And while Sir Jonathan says he "wouldn't be presumptuous enough to come to Australia and tell people how to do things", one lesson emerging from the NHS Programme is the importance of engagement with ultimate end users — clinicians, doctors, nurses and managers — in order to the real goal of change management.
"Whatever system you put in, it will not work in isolation if you don't actually work alongside them to look at their practices and behaviours within the system," he says. "We really are talking about using IT-enabled change management systems, not just using IT to do the things exactly the way we do them today because that's not going to deal with the pressures that all health-care systems are facing, which are pressures of demography as the population gets older, pressures of increasing capability: new drugs, new technology, which is all pretty expensive."
At the same time he says consumers are not only expecting to be treated more like customers, but are demanding health-care to be delivered in a more open and transparent fashion. Access to the Internet means that when patients go to see the doctor they are often much better informed than they ever were before, and are likely to challenge the doctor if they don't like the answers they are given.
"The whole environment means that in fact, the systems have got to change as well as the processes — not just turning from a hard copy record to an electronic patient record. It's much more than that," Sir Jonathan says.
Other challenges to be met include electronic prescribing, electronic transfer of prescriptions, picture archiving, digital imaging, security and patient confidentiality, he says.
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