Is technology killing the NHS?

Maurice Dixon:


Telemedicine, GP appointments by Skype, personal body-worn medical monitoring, auto-blood condition monitoring and treatment, MRI scanners, keyhole surgery, etc, etc are all part of the adoption of technology. However, these are all stovepipe approaches, not within a system-of-systems strategy and technology architecture. Thus, perhaps technologists need to better understand the requirements and needs of their customers before offering and designing systems without user input, and using a spiral evolution approach starting with small quick wins to bud confidence then evolving based on increasing confidence and evidence of value added and cost benefit.

Telemedicine is a relatively recent development and very much a brave new world for the hospital centric NHS. A sea change in the attitude of NHS managers will be required to implement telemedicine which will take many years of overcoming opposition and bureaucracy.


Large hospitals contain thousands of medical devices but most are standalone rather than networked. The concept of networking medical devices in the NHS has been confined to only a few isolated areas, such as critical care suites or neonatal wards, until a few years ago. One reason why most devices are standalone is because they are portable so they can only be networked using a wireless interface. The NHS has always used wired networking for computers and fixed medical devices, so wireless networking is very much a new game.


Networking medical devices outside of a hospital campus – such as hospital at home – is venturing into uncharted territory for the NHS. There are a number of questions that need to be answered:


1. Who provides, and pays for, the communication links between the medical devices used at home and the central controller in the hospital?


2. If a patient dies as a result of a communication link failing, or data being corrupted, then who takes the blame?


3. Some implementations of telemedicine are being provided by medical device manufacturers rather than the NHS. If the NHS chooses to outsource telemedicine to medical device manufacturers (or other private companies) rather than offer telemedicine services directly then is this a case of privatising the NHS via stealth and technology? It is possible that the cost of outsourcing telemedicine to private companies is more expensive than the NHS providing it directly, but if the private company will take the legal responsibility when a patient dies as a result of failure of the equipment or the communication link, leaving the NHS scot free, then the NHS may have no choice but to outsource or potentially be sued for millions.

Maurice Dixon:


Telemedicine, GP appointments by Skype, personal body-worn medical monitoring, auto-blood condition monitoring and treatment, MRI scanners, keyhole surgery, etc, etc are all part of the adoption of technology. However, these are all stovepipe approaches, not within a system-of-systems strategy and technology architecture. Thus, perhaps technologists need to better understand the requirements and needs of their customers before offering and designing systems without user input, and using a spiral evolution approach starting with small quick wins to bud confidence then evolving based on increasing confidence and evidence of value added and cost benefit.

Telemedicine is a relatively recent development and very much a brave new world for the hospital centric NHS. A sea change in the attitude of NHS managers will be required to implement telemedicine which will take many years of overcoming opposition and bureaucracy.


Large hospitals contain thousands of medical devices but most are standalone rather than networked. The concept of networking medical devices in the NHS has been confined to only a few isolated areas, such as critical care suites or neonatal wards, until a few years ago. One reason why most devices are standalone is because they are portable so they can only be networked using a wireless interface. The NHS has always used wired networking for computers and fixed medical devices, so wireless networking is very much a new game.


Networking medical devices outside of a hospital campus – such as hospital at home – is venturing into uncharted territory for the NHS. There are a number of questions that need to be answered:


1. Who provides, and pays for, the communication links between the medical devices used at home and the central controller in the hospital?


2. If a patient dies as a result of a communication link failing, or data being corrupted, then who takes the blame?


3. Some implementations of telemedicine are being provided by medical device manufacturers rather than the NHS. If the NHS chooses to outsource telemedicine to medical device manufacturers (or other private companies) rather than offer telemedicine services directly then is this a case of privatising the NHS via stealth and technology? It is possible that the cost of outsourcing telemedicine to private companies is more expensive than the NHS providing it directly, but if the private company will take the legal responsibility when a patient dies as a result of failure of the equipment or the communication link, leaving the NHS scot free, then the NHS may have no choice but to outsource or potentially be sued for millions.