An independent report published today finds that the "Healthspace" IT project initiated by the Department of Health, NHS Connecting for Health and ministers, with advice from suppliers, might have been flawed from the start.
Healthspace is an internet-accessible personal health record which was developed as part of the NHS National Programme for IT [NPfIT].
Few patients want to use it, a research team from the University of London found.
Early business plans, which were written by the Department of Health and NHS Connecting for Health, with advice from suppliers and consultants, proved overly optimistic. They predicted that between 5 and 10% of the over-16 population would become Healthspace users. There was a fear, which was expressed in early strategy documents, that the take-up would be so great that the technology could be overwhelmed.
In fact, only 2913 people - 0.13% of those invited to open an advanced Healthspace account - - got as far as activating the full functionality of their personal health record.
The DH''s early strategy documents also predicted that patients would use Healthspace to access their NPfIT summary care records and notify their GP of errors, so driving up data quality in NHS medical records. But the research team did not find a single person who had accessed their summary care record.
Professor Trisha Greenhalgh from Barts and the London School of Medicine and Dentistry led the research team. She was joined by researchers from University College London and Raft Consulting. They studied uptake of Healthspace from its release in 2007 until mid-2010.
Greenhalgh's report says there are four main possibilities for the limited success of the Healthspace programme to date:
- a flawed concept
- a flawed product design
- a flawed implementation and embedding
- flawed timing - "people are not ready for this type of personal health record"
Healthspace is supposed to allow patients to enter and store health data such as blood pressure or weight. It has a calendar to store health appointments; email-style communication with the person’s general practitioner; and the ability to access their summary care record.
Healthspace is free but users must register for a basic account online or an advanced account in person at a front office run by their local Primary Care Trust.
Problems included a complex registration process, a “clunky” user interface some aspects of which have been upgraded since the research was undertaken, the need to enter much of the data oneself, limited functionality which did not seem to match how people actually looked after their own health, and the low levels of knowledge about, or interest in, the product from healthcare staff.
The report says that the emergence of rival products such as Microsoft’s HealthVault, which was released in the UK in June 2010, and Google’s GoogleHealth, which was released in 2008, have raised questions about the place of a standard-issue personal health organiser from the NHS.
Greenhalgh's report - BMJ website