Evaluating computerised health information systems: We are still getting information technology wrong

BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7407.163-b (Published 17 July 2003) Cite this as: BMJ 2003;327:163
  1. Matthew G Evans (mge{at}totalise.co.uk), specialist registrar psychiatry
  1. St Ann's Hospital, London N15 3TH

    EDITOR—Littlejohns et al evaluated computerised health information systems.1 After his departure from the Department of Health, Lord Hunt said that his greatest fear was that “we won't get the doctors on board.” Like most clinicians and other “hands on” NHS staff (I suspect), I favour a bottom up approach to information technology in the NHS.

    If Lord Hunt believes that the doctors and nurses will make or break it, why is more not being done to involve us? My experience is that NHS staff are generally interested in the potential benefits of information technology but believe that they lack the knowledge or skills or that they do not want “outsiders” telling them how to do their jobs. Existing processes seem to do little to improve this picture and, I believe, threaten the success of the national programme.

    Resistance to changes in information technology can be reduced by involving clinical staff in training and development processes. Given that widespread participation may be difficult to achieve, “clinical champions” need to be relied on to drive things forward. This is not an easy task. Meetings often clash with clinical commitments, and it is not feasible to cancel a clinic at short notice to attend an information technology meeting. Trusts must recognise the importance of information technology in the clinical process (and clinicians in the information technology process) and be prepared to release doctors from clinical sessions to have an active role.

    Highly trained professionals require equal standing in the decision making processes, along with managers and information technology professionals. Systems should be in place so that interested clinicians are involved at all stages in analysing, designing, implementing, and evaluating systems. Clinicians' involvement may not happen by chance—it needs active encouragement.


    • Competing interests MGE is a doctor.


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