Education And Debate

What value do computers provide to NHS hospitals?

BMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7043.1407 (Published 01 June 1996) Cite this as: BMJ 1996;312:1407
  1. Chris Lock, principal research fellowa
  1. a Clinical Operational Research Unit, Department of Statistical Science, University College London, London WC1E 6BT
  • Accepted 18 March 1996

As the NHS spends around £220 million a year on information technology for use by acute hospitals that are hard pressed for resources, it is reasonable to ask what value is provided. A review of rigorous scientific evidence for the value of information technology to NHS hospitals found that published evidence is scarce and far from conclusive. Information technology in NHS hospitals needs further assessment so that future decisions on such necessary and important investments are based on clear, well documented experience and research.

Recent reports from the Audit Commission have criticised the use of computer systems in NHS hospitals1 2 and have sparked a debate regarding the value of information technology to the NHS and to acute hospitals in particular. The costs are substantial (£220m a year), and some argue that the benefits are nebulous and diffuse. But where is the evidence? Assessing the value arising from investments in information technology, rather than merely their cost, is not straightforward. Much information technology investment has been in administrative systems that might be regarded as successful when they save money.

Recent thinking suggests that this is insufficient, and that a more comprehensive assessment should consider whether information technology supports the commercial and strategic objectives of the organisation.3 4 For the NHS, the impact of computer systems on patient care as well as on the “business” objectives of hospitals should be considered.

When computer systems are assessed against patient care objectives, outcomes should be expressed as would those arising from other clinical interventions. The range of outcomes that might arise from computer systems is potentially huge, and as yet no measure of outcome has been universally recognised. The Audit Commission offered a list of potential clinical benefits of information technology to patient care (box), which illustrates the breadth of potential …

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