For many years, the U.K. healthcare system, the National Health Service (NHS), has been referred to in the U.S. as a prime example of the success of a national healthcare system. Here's a brief summary of the NHS from Wikipedia:
The National Health Service (NHS) is the publicly funded national healthcare system for England and one of the four National Health Services for each constituent country of the United Kingdom. It is the largest single-payer healthcare system in the world. Primarily funded through the government funding and overseen by the Department of Health and Social Care, NHS England provides healthcare to all legal English residents, with most services free at the point of use. Some services, such as emergency treatment and treatment of infectious diseases, are free for everyone, including visitors.
A recent article discussed in great detail the IT challenges being experienced by the NHS (see: In the UK, health care is national and popular. Its health IT is a Balkanized mess). Read the whole thing if you are interested. Below is an excerpt:
For nearly 20 years, the British government has launched one initiative after another to build a digital records system that will improve care at its famed National Health Service. But its clinicians still struggle with a dearth of communication among care team members, leading to prolonged wait times for appointments, confused patients and needlessly repeated tests and procedures. In the United States, progressive Democrats supporting single-payer...contend that a health system deprived of profit motive would make care less wasteful, more efficient and generally just easier for patients to navigate. But if Britain’s struggle to modernize the NHS is any indication, a single-payer system alone wouldn’t necessarily solve the maddening bureaucratic morass that is the $3.5 trillion-per year American health care system. That would take an unprecedented level of cooperation that’s been elusive in the United States, even 10 years after Washington plowed tens of billions of dollars into bringing health care fully online....
But modernizing the NHS, particularly its IT systems, has been a massive headache and a drag on the government’s effort to keep health care spending in check amid the growing expenses of an aging population....While the NHS pays for the vast majority of health care in the United Kingdom, the system is more decentralized than an outsider might think. It consists of scores of “trusts,” each consisting of one or more hospitals. In England, 191 individual boards oversee the provision of health care. Depending on their funding models and priorities, and sometimes on the strength of the local economy, this has resulted in vastly different levels of digitization and coordinated care in different areas of the UK, sometimes even in the same city....The top third of British hospitals have digital technology that’s nearly comparable to U.S. levels in terms of its sophistication. The bottom third still rely on clunky old computers or even paper records.
It probably should come as no surprise that the NIH hospitals are being challenged by the deployment of IT. As in the U.S., clinical record sharing is complex as are computerized financial systems. The latter systems are critical in the U.K. despite the fact that care is free to the patients there. Even for the NHS, budgeting and finance are vital for understanding costs and how to contain them. I don't need to remind the readers of LabSoftNews about the problems associated with the rollout of EHRs in the U.S. and the continuing challenges of interoperability.
I was preciously unaware that there are 191 individual boards representing the various NHS "trusts." Despite the fact that I believe Medicare is generally well run, I am wary of its expansion which is one of the current Democratic proposals, sometimes referred to as Medicare for all (see: Medicare for all: fears and facts). I only need to cite the continuing political machinations around the VA healthcare system as one example of the chaos that can ensue when politicians seek to exert authority over such a massive healthcare system (see, for example: Why the Military and the VA Healthcare Systems Are Not Amenable to Change; Comprehensive History of VistA; What's Next for This Early, Highly Functional EHR?).
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