Published 19 November 2008, doi:10.1136/bmj.a2595
Cite this as: BMJ 2008;337:a2595

Letters

Shared electronic records

What have we really learnt?

The first 150 words of the full text of this article appear below.

Greenhalgh and colleagues see the shared electronic record as having to respond to existing ways of working and established practices, not the other way round.¹ My take is this:

• Powerful forces in established ways of working in the NHS are hostile to technological changes that threaten established and possibly dysfunctional and wasteful practices. As a taxpayer, this is not acceptable, especially when we need to explore better ways of using tax revenues when times are likely to be hard
  
• The scale of complex IT projects empowers dissident critics to feed political interest in their failings. That these projects frequently focus on purely internal (to the NHS) goals and objectives makes them largely inscrutable with respect to benefits that may accrue to patients and their failure more damaging as there are no milestones for delivering taxpayer value. It is better to think of flexible, networked, and distributed approaches—a school of fish . . . [Full text of this article]

¹ Brabourne Lees, Ashford, Kent TN25 6RJ

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