How is health information technology changing the way we deliver NHS hospital care?
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* Thomas Oates

Editor – I read Sood and McNeil's article with interest,1 especially following the subsequent announcement of the NHS Digital Academy. The structured collection, analysis and sharing of routine clinical data may provide an unparalleled opportunity to make patient care safer, better and cheaper, while also enabling novel research.2 As a result, most clinicians are committed to embedding new approaches into their day-to-day work. However, whether we are in a position to bring patients along with us is another matter.

The failure of care.data3 suggested that the existing legal framework governing the use of personal confidential data is out of date,2 that the constant refreshing of NHS arm's length bodies could actively hinder innovation in this area,4 and that there are significant challenges around the models of consent required to facilitate data sharing.5

In addition, achieving meaningful impact is likely to be so costly – a recent estimate from Intermountain Healthcare suggests up to $1 for each data item collected2 – that it will require commercial sector partners. The deleterious effect of private sector involvement in patients' willingness to share their information is well documented6 and may lead to issues over rights of control.7

Finally, sustainability and transformation plans are likely to initially lead to multiple local approaches to digital transformation. Novel health IT projects require significant iteration and testing for optimisation, which may deeply intertwine intervention and context.8 Therefore, transplanting successful local digital strategies into other hospitals cannot necessarily be relied upon.

The health of the nation and the morale of the NHS workforce could be greatly improved by the successful use of health IT to facilitate data sharing. The vision set out by Sood and McNeil is bracing, but can it currently be delivered given these issues?

## Conflicts of interest

The author has no conflicts of interest to declare.

*   © Royal College of Physicians 2017. All rights reserved.

## References

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4.  House of Commons Health Select Committee. Oral evidence: Care.data database, HC 1105 Tuesday 25 February 2014. London: House of Commons, 2014. [http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocument/health-committee/handling-of-nhs-patient-data/oral/6788.pdf](http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocument/health-committee/handling-of-nhs-patient-data/oral/6788.pdf) [Accessed 11 August 2017].
    
    

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