Slashdot Mirror
Biggest IT Disaster Ever?
lizzyben writes, "Baseline has a major story about a major IT disaster in the UK: 'In 2002, the English government embarked on a $12 billion effort to transform its health-care system with information technology. But the country's oversight agency now puts that figure at $24 billion, and two Members of Parliament say the project is "sleepwalking toward disaster"... In scale, the project... (NPfIT) is overwhelming. Initiated in 2002, the NPfIT is a 10-year project to build new computer systems that would connect more than 100,000 doctors, 380,000 nurses and 50,000 other health-care professionals; allow for the electronic storage and retrieval of patient medical records; permit patients to set up appointments via their computers; and let doctors electronically transmit prescriptions to local pharmacies.'" An Infoworld article from earlier this year sketches some of the all-time greatest IT meltdowns.
Well, I recall the FBI's Virtual Case File system that took 2-3 years to develop and costed $170 million to produce an absolute failure. In the end, they found a "suitable commercial replacement." Probably at a fraction of the price.
So, $170 million/3 years = $55 million/year while the article seems to imply an oversight of one billion per year on the NPfIT which is outrageous. I'm confused how one would even spend that much money on an IT project for a country the size of England--were they laying expensive new shiny fibre wire devoted for medical records only to every facility?
My work here is dung.
The biggest IT disaster every was due to choosing the wrong vendor for
sourcing software, in which
deliberate bugs were planted
Resulting in major collapses of Soviet infrastucture.
Some may argue it's not an IT disaster -- but the root of the problem was that people sourced buggy software from closed source vendors and couldn't get their bugs fixed. -- The same thing happens all the time on a smaller scale when people buy Windows.
I know the reason that this project, and others like it, will fail. This project cannot attract great IT people to work on it because its boring and run by bureaucrats. I'm a strong IT developer but I'd never work on a project like this. Life is just too short. I'd look for something a lot more fun that will attract great people to work with.
I have been programming 25 years now and I see a different problem at the root of these massive failures.
The current state of development tools is hideous. We have some very nice powerful languages, Java, C#/.Net, some very powerful databases, but we still have to spend hideous amounts of time making them work together.
These large applications (the FBI and this Health Care system) take soooo long to spec out and build that by the time they are done the requirements have changed, the technology has changed and the developers are always having to restart the process. I will admit, I do not like web applications. They are very limited in robustness. Developers resort to hacks like AJAX to make them somewhat useable. And it makes me mad that in the 21st century I have to resort to using a text based editor to design Graphical UIs. How dumb. Yes there are some WYSIWYG editors but they NEVER get you to where you want to go. Any good web application (of which I guess there 3 or 4) had the HTML written by hand. I had hoped XAML was going to change that. It will not, at least initially. It provides much better user experience potential, but in order to develop a real application you are still going to have to code text by hand.
What went wrong? The dBase III of the 80s was a far better development environment than what we have today. We have taken several steps backwards. Yes the end products that we develop today by hand scale enormously, but they take too long to develop. We spend at least 80% of our time coding plumbing that we shouldn't even had to think about.
If you can cut the development cycle, then maybe you can get a large application developed and delivered before it is out of date. Vendors need to wake up. If someone ever comes out with a real dBase/Notes/Delphi/early VB type product that can deliver large scale applications (hopefully not on web) they would put the others out of business.
Flash: Here is your chance!
slashdot troll = you make a compelling argument I do not like the implications of.
I was involved in the early stages of this. Even from the beginning it had screwup written all over it - so bad that many of those who looked and examined it walked away. Rather than define standards it defined a monolythic entity that was then broken into 6 blocks, given to separate contractors, and then they were told they had to fit together. Then they held a competition to force prices down, played even more tricks to force the price even further down, and gave it to the lowest price bidder. The few weeks around that time were nuts with people taking the most shiny, most optimistic assumptions to beat the competition. 20% off best and final tells its own story.
We haven't even got to the part yet where things really go wrong, they are further down the line. However we already have large firms doing anything to get out and taking large losses to do so.
It is a huge disaster in the making and should be canned as soon as possible. What will be delivered will be an embarassing mess in comparison to what anyone here would expect from a 21st century health system. I'm trying to make sure my data goes nowhere near it
So what you are saying is that poverty must exist in order for you to maintain your high standard of living.
-matthew
"THERE IS NO JUSTICE, THERE IS ONLY ME." -Death
(Side note: The US is the only industrialized country without national healthcare, spends twice as much per patient in healthcare, and yet is not a world leader in healthcare - it often ranks last among industrialized nations in certain categories. It seems that the statistical odds are at least against private healthcare right now).
I would normally agree with you (big government bad, free market good), but you're forgetting one small thing: The Veteran's Administration.
Here was a crappy, failing hospital system run by the US government that has completely transformed itself in the last couple of years. It has successfully deployed a completely electronic patient bookkeeping system (a nurse friend has told me that most of the (privately owned) hospital she works at runs off 3x5 notecards). The administrative overhead is comparable to private hospitals. It is able to negotiate much deeper drug discounts than Medicare and other private hospitals. It works closely with medical schools so its personnel costs are much lower, yet it has experts in many veterans-related fields (things like PTSD, making fake limbs, etc). It rates as one of the top hospitals in quantitative healthcare surveys (which measure things like, "For patients with X, how many of the standard operating procedures Y are usually followed").
In fact, it's done its job so well that - while the costs of private healthcare have *far* outpaced inflation the last couple of years - its budget has been increased at a *slower* rate than inflation.
Of course, like any other large chain of hospitals, there are surgery mistakes and lawsuits. The mistakes are much lower than the national average but, because it's run by the government, are much higher profile when they do happen.
The VA is a good case study of how the government could do healthcare much better than private industry. Its success should be analyzed, studied, and possibly replicated at a much larger scale.
The government has also passed legislation that will allow anyone on the system to release confidential information about a patient when it is seen to be in 'the public interest' (a deliberately vague term). Previously personal information could only be released under specific circumstances with the consent of a patient's GP or specialist. You can imagine how insecure this will be and what a tempting target for blackmailers and scum-sucking journalists looking for dirt.
Despite these concerns the government is proceeding to upload personal information on to the Spine using a system of 'implied consent' - that is, if you don't opt out, your data will be put on to this privacy nightmare. Once the information is on the Spine you cannot ask for it to be removed, nor amend it where it is found to be incorrect. The Guardian has produced the most readable to this meltdown and has also published a guide to ensuring your personal data is not put on to the spine.
Although many people are not aware of it, the Veterans Health Administration (otherwise known as the Veterans Affairs/VA hospital network) in the United States has progressed from a backwards, poorly-kept system in the 1980s to the best, most advanced medical organization in the nation. Read more here, here, or this reprint from Time Magazine.
It's proof that government + healthcare + technology does not always equal disaster.
$nice = $webHosting + $domainNames + $sslCerts
Interesting that you should bring up MS, since my frame of reference is with the same disease.
A friend of the family had a particularly severe form of multiple sclerosis.
Over roughly a decade, she went from walking with a stick, to using a manual wheelchair, to using an electric wheelchair, to having nerves in her legs cut to stop the spasms, to undergoing many, many operations and treatments to lower the pain and to keep her comfortable, to dying.
She was in her thirties. Everyone was amazed she lasted that long.
I seriously doubt the treatment from the NHS was remotely near perfect, but she had all necessary drugs, equipment and carers provided - her house was fitted with stair-lifts, bed-lifts, bath-lifts, ramps and so on, replaced as needed while her disease progressed. Many visits from carers to wash her, dress her, and later change her colostomy and catheter bags, supporting both her and her husband. (Somehow, they managed to turn a blind eye to the 'tomato plants' on her window-sills.)
Tedious Bloggy Stuff - hooray?
Because our government provided health care is an unmitigated disaster because of the fact that it's shoehorned into, and forced to compete within, a "free market" environment which is wholly profit-driven. Removing the health care system from the world of profitability, and placing it into the umbrella of 'state-funded entities', creates an entirely different environment -- one where medical professionals won't be scared shitless to accept government insurance.
I hate to hammer a cliche, but America is the only industrialized country in the world which does not provide some form of universal health care to its citizens. Plenty of people with disabilities leave this country as a matter of necessity. While my opinion as to what the SOLUTION should be is obviously open to argument, these are concrete facts that support the impetus of my statement -- American health care is broken. Whatever your personal situation may be, or mine, there are plenty of examples all around the both of us that point distinctly to that conclusion.