Health it policy in the UK: the case of electronic health records

International audienceThe challenge to provide a nation-wide integrated health service is part of a UK government policy to transform healthcare using information and communications technology. The National Programme for Information Technology launched in 2002 is the largest, non-military, non-scientific government-funded IT programme, with an estimated total cost exceeding £20 bn. This chapter is a longitudinal study of the National Care Record Service, which is the largest part of the programme, aimed to provide 50 million UK (English) citizens with an electronic health record. Using episodic interviewing techniques over ten years and secondary source material, the findings reveal a serious mismatch between health IT policy and the failure to rollout electronic health records on time and within budget. Key stakeholders, notably clinicians and patient groups, continuously question the policy and merits of the programme, not merely as a “technical challenge” but as a means of transforming working practices in healthcare. This study suggests that government agencies therefore need to extend their health technology assessment criteria to include cultural, social, and economic issues, as imposing centrist, top-down health IT policy needs to secure the “buy-in” from diverse and influential groups and individuals to ensure the successful adoption and implementation of health technologies