A Computer Scientist's Reactions to NPfIT
Authors: Randell, Brian
Journal: Journal of Information Technology (2007)
DOI: 10.1057/palgrave.jit.2000106
<jats:p>This paper contains a set of personal views relating to NHS Connecting for Health's National Programme for IT (NPfIT), and in particular its Care Records Service, written from the point of view of a computer scientist, not a medical informatics expert. The principal points made are as follows: Centralisation: Pulling lots of data together (for individual patients and then for large patient populations) harms safety and privacy – it is one byproduct of excessive use of identification when in fact all that is usually needed is authentication. Large centralized data storage facilities can be useful for reliability, but risk exchanging lots of small failures for a lesser number of much larger failures. A much more decentralised approach to electronic patient record (EPR) data and its storage should be investigated. Evolutionary acquisition: Specifying, implementing, deploying and evaluating a sequence of ever more complete IT systems is the best way of ending up with well-accepted and well-trusted systems – especially when this process is controlled by the stakeholders who are most directly involved, rather than by some distant central bureaucracy. Thus authority as well as re…