Ways in which ideal e-enabled government cuts admin costs and pointless work, freeing up time and resources for front line services and reduction in the tax burden
The UK’s expensive and dysfunctional clunking great fist of a centralised health records system is going to take four years longer than expected, says the NAO. According to Kable’s mothership The Guardian
A £12.7bn upgrade of IT systems throughout the NHS in England will not be completed for at least another six years, four years behind schedule, parliament’s spending watchdog disclosed today. Revealing that the scale of the delay to the system was worse than previously thought, the National Audit Office said plans for a national electronic record of the medical files of 50 million patients might not come to fruition until 2014-15.
Grrrr....yawn.
Meanwhile the real world moves briskly in a far more attractive direction. An IBM-Hipaat alliance is the latest - after Google-Cleveland Clinic and Microsoft Healthvault - to offer user-controlled online health records. They send me a press release:
The IBM-HIPAAT collaboration extends patient-driven privacy to Electronic Medical Records (EMRs), Electronic Health Records (EHRs), Personal Health Records (PHRs) and Health Information Exchanges (HIEs). Combined IBM and HIPAAT technologies allow patients to easily specify who is granted access to their personal health information (PHI), what information can be accessed and when. They enable caregivers to implement and enforce patient consent directives, providing “break the glass” access to PHI and EHR data in emergency-care situations, where appropriate.
This commercially-available patient-directed solution is a privacy-based approach to securely controlling PHI access across diverse healthcare applications and settings. When installed in HIE environments as the “consent engine,” Privacy eSuite empowers patients and designated providers to create and record privacy directives. The software then evaluates a provider’s authorization to access a patient’s PHI based on such directives. With the combined offerings, a patient can restrict a particular clinician from accessing PHI, even if that clinician – based on medical role – would typically be granted such access. All access requests are recorded and an audit trail is created.
Nothing on pricing but I bet it wont be costing UK taxpayers anything in tne £6bn-30bn price range bandied about for Connecting for Health.
Wibbi we canned our daft centrally-controlled electronic health records system and the D’oH! just asked Google, Microsoft and IBM-Hipaat to confirm to a standard the NHS was prepared to work to. Then we could choose which sort of electronic patient record we used, and our data wouldn’t be subjected to bossy fishing expeditions from national terrorist-prevention services trying to work out whether we eat the right amount of fruit and veg, or the wrong sort of shellfish. Why will it take so many years and so many billions of pounds before we come to our senses?
I suppose the four year delay gives people more time to opt out of centralised health records. I hope our opt-out is final; it would be a drag to have to renew it every year like a pointless TV licence or car tax disk.
What an easy answer to the 10p tax problem: Reduce taxation by simply adjusting our “personal allowances”: Minimum bureaucracy, minimum complexity, minimum administration cost.
Now, which politician will be brave enough to abolish the silly and grossly unfair TV ownership licence? (Currently 139.50 Pounds per household but equivalent to over 174 Pounds of gross annual income and especially harsh on low-income households.) The whole ghastly TV Licensing bureaucracy, online service and enforcement arm could then be abolished, making further significant savings.
Next, although the car ownership tax has so recently been increased and made even more complicated; which brave politician will abolish it - and the DVLA? The task of administering the safety & road-worthiness of vehicles could be handed to the insurance industry. Again, this would remove a large, expensive, unnecessary bureaucracy together with its unnecessary “enforcement” activities.
Wibbi: All politicians and all governments looked for ways to simplify matters, rather than ways to automate obsolete bureaucracies.
My fourth year of using this HMRC PAYE / NI online service: Another government form successfully submitted ... I hope! All went fairly smoothly; the individual web-pages were reasonably clear; even near the end of the rather tight deadline, the service seemed quite fast; an acknowledgement email arrived promptly. Overall - for people who have broadband - this HMRC online service is much better than the old paper forms.
Update: Don’t miss HMRC’s video podcast which tries to explain this service: It’s easy to mock the upbeat tone and phrases such as “… a simple five step process ...” but it’s a good attempt and reasonably clear to people who have used the paper forms.
Note: Ordinary PAYE employees are shielded from the horrendous complexity of the UK’s Tax and NI system. This video gives a tiny insight.
Wibbis:
1. Instead of using “print” from the web-browser, I’d like the option to download PDFs of the completed forms.
2. Although you’re typing figures taken from PAYE & NI forms, it would still be useful if all boxes had descriptive labels (or even descriptive help) rather than labels such as “1e.”
3. Is it really essential for all UK companies to files this information in the short space between the end of the tax year and the 19th May?
Permission to use the OGC logo in any context and in any media must first be obtained in writing from OGC, please contact the OGC Service Desk.
So I hpe they’ve issued written permission to bloggers in Spain
in FranceNo ven nada raro.Y si le volteamos unos 90 grados. Estas mentes sucias del gobierno siempre liándola. ¿Poco tacto o falta de creatividad? El nuevo diseño del logotipo de la Oficina de Comercio Gubernamental del Reino Unido (OGC - siglas en inglés-), cuyo diseño fue presentado el año pasado, ha sido criticado por sus supuestas connotaciones sexuales que despierta al ser girado 90 grados.
ItalyLe nouveau logo de l’OGC (Office and Government Commerce), conçu par l’agence FHD London pour la modique somme de 14 000£ (21 000€
: ça fait quand même 7 000€ par lettre, est l’objet d’un buzz sur Internet, et vous allez voir, ce n’est pas pour rien !
in GreeceLeggo da Spotanatomy la notizia “curiosa” che l’Office of Government Commerce, l”ente inglese istituito per far chiarezza e aiutare a capire il sistema degli appalti pubblici, ha dovuto cambiare di corsa questo logo (foto in alto) costato ben 14.000 sterline.
Το Βρεατνικό OGC (Offie of government Commerce) αποφάσισε να δημιουργησει ένα νέο Logo. Επένδυσε λοιπόν 14,000 λίρες και εμπνεύστηκε, δε ξέρω απο που το παραπάνω σήμα. Πως σας φαίνεται; Ακριβό; Τώρα; Ο εκπρόσωπος του OGV πάντως δήλωσε “It is true that it caused a few titters among some
and in various other places to which my language skills do not extend
这个LOGO是英国商务部(Office of Government Commerce)花14000英镑请人设计的.网站暂时还没换上这个新的,但已经用于鼠标垫及笔上.天才无处不在,发现原来是酱紫滴(点开看哦
.这个设计师真是油菜油菜滴.囧TL. 如果还不明白啥意思,百毒知不道万能!Via PS:谷歌翻译也SO强大嘛,”囧”都能翻译出来.果然,宅文化开始走向世界了
Britain appears to have forged a global lead in onanistic logos.
According to an August 2007 article in the FT, contracts will be awarded for suppliers to the NIS this Spring. Now. But will any suppliers bid? After all:
• The NIS may turn out to be a smaller system than suppliers expected and there may be less money to make out of it as a result. Crosby has ruled that the high volume of transactions that go through the banks and the big retailers are not on the menu. There is no reason for suppliers to expect the NIS to be involved in DWP benefit claims nor in the health service nor education. Scotland may refuse to use the NIS, and Wales, too. Its advocates always claim that the NIS will be used to prove everyone’s right to work in the UK but IPS failed to provide the ID checking service they promised. And it may be that, far from everyone aged 16 and over, only certain sections of the population will be fingerprinted.
• The timescales are stretching. Far from starting at the end of 2009, as previously planned, the NIS will not start to be rolled out in earnest now until 2012. And given IPS’s track record, suppliers would be well advised to allow for more delays.
• As the economy dips, people will want more assurance that their stealth tax money is being well spent. Hard to provide that assurance, when a number of prospective suppliers have already pulled out of the bidding, the House of Commons Science and Technology Committee are just as unimpressed with IPS’s plans as Crosby and the biometrics on which the NIS depends are unreliable.
• There are alternatives to the NIS. Identity assurance could be provided by the banks and/or the mobile phone companies and/or the utility companies and/or the credit referencing agencies. The NIS could become irrelevant. These other systems could be more effective and could come on-stream earlier than IPS’s 15-year timetable – a surprisingly relaxed timetable, given that we’re talking here about the UK’s response to crime and terrorism.
• Suppliers to the NIS would be victims of the lack of trust in the government identified by Crosby – they would be tarred with the same brush.
• IPS is not some unstoppable behemoth with a mandate to monitor everyone in the UK. On the contrary, it is a supplicant, in sales talks with prospective customers, and it hasn’t closed a single deal yet.
• Suppliers will be dependent on IPS and IPS are vulnerable. They are dependent on Labour and Labour treat the NIS like a political football. If the Lib Dems or the Conservatives come to power, the NIS will be cancelled, as its equivalent was in Australia, and suppliers cannot expect to be bailed out.
So now how sensible does it look for a supplier to invest in this project? Which sensible chief executive would commit the funds? Why? What return is sensibly to be expected? What price risk?
(This article is the summary of a longer paper on the subject, ‘A risk assessment for prospective suppliers to the UK NIS’, which first saw the light of day on IdealGovernment.com in November 2007.)
Picked up by the IdealGov concealed microphones at a recent CIO meeting, spoken (it would seem) by the senior responsible officer for spending £25m a year of taxpayers’ money on NHS Choices
Quite right. NHS Choices’ “voice” function promises to be more expensive and less well moderated than the existing and simple-to-use Patient Opinion. But most serious of all, it won’t be independent at all. The idea is we voluntarily voice our feedback via NHS Choices into a crown copyright publi-private partnership, so future secretaries of state can use our data to make politicised editorials and some outfit like Dr Fosters can mine it as intellectual property. Je pense pas; non, noooooon, non! Geklauten Daten? Nein Danke!
Wibbi: we applied all three core IdealGov principles in one go here. We score a quick win, we use a process of co-creation, and dig deep to build gov 2.0 on a foundation of trust. All we have to do is use the money we’re going to waste on some arm-manufacturing contractor writing a £multi-million Transport-Direct/DirectGov/BusinessLink type EU-rules procured NHS Choices/Voices clunketerium web site. Instead we could use a fifth the money to promote and roll out the creative-commons and not-for-profit Patient Opinion faster. At the very least we could remove the “planning blight” NHS Chioices/Voices casts on Patient Opinion, which works nationally already with simple clean design, exemplary tagging, moderation and flexible feedback options.
JFDDI! Desist! The senior officials know it makes sense. I think the Minister in charge is Dawn Primarolo (not Ben Bradshaw. Or Alan Johnson is top dog at health.) Gordon - have a word would you? [Thought: perhaps we could install an IdealGov-branded Middlesboro’-style talking CCTV camera in #10, so we can keep an eye on the PM and also offer him some top tips at convenient moments 24/7]
Not having received my new biometric bus-pass, I checked the local council’s web-site. This confirmed that the council had already dispatched them and that they should arrive before the end March 2008.
Concerned that my application or “passport quality” photos had been lost, but not knowing which department was responsible, I couldn’t use the council’s online enquiry form or enquire by email.
So, I phoned the council, to be greeted immediately by a recorded announcement that dispatch had been delayed by at least another week. When I asked, the call-centre staff said that it would take more than a week to correct this information on their web-site.
Wibbi: Government and “officialdom” kept their web-sites up to date: So often in recent crises, broadcast announcements have directed concerned people to 0845 or 0870 phone numbers rather than to official web-sites. Surely, a good web-site can handle far more enquiries, far more efficiently than a human call-centre?
Wibbi: These new bus-passes did not require “biometric grade” photos: Many users of bus-passes wear spectacles, but photos usually have to be taken without – presumably to help the digitization process. This means that few users will match their new photos.
Anna Kelly from the Swedish Administrative Development Agency drops a bit of a bombshell. The generally enlightened Swedes closed their central government portal last week. Now there’s nothing there (and no, it’s not for sale).
Nick and I tried to ask Anna about the reasoning behind what could well be an eminently sensible decision. But she’s baffled and a bit hurt by it, and can’t see any rationale beyond misguided cost-cutting.
The UK of course is going in the opposite direction, axing all the other web sites centralising all content on DirectGov, which still lacks a decent search engine.
Ollie Letwin asked a good question about how the NHS processes people opting out of the centralised health record. Here’s what the Minister might have said
You can see what Ben Bradshaw did say here. For some reason he just waffled, perhaps hoping the question will go away. But it wont, because the alternatives to centralised NHS records are going to be getting better so fast.“We quite appreciate, in the light of our recent data cock-ups, that many people will have reservations about signing up to national centralised health records run by the government. That’s fine; they’re entitled to their views. We shall simply make sure that the centralised NHS service we deliver is so safe, so worthwhile and so eminently worthy of trust that in due course they decide they want to sign up.
“In the meantime we’ll respect their wishes and continue to offer them the best service we can. Oh, and if they choose to sign up with a personal health information provider (such as Google or Microsoft) we’ll make sure our interfaces can interoperate with these systems as standards emerge. After all, by looking after their own records, they’re saving us money and effort, aren’t they, and getting exactly what they want. In fact, it’s really quite a good idea.”
Because they’re politicians, they seem to assume that anything that opposes them is “politically motivated”. It doesn’t seem to occur to them that there are people who don’t give a damn about the politics of it all. We just want to be responsible for our own data, and to be treated with respect, as if our wishes mattered. Not to spend life going through some bureaucratic mincing machine with the sand of don’tcareist incompetence scattered liberally through its delicate workings.
Oh wow. Oh wow. Every bit as exciting - and this is saying something - as the Viva Obama Mariachi is the long-awaited first public sighting of the MySociety FoI service. So what does it do?
It makes it easy to make FoI requests.
It lists central and local government FoI officers, and you can update the list.
It shares the meandering correspondence and the results obtained under FoI (such as a full listing of all the one-man protests outside Parliament). I hope this avoids the absurd ”yes I gave it to you but it’s still crown copyright so if you put it on your website we’ll sue you” insulting waste of taxpayers’ money.
If we all use it, gradually we’ll accumulate an open resource of government data using unfussy contempory web design, managed by people we trust because they perform and don’t have a control-phreak or commercial agenda.
My suggestion is we ask if Cabinet Office wouldn’t mind pointing the now unused domain name “open.gov.uk” at the new MySociety site. Because that says exactly what it does - beautifully designed, no editorial, no nonsense, no absurd Ts&Cs and at no cost to the taxpayer. The site is dedicated to the late Chris Lightfoot, who died almost exactly a year ago.
It’s ethnography in action, it’s open, it’s legal and respectful. It’s efficient (because it’s free and becase each request needs only be made once). It’s transparent, democratic and helps build the foundation of trust (on open source Rails, as it happens). So far there’s only one user - Julian Todd. Let us make it tens of thousands. The potential is immense.
Francis: you’re a legend. Go MySoc!
The Google personal health record project starts off with a collaboration with the Cleveland Clinic, we learn today from something called Webware.
Between 1,500 and 10,000 patients at the Cleveland, Ohio, facility will participate in the project’s test run, volunteering to have their medical records transferred to their Google accounts. The hospital already keeps electronic records for over 100,000 patients in an internal system called MyChart, but when those personal health records, or PHRs, are shared with Google, patients will be able to use them outside of the Cleveland Clinic. Included in the data will be prescription information, medical histories, and details about conditions and allergies.
“Patients are more proactively managing their own healthcare information,” Dr. C. Martin Harris, the Cleveland Clinic’s chief information officer, said in a statement. “At Cleveland Clinic, we strive to participate in and help to advance the national dialogue around a more efficient and effective national healthcare system.”
“We believe patients should be able to easily access and manage their own health information,” Marissa Mayer, Google’s vice president of search projects and user experience, said in the same statement.
I saw a MyChart presentation, and I think this will be a whole load better.
Webware also points to other initiatives and explores the privacy concerns
Google isn’t the only tech titan looking to change the healthcare industry. AOL founder Steve Case has launched a new company, Revolution Health; InterActiveCorp has invested in several health-related start-ups; and Microsoft has been working on a medical record service.
But all these “health 2.0” initiatives will inevitably raise privacy concerns, and critics of such projects have already begun to make themselves heard. The World Privacy Forum, which has highlighted concerns about medical identity theft in the past, has already issued a report voicing concerns about third-party PHR systems that aren’t covered by the Health Insurance Portability and Accountability Act (HIPPA), which has been in effect since 1996 and requires individuals to be notified when a party other than a patient’s doctor wants to access confidential medical data.
Not only is security an issue, the nonprofit has said, so is the likelilhood that marketers and other corporate entities will be able to exploit otherwise confidential data. The World Privacy Forum has not taken a specific stance on Google’s new project or on others like Microsoft’s.
It’s coming to something, you might think, when the world takes lectures on the best way to store medical records from a leviathan tech company that’s barely out of its nappies, But, weirder still when such a company takes a more sensible approach, and explains it more straighforwardly, and charges us less for it that our own government does.
The PHR advocates make complete sense to me, and make nonsense of our overpriced and meandering Connecting for Health programme. And if there are any cost overruns (or indeed weird unaccounted-for expense claims) it’s their problem, not the generally law-abiding UK taxpayer’s.
Similar story in the Reg (26 minutes ago - they can’t have had such a big dinner as me); Infoworld etc.
There’s a flattering reference to IdealGov in this week’s Economist, with a bit of a sting in the tail. But it makes me look like an unconstructive critic, so to be true to the spirit of Wibbi I have to add something. The Economist says (in a piece about e-government/i-government called Look it up on the web)
But directgov has its critics too. William Heath, who runs a witty blog on government reform, idealgovernment.com, describes the website as a “random generator of self-referential public-service information”. That may be a bit unfair. Directgov’s managers agree that the site’s search engine needs improving, but argue that its main role is to package information into useful clusters: “coherent citizen-focused topics”, in e-government-speak.
This begs the question: how could DirectGov be better? Is our criticism unfair, as The Economist suggests? It’s intended to be friendly and constructive, and perhaps I have to do a bit more work to make it that.
What’s the background? This isn’t an official history, but how I see it from off the top of my head. DirectGov replaced UKOnline which replaced open.gov.uk. Each brand change betrays a more prescriptive role. In the beginning was an intention to use the web to help gov be more open. That brings with it transparency, ease of access, trustworthiness. I believe open.gov was conceived by the technically able Mark Gladwyn, a thoughtful and clear-headed telecoms expert keen to open up the possibilities of the web for government.
It would have been great if government had stuck to the task of putting its own house in order, but the dotcom boom drew the politicians and spin doctors into this web agenda. On 11 September 2000 ukonline.gov.uk was launched by a government that by now saw itself as the champion in getting us all online. It squatted on an existing UKOnline brand (remember that footer on our official UK web site which said
The Government-backed service UK online should not be confused with the Internet Service Provider UK Online.
The whole UKOnline stage struck me at the time as an unnecessary and unwelcome piece of rebranding. I still don’t know how much the taxpayer had to pay UKOnline to make them go away. Apparently the PM wanted it to be UKOnline, and that’s what happened. The new UK government webmaster general was not a computer scientist but a spin doctor called Lucian Hudson. He wanted the site to be sticky. It became an editorialising, one-size-fits all mess.
I lost interest. I can’t be doing with the voice of government spin and PR. I’m fascinated by the possibilities of opening up government to reform, improvement, scrutiny and all the good things that create trust and accountability. I don’t want to be told how many veg to eat a day, how to handle savings or what a good job our elected representatives are doing.
DirectGov was launched April 2004 to hold content, as opposed to just pointing to it. In the spirit of Transformational Government it is citizen-directed, breaking people into groups and telling them what to do. It now has a vast amount of content, all on the direct.gov site, accessible by direct.gov search, A-Z directories and topic guides. The news headline from the Jan 2007 Transformational gov annual review was that 500-odd government web sites would be cancelled and subsumed into DirectGov. I’ve no idea whether there are sighs of relief, howls of outrage or just indifference from the users of those sites, or whether anyone has researched this.
We’ve made a lot of play through the years about how much better the MySoc volunteers’ twopenny-halfpenny DirectionlessGov site is for search - see eg this thread on the Alan Mather site). Hence my criticism quoted above. But it’s fair comment - I disagree with The Economist - and it holds important lessons. The Wikipedia entry covers it and Francis Irving’s challenge is that since people find things by search Direct.Gov should not exist.
This might sound like a counsel of despair - give up, go home, leave everything to Google. But I don’t think it is.
Government can use the web to do fantastic things. It could become open, transparent and - as we asked from week two of IdealGov - navigable. It could open up data sets to people and business and create new value and efficiency. This is explored in the “Power of Information” Review (pdf). The challenge the authors Tom Steinberg and Ed Mayo identified, which the government accepted, was
to maximise the benefits for citizens from this new pattern of information creation and use. When enough people can collect, re-use and distribute public sector information, people organise around it in new ways, creating new enterprises and new communities. In each case, these are designed to offer new ways of solving old problems.
Its recomendations are that government welcome and engage with the user-generated web sites which have common social and economic objectives (NetMums, TheStudentRoom, Moneysavingexpert); supplies innovators with government-held information when they need it, in a way that maximises the long-term benefits for all citizens; prepares citizens for a world of plentiful (and sometimes unreliable) information and helps excluded groups take advantage.
This is a really exciting agenda. The DirectGov team is in the right place to do this, and has the right resources. It would be highly illogical to ask anyone else to do it. DirectGov has the right links to other government departments and the resources. It could be the government’s BBC Backstage. It could present the friendly face of government to MySociety, NetMums and the rest of innovative, online NGO-world. It could even be the government’s SourceForge. These activities aren’t expensive, intrusive, editorialising. They attract really smart technical people (who, oddly, sometimes aren’t as expensive as people who think they’re smart and think they understand technology).
The “Power of Information” agenda goes with the grain of what technology wants (as Kevin Kelly puts it) and of what people want (which is after all Ed Mayo’s specialist subject). It’s open.gov with a technically-informed agenda. It could be profoundly transformational. Let’s do it!
Did I mention that a volunteer called Harry Metcalfe has put together over a weekend a classic MySociety consulations web site which scrapes government data about consultations and puts them i exemplary searchable format? Nice one Harry! Saves the taxpayer spending £20m on consultants to do the same thing.
Scotland is doing a “OneScotland Portal”. Following IPS logic, we would say Scotland is unique and it’s important to spend a lot of money on technology to keep it that way. Anyway, someone probably not called Patrick McGoohan writes to point out the odd rationale in their FAQs behind not using Google or their search facility:
Q: Why not just use Google?
A: Google is a good search tool particularly for Internet users who are web literate and proficient in creating searches. We want to create a “no wrong door” approach and the purpose of the OneScotland Portal is to provide a single point of access which will have a strong brand. Through the use of directories (e.g. A-Z, topic areas), the Portal will help the citizen to easily find what they are looking for.
Are they really saying they’ll create something easier to use than Google? Design skills in the Silicon Glen must be in remarkable fine fettle. Or are they implying (as Patrick mischievously suggests) that the Scottish electorate is too dim to use Google? Surely that is to invite a torrent of abuse and a Glasgow kiss?
Anyway, they also tackle a rather easier question:
Q: Why not join Directgov?
A: Directgov is an integral part of the UK Government’s Transformational Government Strategy and Varney ‘Service Transformation’ report which reflects UK reserved policy. The Transformational Government strategy does not reflect Scottish policy and has not been adopted by Scotland for devolved matters. Much of the strategy advocates the need to join up across Whitehall departments rather than the wider public sector approach which we are taking in Scotland.We are ahead of the UK in developing a Citizen’s Account and National Entitlement Card and the development of the OneScotland Portal builds on that work.
The OneScotland Portal will allow us to develop a uniquely Scottish image to front citizen access to public services and information, regardless of whether they are local or central and, in time, regardless of whether they are reserved or devolved.
Alright, so no DirectGov then either. I’m stumped for further suggestions. I’m sure we can suggest something helpful. How about putting your FAQs into simple HTML instead of making me download a Word document?
Being of little consequence, again this year I filed my Personal Self Assessment tax return online. Luckily, missing the later chaos. The service seemed better this year although the form still contains too much jargon and, thanks to the crazy complexity of our tax system, it is still far too complicated.
Late as always, I followed the usual routine:
- Middle of January 2008, logged-on to check that my password still worked;
- Spent ages hunting around the house for all the papers;
- Added a new sheet to my tax spreadsheet to hold the 2006-2007 data;
- 24th January, entered & saved the data using the HMRC’s “free” online forms service;
- Downloaded a PDF of the completed tax form & calculations, for checking;
- 29th January, corrected an error in my data, then “submitted” my return online, promptly receiving an acknowledgement email;
- 6th February, received a letter confirming payment of my tax refund!
This page has been viewed 1000960 times
Entries: 1523 | Comments: 2374 | Trackbacks: 206
Most Recent Entry: 05/16/2008 10:36 pm
Most Recent Comment: 05/16/2008 11:49 am
Members: 185 | Logged in: 0 | Guests: 33
Most recent visitor: 05/17/2008 04:21 am
Most visitors ever: 443 on 10/12/2005 02:21 pm