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There has been a very poor record of NHS and IT, at least for the last two decades i.e. the previous Labour government wasted £10bn+ and failed to provide any s

There has been a very poor record of NHS and IT, at least for the last two decades i.e. the previous Labour government wasted £10bn+ and failed to provide any solutions. In the process, they alienated a range of medical professionals by creating a culture of mistrust towards the digital strategy[1]. In 2016, the 'WannaCry' ransomware attack, exposed the gaping holes in the system[2]. The current trend of rushing to give access to parts of the silo/NHS Spine to other providers like Babylon health et al., without due consideration or a debate, is another can of worms best left unopened.[3] In the absence of any robust measures to safeguard data, it is right for the patients to be diligent and have a high degree of control over who gets access to their health data and opt-out while they still have a choice, as no explicit promises are provided by the NHS to keep your data confidential: use anonymised data whenever possible[4] [1] https://www.theguardian.com/society/2013/sep/18/nhs-records-system-10bn https://www.theguardian.com/society/2013/sep/18/nhs-records-... [2] https://www.bbc.co.uk/news/technology-41753022 https://www.bbc.co.uk/news/technology-41753022 [3] https://www.wired.co.uk/article/babylon-health-nhs https://www.wired.co.uk/article/babylon-health-nhs [4] https://www.nhs.uk/your-nhs-data-matters/where-confidential-patient-information-is-used/ https://www.nhs.uk/your-nhs-data-matters/where-confidential-...

cs02rm0 7y ago
I was a software dev working in the NHS at the time of the National Programme for IT. They couldn't decide how they wanted authorisation to work, whether it was role based or whatever else. We put a config flag in to switch between the two models they were going back and forth between and just twiddled it every week for months. There was some set charge every time they did it. They had the opposite problem with anything that actually mattered where they couldn't make a decision at all. Some of that software is still running in hospitals 10+ years later with apparently little change since the the NPfIT died. I moved out of the healthcare domain shortly after that. A few years ago I tried to sell some software for next to nothing to the NHS for a team my wife worked for. A simple webapp backed by a DB instead of spreadsheets on a shared drive. They took the idea and gave it to an in house employee who was running it as a side project (charging more for it than I was) and never finished building it. Speaking to someone in charge of innovation for a large part of the country recently, he said he couldn't even take some software I'd offered for a free trial. As he saw it the system was so broken he was warning everyone off. And his job was innovation. The NHS is ripe for improvement. I suspect its management haven't got a clue what they're doing though and fear the lure of big tech firms will be the only thing they can't resist.
- TazeTSchnitzel 7y ago
  Now living in Sweden which has what seem like very sophisticated e-health systems by comparison (at least on the user-facing side), I wonder why the UK couldn't have purchased and adapted an existing system that worked elsewhere.
  - noir_lord 7y ago
    NIH combined with the optics of paying 'foreign' developers. Which is silly given who actually owns large parts of British infrastructure but... We have a confluence of shitty corrupt middle managers masquerading as politicians and a terrible press. I honestly have come to the conclusion that the UK is pretty fucked in the mid to long term.
  - cs02rm0 7y ago
    You've reminded me of someone I know who also worked for an NHS body related to innovation/improvement who went to Amsterdam I think for an international healthcare conference. I said it must have been interesting, lots to learn about. She replied that the NHS was the best in the world and there was nothing to learn about from anyone else in any respect. Sadly, although I remain convinced many people must be slogging against the system, I suspect she isn't alone in that view.
  - DanBC 7y ago
    It's not "the NHS". It's a bunch of GPs, hospital trusts, mental health trusts, community care trusts, and they're all independent competing non-profit businesses. The current Secretary of State at the Department of Health and Social Care is pushing open standards and interoperability, but has an idealogical attachment to private companies providing software after competitive tender.
  - benmaraschino 7y ago
    Denmark's healthcare system tried to implement Epic nationally, and if this article is anything to go by, it didn't go so well: https://www.politico.com/story/2019/06/06/epic-denmark-health-1510223 https://www.politico.com/story/2019/06/06/epic-denmark-healt... Essentially, different healthcare systems have different needs which are reflected in how their electronic health record systems are architected. For example, EHRs in the US are optimized for billing, and if you're moving an US-centric EHR, like Epic, to a country like Denmark with universal healthcare, all that functionality becomes superfluous. Not to mention the language differences, as well, which are touched upon in the article. It's possible that similar concerns played into the NHS's decision to build their own system. Some NHS trusts are moving forward with their own Epic implementations, however. For example: https://www.digitalhealth.net/2018/06/royal-devon-exeter-nhs-foundation-trust-gets-epic/ https://www.digitalhealth.net/2018/06/royal-devon-exeter-nhs...
DanBC 7y ago
> The current trend of rushing to give access to parts of the silo/NHS Spine to other providers like Babylon health et al., without due consideration or a debate, is another can of worms best left unopened.[3] I don't get it. Babylon is just another provider. There's not much difference between Babylon and other GP providers - they get your data if you're their patient and not otherwise. They're subjected to the same rules as other GPs. There isn't some huge database somewhere of "all the NHS data" that providers can dip into. Each provider has it's own data, with little bits fed-back into the gp system or the spine.
- johnnycab 7y ago
  >I don't get it. Babylon is just another provider. There's not much difference between Babylon and other GP providers - they get your data if you're their patient and not otherwise. They're subjected to the same rules as other GPs. Babylon is unlike any other providers; it is an AI & Data first, app-based subscription model with a mix of state funded services. It's aim is to acquire more data in order to train models. The overwhelming majority of traditional GP's are primarily focused on patient first policy ─ they are usually non-profit with scant resources and a poor to non-existent IT strategy. To normalise these new models by trivialising differences between traditional services (as flawed, as they might be) would only serve to marginalise existing practices and it is the first step towards introducing scope-creep by politicians, who have an unhealthy obsession with statistics, quick fixes and making Faustian pacts with the private sector. Babylon claims to go beyond any GP by being on par with human doctors and boasts of it's partnerships with Samsung and Tencent and counts DeepMind as one of it's investors. Just like any startup looking to disrupt, the platform is cloud-based and hosted on AWS[1]. It records every interaction, including video ─ which is retained for later review. It is growing at an exponential rate, despite a limited presence in London. The patient database reveals that it caters to a very specific demographic across varied and different parts of the city i.e. 83% of patients are aged between 20 to 39 years. While it is still in it's infancy, it has already been involved in legal tussles and has been accused of dubious practices[2][3]. There is no visibility on algorithms, models and related datasets nor is there any indication of AI ethics being in place. There is also the issue of the CEO being linked to a white elephant project before his current fast-tracked foray into digital healthcare, which was probably rubber-stamped by officials in Whitehall. Although, it is undeniable that the NHS is overburdened and could do with some help to ease the pressure, but Babylon seems to be doing the exact opposite by applying the 'moving fast-breaking things' ethos inside an institution, which is already broken and moving slow. I have already linked the Wired article, which discusses some of the topics above in-depth, other facts are supported by the FT article (paywall) and Forbes, which are reasonably reputable sources in my opinion. https://www.ft.com/content/19dc6b7e-8529-11e8-96dd-fa565ec55929 https://www.ft.com/content/19dc6b7e-8529-11e8-96dd-fa565ec55... https://www.forbes.com/sites/parmyolson/2018/12/17/this-health-startup-won-big-government-dealsbut-inside-doctors-flagged-problems/#69448ba8eabb https://www.forbes.com/sites/parmyolson/2018/12/17/this-heal... [1] https://aws.amazon.com/blogs/startups/how-babylon-health-builds-an-ai-doctor-app-and-scales-globally-with-aws/ https://aws.amazon.com/blogs/startups/how-babylon-health-bui... [2] https://www.digitalhealth.net/2017/12/babylon-healthcare-cqc/ https://www.digitalhealth.net/2017/12/babylon-healthcare-cqc... [3] https://www.artificialintelligence-news.com/2019/04/12/babylon-health-ai-test-gp-at-hand/ https://www.artificialintelligence-news.com/2019/04/12/babyl...

cs02rm0 7y ago

I was a software dev working in the NHS at the time of the National Programme for IT. They couldn't decide how they wanted authorisation to work, whether it was role based or whatever else. We put a config flag in to switch between the two models they were going back and forth between and just twiddled it every week for months. There was some set charge every time they did it. They had the opposite problem with anything that actually mattered where they couldn't make a decision at all. Some of that software is still running in hospitals 10+ years later with apparently little change since the the NPfIT died. I moved out of the healthcare domain shortly after that. A few years ago I tried to sell some software for next to nothing to the NHS for a team my wife worked for. A simple webapp backed by a DB instead of spreadsheets on a shared drive. They took the idea and gave it to an in house employee who was running it as a side project (charging more for it than I was) and never finished building it. Speaking to someone in charge of innovation for a large part of the country recently, he said he couldn't even take some software I'd offered for a free trial. As he saw it the system was so broken he was warning everyone off. And his job was innovation. The NHS is ripe for improvement. I suspect its management haven't got a clue what they're doing though and fear the lure of big tech firms will be the only thing they can't resist.

TazeTSchnitzel 7y ago
Now living in Sweden which has what seem like very sophisticated e-health systems by comparison (at least on the user-facing side), I wonder why the UK couldn't have purchased and adapted an existing system that worked elsewhere.
- noir_lord 7y ago
  NIH combined with the optics of paying 'foreign' developers. Which is silly given who actually owns large parts of British infrastructure but... We have a confluence of shitty corrupt middle managers masquerading as politicians and a terrible press. I honestly have come to the conclusion that the UK is pretty fucked in the mid to long term.
- cs02rm0 7y ago
  You've reminded me of someone I know who also worked for an NHS body related to innovation/improvement who went to Amsterdam I think for an international healthcare conference. I said it must have been interesting, lots to learn about. She replied that the NHS was the best in the world and there was nothing to learn about from anyone else in any respect. Sadly, although I remain convinced many people must be slogging against the system, I suspect she isn't alone in that view.
- DanBC 7y ago
  It's not "the NHS". It's a bunch of GPs, hospital trusts, mental health trusts, community care trusts, and they're all independent competing non-profit businesses. The current Secretary of State at the Department of Health and Social Care is pushing open standards and interoperability, but has an idealogical attachment to private companies providing software after competitive tender.
- benmaraschino 7y ago
  Denmark's healthcare system tried to implement Epic nationally, and if this article is anything to go by, it didn't go so well: https://www.politico.com/story/2019/06/06/epic-denmark-health-1510223 https://www.politico.com/story/2019/06/06/epic-denmark-healt... Essentially, different healthcare systems have different needs which are reflected in how their electronic health record systems are architected. For example, EHRs in the US are optimized for billing, and if you're moving an US-centric EHR, like Epic, to a country like Denmark with universal healthcare, all that functionality becomes superfluous. Not to mention the language differences, as well, which are touched upon in the article. It's possible that similar concerns played into the NHS's decision to build their own system. Some NHS trusts are moving forward with their own Epic implementations, however. For example: https://www.digitalhealth.net/2018/06/royal-devon-exeter-nhs-foundation-trust-gets-epic/ https://www.digitalhealth.net/2018/06/royal-devon-exeter-nhs...

DanBC 7y ago

> The current trend of rushing to give access to parts of the silo/NHS Spine to other providers like Babylon health et al., without due consideration or a debate, is another can of worms best left unopened.[3] I don't get it. Babylon is just another provider. There's not much difference between Babylon and other GP providers - they get your data if you're their patient and not otherwise. They're subjected to the same rules as other GPs. There isn't some huge database somewhere of "all the NHS data" that providers can dip into. Each provider has it's own data, with little bits fed-back into the gp system or the spine.

johnnycab 7y ago
>I don't get it. Babylon is just another provider. There's not much difference between Babylon and other GP providers - they get your data if you're their patient and not otherwise. They're subjected to the same rules as other GPs. Babylon is unlike any other providers; it is an AI & Data first, app-based subscription model with a mix of state funded services. It's aim is to acquire more data in order to train models. The overwhelming majority of traditional GP's are primarily focused on patient first policy ─ they are usually non-profit with scant resources and a poor to non-existent IT strategy. To normalise these new models by trivialising differences between traditional services (as flawed, as they might be) would only serve to marginalise existing practices and it is the first step towards introducing scope-creep by politicians, who have an unhealthy obsession with statistics, quick fixes and making Faustian pacts with the private sector. Babylon claims to go beyond any GP by being on par with human doctors and boasts of it's partnerships with Samsung and Tencent and counts DeepMind as one of it's investors. Just like any startup looking to disrupt, the platform is cloud-based and hosted on AWS[1]. It records every interaction, including video ─ which is retained for later review. It is growing at an exponential rate, despite a limited presence in London. The patient database reveals that it caters to a very specific demographic across varied and different parts of the city i.e. 83% of patients are aged between 20 to 39 years. While it is still in it's infancy, it has already been involved in legal tussles and has been accused of dubious practices[2][3]. There is no visibility on algorithms, models and related datasets nor is there any indication of AI ethics being in place. There is also the issue of the CEO being linked to a white elephant project before his current fast-tracked foray into digital healthcare, which was probably rubber-stamped by officials in Whitehall. Although, it is undeniable that the NHS is overburdened and could do with some help to ease the pressure, but Babylon seems to be doing the exact opposite by applying the 'moving fast-breaking things' ethos inside an institution, which is already broken and moving slow. I have already linked the Wired article, which discusses some of the topics above in-depth, other facts are supported by the FT article (paywall) and Forbes, which are reasonably reputable sources in my opinion. https://www.ft.com/content/19dc6b7e-8529-11e8-96dd-fa565ec55929 https://www.ft.com/content/19dc6b7e-8529-11e8-96dd-fa565ec55... https://www.forbes.com/sites/parmyolson/2018/12/17/this-health-startup-won-big-government-dealsbut-inside-doctors-flagged-problems/#69448ba8eabb https://www.forbes.com/sites/parmyolson/2018/12/17/this-heal... [1] https://aws.amazon.com/blogs/startups/how-babylon-health-builds-an-ai-doctor-app-and-scales-globally-with-aws/ https://aws.amazon.com/blogs/startups/how-babylon-health-bui... [2] https://www.digitalhealth.net/2017/12/babylon-healthcare-cqc/ https://www.digitalhealth.net/2017/12/babylon-healthcare-cqc... [3] https://www.artificialintelligence-news.com/2019/04/12/babylon-health-ai-test-gp-at-hand/ https://www.artificialintelligence-news.com/2019/04/12/babyl...