U.K. Dept of Health: Prescription for Disaster

In late September, Accenture, the global management and technology consultancy, announced it was walking away from a $3.73 billion contract as an information-technology services provider on the world’s biggest non-military I.T. project, a hugely ambitious and complex attempt to transform England’s entire National Health Service through technology. Accenture, which failed to respond to numerous requests for interviews, did not say why it was exiting the National Health Service (NHS) project, but earlier this year it had set aside $450 million to cover potential losses from its work in England. Its exodus represents the latest in a series of setbacks and missteps that have plagued the highly controversial program since its inception.

In scale, the project, called the National Program for Information Technology (NPfIT), is overwhelming. Initiated in 2002, the NPfIT is a 10-year project to build new computer systems that would connect more than 100,000 doctors, 380,000 nurses and 50,000 other health-care professionals; allow for the electronic storage and retrieval of patient medical records; permit patients to set up appointments via their computers; and let doctors electronically transmit prescriptions to local pharmacies.

For more on a related topic, see Studies Show Electronic Medical Records Make Financial Sense

To date, the NHS has delivered some of the program’s key elements. For example, in late October Health Minister Lord Warner announced that 1 million patient referrals to specialist care have been made through a Choose and Book service that allows patients to book appointments electronically. As of August, 97% of doctors’ offices were connected to a new national network, N3, which is a major component of the project.

Yet, many pieces of the project—including deployment of key electronic records software—have been delayed and the program’s cost has ballooned.

The NPfIT was initially budgeted at close to $12 billion. That figure is now up to about $24 billion, according to the National Audit Office (NAO), the country’s oversight agency. And it is as high as $28.4 billion, according to other estimates. Even the lower of those two amounts is more than the price tag for building the English Channel Tunnel or Boston’s massive Big Dig project, considered to be the most expensive civil project ever. Worse, the funding established to pay for the system has, temporarily at least, dried up.

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