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In 2013, Cambridge University Hospitals (CUH) NHS Foundation Trust signed a 10-year, £200m ($314m) contract with HP and Epic for an IT outsourcing and Electronic Patient Record (EPR) program, which went live at the end of 2014. We recently met with senior clinicians and executives from CUH at an event hosted by HP.

The bold ambition of CUH’s program makes this an unprecedented step for a UK NHS Trust, with subsequently higher stakes. However, in our view, the additional risk is mitigated by the obvious clarity of vision at board level and the substantial amount of smart planning and external governance involved. The early implementation results are encouraging.

A sobering point of discussion was the extent to which many NHS organizations are reaching a digital breaking point. CUH’s choice is one possible route to effective healthcare digitization. Many other organizations will choose (or be forced) take a more incremental approach. The case for effective IT outsourcing has never been stronger, but pressured NHS organizations will require more support.

Emerging lessons from CUH’s journey

CUH’s decision to embark on this journey was underpinned by multiple operational and strategic drivers, ranging from poor information sharing to building a platform it can share with others to support future clinical research. There are many interesting lessons and factors (it is Epic’s first UK EPR deployment) emerging from the program. Some are the classic IT cost, performance, and flexible financing benefits of long-term IT outsourcing vendor partnership approaches (in the case of CUH and HP, with an emphasis on IaaS and SaaS), well-known in other industries, but far less so in healthcare. Some highlight the potential of organizations to use digitization as a catalyst for change; for example, the increased professionalization of care and application rationalization as a consequence of going through the process of EPR deployment. Others underline the sheer size of the challenge to change the culture and the institutionalized ways of doing things in a large and complex healthcare organization. If there is one salient point to take away, it’s that this program was just as much about change management and strategic planning for both CUH and HP’s services teams as it was about technology.

NHS organizations need more support for digital transformation

The UK government is pushing digital health, but the question is how NHS organizations can find the time and money to step back, plan, and invest at a time when funding and operational pressure is at an all-time high. To avoid the digital health agenda remaining more rhetoric than reality by 2018, it requires support across the board. There needs to be more effective best-practice sharing and collaboration between NHS organizations, stronger supplier partnerships, while more cost-effective on-demand IT delivery models like XaaS, which allow for more agile service consumption, should be encouraged. Finally, the government must reduce the barriers (including cost) to better procurement, training and project management.


Further reading

Manchester’s devolved health and social care budget raises the stakes for IT, IT0011-000353 (April 2015)

2015 Trends to Watch: Healthcare Technology,IT0011-000328 (November 2014)

Effective Information Sharing in Healthcare: Challenges and Opportunities, IT0011-000324 (July 2014)


Charlotte Davies, Lead Analyst, Healthcare

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