Biggest IT Disaster Ever? 405
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.
Honorable Mention (Score:5, Interesting)
So, $170 million/3 years = $55 million/year while the article seems to imply an oversight of one billion per year on the NPfIT [wikipedia.org] 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?
Far far bigger - IT sourcing bug killed a country. (Score:5, Interesting)
The biggest IT disaster every was due to choosing the wrong vendor for
sourcing software, in which
deliberate bugs were planted [fcw.com]
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.
It's failing because good IT people will avoid it (Score:5, Interesting)
A different spin (Score:5, Interesting)
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!
Re:Keywords: Government. Health Care. Disaster (Score:3, Interesting)
It never ceases to amaze me that there are people who will apply the "pull yourself up by your bootstraps" mentality to those suffering from Muscular Dystrophy, ALS, Leukemia and all of those others afflictions that obviously afflict far more than just the 'lazy' and 'irresponsible'. Is this compassionate conservatism in action?
I don't use an AMA Doctor in the States, I use an AAPS Doctor. He doesn't accept insurance, Medicare, Medicaid, or any third party payment, and neither does anyone in his clinics. They're all older doctors. He still makes housecalls. He charges me about $30 a visit for a basic checkup, and because he runs on a cash basis, he sees me for as long as I need him, and I just pay for the time. I'm in and out in 15-30 minutes. His housecalls are about $30 more. I believe he said that when he was still AMA-affiliated, his overall collections were about 40%, now he collects over 100% of his bills at the point of service (the overage is a tip, which I always give him for good service). I am significantly healthier (blood pressure down, cholesterol down, weight way down) and so is my lady (asthma gone) because of his dietary advice over medicine.
My lady's brother had MS and died in a fire because of it. This same doctor's clinic treated him at home for no additional charge, and when he lost his job, they continued to care for him at no cost at their office (we drove him there). The doctors repeatedly tell me that most health care is cheap. I have insurance for emergencies only (with a $10,000 deductible now) and my insurance is cheap even though I am a smoker and have a pre-existing condition of kidney stones -- in fact, my lady and I pay less as a household for a year than most people do in a 6-9 months with their overriding policies.
The poor and sick have always had religious hospitals to help -- as well as hospitals sponsored by donations. Today, we pay 50%+ of our gross income to government, so few of us can support religious and charitably hospitals, although my family still gives the difference between our old insurance and our new one to a local charitable hospital in Chicago that runs 100% on donations and user fees.
Don't spin the "what about the poor?" stuff since it is the poor that are hurt by government health care. Try visiting any emergency room in Lake County, Illinois and see how long it takes to get service.
Big surprise... (Score:5, Interesting)
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
Duke Nukem Forever (Score:2, Interesting)
Re:Keywords: Government. Health Care. Disaster (Score:3, Interesting)
should you choose to have one.
If you keel over in London you should get a paramedic equiped
with defibrilator within 10 minutes, quite often an actual doctor
will be traveling with the paramedics. If its serious and traffic is bad you
get a chopper to the hospital where serious case are treated immediatly.
You can get to the operating table within an hour.
And all this without a single check for medical insurance or endless
calls to your HMO to get the treatemnt approved.
And its extaordinarily cost effective. The UK spends less per
head on medical expenses than any other G8 economy. %50 less than
the US for eqivalent service.
The major problem with the NHS is because people are treated according
to clinical priority (rather than money or quality of insurance) if you
have an ingrowing toe nail there is always someone worse off than you
who gets treated first.
Gotta be better than the mess in the USA!
P.S. If you are going to hospital I would recommend Denmark.
absolutely the best medical care money cant buy. Its free.
Re:Keywords: Government. Health Care. Disaster (Score:5, Interesting)
So what you are saying is that poverty must exist in order for you to maintain your high standard of living.
-matthew
Re:Keywords: Government. Health Care. Disaster (Score:4, Interesting)
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.
Private sector failure, not government (Score:3, Interesting)
It is a project paid for by the government but not a government project.
From TFA:
"Accenture proved the big winner ... Computer Sciences Corp. (CSC) was awarded Northwest with West Midlands; BT beat out IBM to get London; and a Fujitsu-led alliance won the Southern region. BT was also given the contract to build both the N3 network and the National Spine, while yet another vendor, Paris-based I.T. services provider Atos Origin (formerly SchlumbergerSema), was commissioned to provide Choose and Book."
If anything, this is an argument for bringing these projects in-house (a true government project). There is no way it can be said that outsourcing saves money and they couldn't afford to do this in-house - $24 billion buys you a lot of good staff.
Am I the only person who is bored of hearing people whine about the failures of government when it was actually private companies that destroyed the project? We're told by much of the press that governments are wasteful but when a trillion dollars is lost in the dot-com bubble of the private sector, this demonstrates the efficiency of free markets...
There's also a serious privacy issue at stake here (Score:5, Interesting)
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 [guardian.co.uk]meltdown [guardian.co.uk] and has also published a guide to ensuring your personal data is not put on to the spine [guardian.co.uk].
One GOOD example of healthcare + government + IT (Score:5, Interesting)
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 [charlestonbusiness.com], here [washingtonmonthly.com], or this reprint from Time Magazine [va.gov].
It's proof that government + healthcare + technology does not always equal disaster.
Re:Keywords: Government. Health Care. Disaster (Score:5, Interesting)
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.)
Canadian Gun Registry (Score:3, Interesting)
The project which was meant to cost approximately $119 million ended up costing over a billion dollars to implement. Documents obtained by the Canadian Broadcasting Corporation now estimate the program cost at $2 billion.
I don't get how it can cost so much when its just a simple database app that most of us could write in a day. However I have heard that noncompliance of gun nuts was a cost. Eg flushing rolls of toilet paper to cause a flood.
Re:Keywords: Government. Health Care. Disaster (Score:3, Interesting)
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.