opposite approaches to information technology adoption - neither of which now makes sense". It says that governments have tried highly centralised national procurements and implementations. "When they have failed due to lack of local engagement and lack of sensitivity to local circumstances, we have veered to the opposite extreme of 'letting a thousand flowers bloom'. The result has been systems that don't talk to each other, and a failure to harness the shared benefits that come from interoperable systems."
The review says there is "broad consensus" on the NHS's future. "It is a future that empowers patients to take much more control over their own care and treatment. It is a future that dissolves the classic divide, set almost in stone since 1948, between family doctors and hospitals, between physical and mental health, between health and social care, between prevention and treatment."
With notable understatement, "across the NHS we detect no appetite for a wholesale structural reorganisation". Among its predictions are that "multi speciality community providers" will combine GPs with other community health services, hospital specialists, mental health and social care.