City University's Centre for Health Informatics (CHI) has launched a research programme and policy challenge paper to explore how NHS IT services can be improved and made more cost-effective in the face of "past failure".

The challenge paper calls for new NHS systems to be based on a combination of open standards, open source software, open system interfaces and agile development.

The paper states, "The NHS is just emerging from a decade of wasted opportunity in the development of clinical information systems, particularly Electronic Health Records.

"The National Programme for IT was a centralised approach to information sharing that has failed on a number of levels. This has delayed the introduction of new systems, weakened the commercial supplier base and disheartened many IT professionals in the service. The NHS needs a fresh approach to clinical IT."

Professor John Chelsom, leader of the City programme, says, “Whilst none of the elements of open health informatics are new in their own right, there are surprisingly few systems deployed which fully embrace and gain advantage from the combination.”

The paper aims to quantify the benefits that open health informatics can provide, to identify the barriers to adoption, and to inform decision makers that are involved in appraising technology for clinical information systems. 

“The four principles that underpin open health informatics have all been tried and tested, in both clinical settings and in wider business and public sector environments,” said Chelsom. “But despite this we continue to see a proliferation of proprietary systems and services in the NHS, which lock-in clinical data, pathways of care and working practices."

He said it may take "one or two generations of systems before fully open solutions become the norm". But Chelsom believes reaching this level will lead to "more effective solutions with considerably reduced costs".

The Open Health Informatics programme will combine work by City University London MSc and PhD students, together with applied research in collaboration with primary and acute care providers. 

Last month, the BCS said the NHS must move away from the current "limited supplier model" in the £12.7 billion National Programme for IT.

In its response to a Department of Health consultation on the "Information Revolution", BCS, The Chartered Institute for IT, said it was fundamental to the success of IT in the NHS that the market is opened up to a wide range of suppliers.

It said the NHS needed to take "rapid steps" to "reintroduce competition into the NHS supplier market". Currently, NHS IT under the National Programme is provided by two dominant suppliers, CSC and BT, with additional capacity on offer from other providers.