Category Archives: technology

After billions spent on NHS IT, a carrier bag to transfer x-ray images

By Tony Collins

After fracturing my angle (slipping on a slope while mowing the lawn) I’ve been surprised how well parts of the NHS work – but not when it comes to the electronic transfer of records and PACS x-ray images from one trust area to another.

The minor injuries unit at one trust wasn’t able to send its PACS images to another trust’s orthopaedic department because it used a different PACS.  [The NHS has spent more than £700m on PACS ]

“Can’t we email the images?” said a senior nurse at the minor injuries unit. In reply the clinician looking at my x-rays gave a look that suggested emailing x-rays was impossible,  perhaps for security and cost reasons. [PACS images are sometimes tens of MBs.]

In the end the minor injuries unit (which within its own sections shared data electronically) had to download my x-rays onto CD for me to take the other trust’s orthopaedic department.  The CD went into a carrier bag.

The next day, at a hospital with an orthopaedic department, after 4-5 hours of waiting in a very busy A&E, I gave a doctor the CD. “I don’t think we can read that,” he said. “We don’t have any computers which take CDs.”

After a long search around a large general hospital the tired doctor eventually found a PC with a CD player. Fortunately the minor injuries unit had downloaded onto the disc a self-executing program to load the x-rays. Success. He gave his view of the fracture.

Even then he didn’t have my notes from the minor injuries unit.

Comment

My care was superb. What was surprising was seeing how things work – or don’t – after the NHS has spent more than £20bn on IT over the past 20 years.

The media is bombarded with press releases about IT innovations in the NHS. From these it’s easy to believe the NHS has the most up-to-date IT in the world. Some trusts do have impressive IT – within that trust.

It’s when records and x-rays need to be transferred outside the trust’s area that the NHS comes unstuck.

As a nurse at my GP’s practice said, “Parts of the NHS are third-world.”

Since 2004 billions has been spent on systems to create shareable electronic patient records.  But it’s not happening.

Within those billions spent on IT in the NHS, couldn’t a little bit of money be set aside for transferring x-rays and patient notes by secure email? That’s the real innovation the NHS needs, at least for the sake of patients.

In the meantime the safest way for x-rays and notes to be transferred from one trust to another is within the patient’s carrier bag.

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EC probes IBM CIO secondment at the Met Office

By Tony Collins

A part of the European Commission is investigating a decision by the Met Office to appoint an IBM executive as CIO while he worked at the same time for IBM, the organisation’s main IT supplier.

The investigation was prompted by concerns of campaigner Dave Orr who wrote to the EC about the Met Office’s appointment of an IBM secondee David Young as CIO for two years between 2010 and December 2012.

Now Michel Barnier, the EC Commissioner responsible for internal market and services, says in a letter to Orr’s MEP Sir Graham Watson that the EC’s Directorate-General for Internal Market and Financial Services has been carrying out “an in-depth analysis” of the facts presented by Orr.

As part of this, the EC has written to the UK government seeking clarification on a number of points.

Some of Orr’s concerns arise from the Met Office’s responses – and non-responses – to his freedom of information requests. One of his concerns is of a potentially cosy relationship between the Met Office as a publicly-funded organisation and its principal IT supplier IBM; and he has wanted to know why the job of Met Office CIO was not openly advertised in a competitive recruitment process and whether its appointment of an IBM secondee had the potential for a possible conflict of interest.

Orr said that the secondment had the potential to confer a unique and significant intelligence and relationship advantage for IBM that other supercomputer suppliers could not hope to match. “In my view, that is anti-competitive and may in spirit at least, fail the EU procurement rules,” said Orr.

Barnier said that the existence of a conflict of interest would “depend on a number of factors such as the precise role and responsibilities the position entails, in particular whether it includes formulating and preparing technical specifications or tender documents for future IT contracts that the Met Office may put out to tender”.

It is also relevant, said Barnier, whether the terms and conditions of the secondment “impose any obligations or restrictions on the head of the department to prevent conflicts of interest, both during the secondment and afterwards”. He also wanted to know if internal rules were in place to prevent conflicts of interest in the course of tendering procedures.

The Met Office and ministers said that Young was not involved in procurement decisions relating to existing supercomputer facilities. Norman Lamb, then minister at the Department for Business Innovation and Skills, said last year:

“Any potential conflicts of interest regarding David Young’s appointment were fully considered prior to his appointment and his terms of engagement specifically cover these …

“David Young had no involvement in the procurement process for existing supercomputing facilities, either for IBM or the Met Office, and he will have completed his secondment and left the Met Office prior to the selection of replacement supercomputer facilities.”

A wise decision?

The decision to second an IBM employee to run the 300-strong IT department, which is based at the Met Office’s supercomputer site in Exeter, raises questions that may go beyond the potential for a conflict of interest.

As Young was unable to be involved in some buying decisions and was unable to attend the technology strategy board to avoid any potential for a conflict of interest, did the Met Office restrict itself unnecessarily in hiring a CIO who faced these constraints?

Did the Met Office waste money – and a precious two years – hiring a lifeguard whose terms of employment required him to wear handcuffs?

The secondment of Young came at a difficult time for the Met Office – and some of the main difficulties it faced in 2010 are largely the same today.

Responses to Orr’s FOI requests and a report by the House of Commons’ Science and Technology Committee highlight some of the Met Office’s challenges:

– A need for modernised software that will take advantage of next-generation supercomputers.

– A need for a replacement supercomputer that has twice the power of the existing one which operates close to one petaflop (one thousand million million floating point operations per second).

– Funding a new supercomputer (with optimised software) at a time of cut-backs in government spending.

A Met Office Executive Board paper said that its executives have had “soft” negotiations with various suppliers about next generation supercomputer technology. They spoke to Bull, Cray, Microsoft, NEC and SGI.

“Vendor presentations indicate that performance increases will come from increasing the number of processors and/or adding co processors designed to process arrays of data efficiently, rather than increasing the speed of individual processors,” said the Met Office paper.

The Met Office says that “significant optimisation work will be needed [on the code] and, if this is not completed around 2014, a delay in the launch of the procurement may be unavoidable.” It has been seeking software engineers with experience of Fortran (which was originally developed by IBM) or C, Unix or Linux and Perl.

A House of Commons report in 2012 emphasised the need for new technology at the Met Office. The report of the Science and Technology Committee “Met Office Science” said in February 2012:

“It is of great concern to us that these scientific advances in weather forecasting and the associated public benefits (particularly in regard to severe weather warnings) are ready and waiting but are being held back by insufficient supercomputing capacity. We consider that a step-change in supercomputing capacity is required in the UK.”

MPs acknowledged that “affordability is an issue.”

The Met Office declined to answer Orr’s FOI requests about the cost to the taxpayer of employing Young.

Since Young’s  secondment ended in December 2012 the Met Office has hired one of its own employees as CIO. Charles Ewen has worked for the Met Office since 2008. He works with science teams to operate the Met Office’s high performance computing facilities. He is responsible for the development and implementation of the Met Office’s ICT Strategy and for the internal technical teams within the Technology Information Services Directorate.

Comment:

The Met Office hired Young for the best of reasons: after a succession of internal management changes it wanted a highly professional, stabilising CIO. But did it need a CIO from IBM, its principal IT supplier?

That the Met Office was sheepish about the appointment of an IBM secondee was, perhaps, revealed by its website which, in giving a profile of Young, did not mention – at first – that he was seconded from IBM. After Dave Orr’s FOI requests the Met Office corrected its website omission, making clear that Young was on secondment from IBM.

The Met Office has been in existence nearly 16o years. It was founded by Vice-Admiral Robert FitzRoy in 1854 as the Meteorological Department of the Board of Trade. It is highly regarded internationally. A testament to the quality of its computer models  – which are used for daily forecasts – is that its “Unified Model” is licensed in Norway, Australia, South Korea, South Africa, India, New Zealand and the US Air Force.

Scientists say that a three-day forecast today is as accurate as a one-day forecast was 20 years ago. But in the UK the Met Office gets a bad press – not always unjustifiably.  There is a perception that the accuracy of forecasting is not improving. Sometimes it seems poor.

The algorithms that form the basis of weather and climate models place huge demands on supercomputing architectures. The models produce exceptionally large volumes of data. Although the Met Office had a new IBM supercomputer in 2008 it soon needed more powerful hardware and modernised software.

So was it a good idea, with all the challenges the Met Office faced in 2010 – including the need to persuade the government of the need to fund  new supercomputer facilities – to appoint a CIO for two years who, because he was an IBM secondee, had understandable restrictions on his freedom to do his job, restrictions the Met Office has been reluctant to reveal, despite Dave Orr’s FOI requests?

Hole in the head

The Met Office may regard an EC inquiry into its appointment of an IBM secondee as the last thing it needs now. But accountability should not be left to the occasional scrutiny by a Commons committee – or to Dave Orr’s FOI requests.

Campaign for electronic patient information centre

By Tony Collins

Shane Tickell, CEO of health IT supplier IMS Maxims, is leading a campaign for a national electronic patient information centre.

It would enable NHS staff, healthcare organisations and government suppliers to share details of, or learn about, innovative practices that work.

In a guest blog, Tickell argues that there are many examples of innovation in the NHS but information on the successes is scarce or not available in one place.

He advocates a physical and a virtual centre. Information, case studies, best practice and ideas from the NHS would be shared online. There are some websites that do this, but in isolation. The virtual site he proposes would be interactive and a way of collating information that exists in silos.

The physical centre, Tickell says, could be anywhere on the UK, potentially using some of the 2,000 acres of unused NHS estate. It would be a forum for education and sharing, where suppliers could showcase their systems, and NHS staff could speak openly about what they need from suppliers.

It would also be a place for policy to be explained by government officials, where quangos define their requirements, and NHS trusts share what they are doing and the lessons they have learned.

Shane Tickell writes:

“As an acceptance grows across the NHS that there is a crucial need for integration across health and social care, the extent to which our National Health Service is disjointed is becoming increasingly clear.

In many areas, although of course not all, there are so many examples of different approaches, poor collaboration and lack of joined thinking between organisations despite their attempts to achieve the same goals. On many occasions, I’ve seen examples where an NHS organisation has shared the results of a successful pilot with another organisation hundreds of miles away and yet the trust just a few miles down the road has no idea the initiative even exists.

In recent years, healthcare IT events such as EHI Live have helped suppliers of all sizes showcase their solutions, albeit just once a year.

However, despite best efforts, most often suppliers with the biggest marketing budgets often take the centre stage, while the smaller, more innovative companies huddle around the edges trying to grab the attention of the odd delegate who is less wowed by the exciting gizmos and freebies on the bigger stands.

Equally, these events have been valuable in enabling the NHS to share their experiences by allowing them to participate in best practice showcases. But while these shows are valuable in providing those once-a-year opportunities to network and see what is available, ideas and information gathered can soon be forgotten once back in the busy NHS setting, until the next time an event comes around.

There are more than 400 pilots across the NHS and 300 ‘examples of innovation’ alone, according to the BCS. On top of all of that, my team recently mapped more than 40 NHS organisations and bodies, who work virtually disparately to attempt to provide the NHS with direction, standards and protocols.

So where does this leave the NHS – confused? Disjointed? Not a clue where to start when they are told that they need to collaborate and innovate to improve patient safety and care while saving vast sums of money?

The NHS needs a place that provides an educational and innovation forum covering everything related to electronic health and wellbeing that is available all year round – an electronic patient information centre.

At present there are pockets of innovation across the country. Initiatives set up by the National Innovation Centre and its associated ‘innovation hubs’ are providing a useful mechanism to support and adopt healthcare technology across the regions.

But an all year round centre would provide a central location for healthcare organisations, bodies, government and suppliers to meet, discuss and understand policy. Equally important, the centre would provide a valuable place to educate on future challenges and where they are being driven from and an opportunity to work together to help to address them as soon as they start to emerge.

Although it would require investment, such a centre would provide trusts, CCGs, private and independent organisations and just about anyone with an interest in health and social care regardless of their budget, size, location or IT savviness with the opportunity to attend at a time that is convenient for them.

Meanwhile, suppliers of any shape or size would have a level playing field from which to be represented and educate their current and potential customers, rather than trawling up and down the country trying to find inroads to speak to those on the frontline. In addition, it would ensure that all is not lost from the National Programme for IT and that lessons learned are shared.

For too long the NHS has had to rely on word of mouth and second-guessing how surrounding organisations are achieving success. Now is the time to really work together to ensure true innovation is shared and for everyone to have a chance to be part of it.”

LinkedIn group – Electronic Patient Information Centre 

shane.tickell@imsmaxims.com.

New York’s new CIO to create centre of excellence to prevent failing IT projects

By David Bicknell

New York’s recent problems with IT projects have been well documented.

Its latest solution: appoint a new CIO, with a wide remit that includes innovation and the setting up of a ‘centre of excellence’  to nail down failing projects.

Rahul Merchant joins with a background served at US mortgage and housing specialist Fannie Mae and at financial services company Merrill Lynch.

He will become the first Citywide Chief Information and Innovation Officer and Commissioner of the Department of Information, Technology and Telecommunications reporting to New York’s mayor Michael Bloomberg.

His role will involve overseeing New York’s information technology development and management, with a focus on delivering technology projects on-time and on-budget.

Merchant will succeed Carole Post, who recently announced she will be leaving for a position at New York Law School.

“By bringing the City’s IT infrastructure and development under one office, we can ensure we are using best practices across agencies, leveraging the City’s enormous IT infrastructure to our maximum advantage and holding contractors accountable for delivering results,” said Bloomberg. “Rahul is a seasoned executive who has proven himself time and again as a leader and an innovator in the industry.  He is going to do an outstanding job as New York City’s first Chief Information and Innovation Officer and we are excited to add him to our talented team.”

Merchant will be responsible for New York City’s IT infrastructure, as well as oversight of the implementation of key technology initiatives that enable the City’s various agencies to serve 8.4 million New Yorkers.

What will be worth watching is seeing how he tackles New York’s reputation for troubled IT projects by creating a Centre of Excellence that will  “standardise business processes for the implementation of large technology projects, institute a system of vendor evaluation to hold contractors accountable for meeting project milestones, and update the City’s technology contracts to focus on the delivery of established milestones to meet agency business needs.”

According to Bloomberg, Merchant will work closely with agency commissioners and chief information officers “to ensure that IT projects leverage existing infrastructure and software to the maximum possible extent, and that the City’s overall IT budget meets core agency business needs and the City’s overall technology objectives.”

He will also spearhead the New York’s efforts to remain a leader in technology innovation, by leveraging its  technology assets and partnerships with academic institutions, technology firms, and entrepreneurs.

He won’t be short of people to help. Merchant will lead a 1,200-strong staff responsible for managing the City’s information technology infrastructure as well as serving the information technology needs of 45 mayoral agencies, dozens of other governmental entities, and nearly 300,000 employees.

Here’s how local sites reported Merchant’s appointment:

Crain’s New York Business: Major taps Merrill Lynch vet to tame tech projects

Tech President: New York City just radically changed who manages its IT projects

Government Technology: NYC names Rahul Merchant to CIO and Innovation role

UK technology firms spurn BRICS deals in favour of home investment says Grant Thornton report

By David Bicknell

Medium-sized UK technology companies are forgoing demonstrable investment opportunities in the BRICS economies in favour of domestic deals, according to new research from audit specialist Grant Thornton. 

The research shows that three-quarters (75%) of medium sized UK technology companies have no plans to invest in new markets in the next 12 months.

The study reflects trends over the last five years for mergers and acquisitions in the technology market, which show that domestic investment continues to be the number one priority for ICT businesses. 141 UK to UK deals were completed in 2011,  a higher volume than with any other market.

In terms of outbound investment from the UK technology sector, mature markets such as the USA, Australia and Germany have consistently remained at the top of the league in comparison to other emerging markets. 

Wendy Hart, Head of Technology at Grant Thornton UK, is calling on investors in the UK’s technology mid-market to think beyond traditional investment regions and seize opportunities. She says: “Over the last five years the volatility of the global market has inevitably had an impact on the volume of cross-border deals taking place.

“Traditional, mature markets such as those in the G7 remain attractive to UK firms because of a familiar business environment, language commonalities and greater access to highly skilled employees. In contrast, outbound investment into fast-growing, tech-friendly economies such as India, China, Brazil and Israel is still relatively low.”

To help highlight the opportunities available, Grant Thornton has produced an ‘expansion index’ guide, which compares existing UK investment markets such as the UK, the USA, Germany, France and the Netherlands with emerging economies. The data demonstrates that the markets with the biggest opportunities are also the markets that present the biggest challenge for investors.

Wendy Hart continued: “The sheer volume of information that a business has to get to grips with before making an investment into an unfamiliar market can be daunting. There are three key stages that are vital foundations for a market entry strategy: full assessment of the opportunity available; thorough preparation so that a business is ready for execution; and management of the actual execution itself.”

In the report, Grant Thornton has also called on technology investment experts from around the world to provide detailed insight about key technology markets, both traditional and emerging.

Nick Farr, Head of China Britain Business Services at Grant Thornton UK, said: “One of the reasons that UK technology businesses are reluctant to enter China is a fear of copying or reverse-engineering of their products. Whilst this is still a risk, as China’s patent system evolves there are increasing opportunities for businesses to protect their intellectual property (IP). These opportunities are being noticed. Recent research by the China-Britain Business Council showed that 59% of UK businesses with a presence in China want to increase their R&D activity there.”

Some snapshots from the report:

China

“Grant Thornton’s Technology Expansion Index ranks China second for economic growth and third for infrastructure and technology. On the flip side, China is one of the lowest ranked markets for political and legal landscape and has one of the most complex systems in the world for business start-ups. It is this dichotomy, paired with the complexities of Chinese culture, that best explains the lack of UK businesses looking to enter the Chinese market.

“However, great returns are never easily achieved. The opportunity in China is huge, not just in terms of salary arbitrage and tax incentives. Despite the recent slowdown in China, growth is still upwards of 8% and this high growth potential means that those companies able to access the Chinese market will be better at meeting consumer needs and faster to market, leaving those who shied away from early investment trailing in their wake.”

Brazil

“At 8.5 million square kilometres, Brazil is the size of a continent, and currently accounts for 40% of Latin America’s economy. IMF GDP growth forecasts through 2013 are strong at 4%, potentially underpinned by the impact of the 2014 World Cup and 2016 Olympic Games, which will drive technology investment. The domestic market for IT in Brazil is now the seventh largest in the world. $165.7bn was spent on ICT in 2010 with only $2.4bn of services exported.

“Brazil is a potential technology investment hotspot because of its large, stable, growing economy; a modern financial system that has largely escaped the global financial crisis; a strong base of local investors; and robust capital markets and a middle class of almost 100 million people aspotential technology consumers.”

India

“The Indian Government’s new ICT policy aims at speeding up development, including plans for fibre optic cable installation and aggressive broadband implementation.

“A strong driver for IT investment is India’s own Generation Y who are primed to become hungry consumers, particularly of IT, consumer technology and social media. India’s consumermarket, currently the world’s thirteenth largest, is expected to become the fifth largest by 2025. Its telecommunication industry, the world’s fastest-growing, added 227 million subscribers duringthe period 2010–11.” 

UK

“According to our survey, 18% of UK technology companies plan domestic investment in the next 12–18 months. Despite the economic downturn, or perhaps because of it, many technology companies are still lookingto consolidate and strengthen theirpresence at home rather than seeking out riskier, but potentially more rewarding climates.

“There is a trend in the UK technology market where large corporates are increasingly looking to acquire companies that provide specialist services or offer some innovation that addresses a niche they want to reach. Importantly, the current state of the overall market means that these companies can be acquired more cheaply than might have been possible pre credit-crunch,” says Wendy Hart.

For more details or for a hard copy of the report, which also features case studies on a number of UK technology companies, including Galleon Holdings, Ideal Industries, Mobile Tornado, Kelkoo, and Tessella, contact Emma Ap-Thomas at Grant Thornton. Tel: 0207 728 2348 or emma.ap-thomas@uk.gt.com

Grant Thornton UK website