Published: 16/01/2003, Volume II3, No. 5838 Page 1

Delivering 21st Century IT Support for the NHS gives us a vision for what IT should contribute to healthcare delivery. It is a revelation, enabling consumers, clinicians, managers and others to grasp the final destination on the technology journey.

What is not so clear is how we will get there.Will we be travelling via motorwaystyle big-bang procurement, or taking the country route where there is more time for evaluation of the road travelled?

The new IT strategy is broader in scope than any previously drawn up for the NHS.

It is to be applauded for its focus on the patient, rightly regarding healthcare professionals and managers as important support acts in the delivery of a service that meets consumer need.However, the devil is in the detail.And until procurement issues, the specification for the integrated care records services and implementation milestones are sorted out, it will be hard for healthcare organisations to develop longterm, strategic plans that are guaranteed to be in line with government thinking.

While the sorting out goes on, the patients still keep coming - and they rightly expect the NHS to have the capacity to deal with them appropriately.Moving towards the vision is a long journey. Something needs to be done to get us on the road.

We are not starting from nothing.Many healthcare organisations have implemented solutions that go beyond basic administrative functionality. These range from 'coal face' applications, such as electronic ordering, to clinical audit and management reporting systems and they have improved the efficiency and quality of healthcare delivery.

Unfortunately, implementation of these proven solutions is not consistent. Some organisations have forged ahead with incremental additions to their existing IT portfolio and others have held back.

Perhaps the latter have been waiting for the ultimate plan for implementing the vision all at once. It is likely to be a long wait. Priorities will change and new experiences and technologies will mean the final goal is a moving target.

Provided that any new implementation is in line with the long-term aim and required standards, why do not healthcare organisations take advantage today of the proven benefits that adding clinical and other functions can bring?

The step-wise approach helps everyone.

Patients get better care.Healthcare organisations operate more effectively and spend less time worrying about the implications of major procurements.The government gets a cost-effective means of implementing its vision, in which clear progress toward the final destination can be demonstrated.

So, let's not wait for a miracle but use what we have to make the vision a reality, sooner.

Dr Lindsey Harris, strategic development manager, Torex Health