To what extent was Choose and Book a failure? Explain your answer

Summary

In 2010 cardiologist by the name of Duncan Dymond complained that too many patients were arriving at his hospital at incorrect times and in far worse shape and in need of different specialists. The reason for this issue is because in 2004 the National Health Service installed a system called the choose and book system. Costing nearly 200 million pounds. At first it sounded like a plan because it would basically help all doctors with appointments and ensure that they stay on track throughout their days weeks and months. It was also supposed to help patients be on time and at the right location. But because the system was pushed out too fast it had many glitches to overcome. The major problem that came of this was that the 2 major administration systems that the hospitals were already using was not compatible with choose and book and when something isn’t compatible it just doesn’t work. Choose and book was generally geared to be the go between the 2 systems (PAS and GP). The objective of Choose and book was supposed to be able to book 90% of all referrals by December 2006 and that objective was never met. Four years later choose and book was installed into 94% of all GP surgeries it was only used to book 54%. The major role for choose and book was to make everything easier in fact 100 million pounds incentive was issued and that did not help the situation because if doctors feel that it is too hard to use or too difficult they will revert back to their old habits.

Support

According to Bio med choose and book has been a complete failure. Choose and book was supposed to not only help doctors but it was also geared to help patience. The concept was for patience to be able to go online and book an appointment when and where they so choose. Among the Choose and Book patients, 66% (31/47; 95% CI 52 to 78%) reported not being given a choice of appointment date, 66% (31/47; 95% CI 52 to 78%) reported not being given a choice of appointment time, 86% (37/43; 95% CI 74 to 94%) reported being given a choice of fewer than four hospitals in total and 32% (15/47; 95% CI 20 to 46%) reported not being given any choice of hospital. A survey was completed to see how patients liked choose and book and the results were not in the favor of the system. A total of 104 patients took part in the study between 4 May and 9 August 2006. Of these, 47 were Choose and Book patients. This represents 44% of the 107 total Choose and Book patients seen at the Hillingdon site between these dates. A further 57 patients were referred through the conventional Partial Booking referral process, 19 matched and 38 from additional clinics. Figure 1 presents a flowchart of recruitment.

Data were collected on participants’ gender, age, ethnic group and specialty division; see Table 1. Age data was Normally distributed; other variables are categorical. The two groups were not statistically significantly different on gender, age or ethnic group. The sample was compared with data obtained on all first outpatient attenders at the Trust in the same time period: χ2-tests showed no statistically significant difference by gender, age category or ethnic group.

 

Variable	Categories	Choose & Book (n = 47)	Partial Booking (n = 57)	TOTAL	Test comparing groups (excluding missing data)
Gender	Female	29	38	67	Fisher’s exact p = 0.7
	Male	18	19	37
Age	16–29	10	9	19	Mann-Whitney z = 1.5, p = 0.1
	30–44	6	18	24
	45–59	11	17	28
	60–79	16	11	27
	80+	4	2	6
Ethnic group	White British	30	41	71	Fisher’s exact p = 0.6
	South Asian	9	8	17
	Other	3	7	10
	missing	5	1	6
Specialty division	Ambulatory Care	10	29	39	Fisher’s exact p = 0.008
	Surgery	14	8	22
	Women & Children	8	10	18
	Medicine	11	6	17
	missing	4	4	8
“How important to you is being given choice over where you go to receive hospital treatment?”	Very important	21	27	48	Mann-Whitney z = 0.8, p = 0.4
	Important	12	17	29
	Slightly important	3	4	7
	Not important at all	0	4	4
	missing	11	5	16

 

 

With studies NHS has been able to update and fix glitches in the systems. Choose and book is still being used today. It’s being used because when used in the manner it was supposed to it is a very reliable system. Part of the reasons it had difficult in the beginning is because 1 it was new and 2 it wasn’t compatible with other systems. Remember when cell phones first came out or when computers themselves first came out no one wanted to use them because they were difficult to understand or get used to but once you did they worked amazing. Something happened with choose and book. Upgrades have been done since and upgrades will continue to come. As of today, more than 40,000 patients use the system every single day.

Evaluation

 

Information System projects are very difficult projects to manage they are known as runaway projects they have a failure rate of 40 percent. Projects are generally estimated to a specific timeline and budget thou Information System project usually fail to meet the time line and the specified budget. Per Management Information System “A joint study by McKinsey and Oxford University found that large software projects on average run 66 percent over budget and 33 percent over schedule; as many as 17 percent of projects turn out so badly that they can threaten the existence of the company (Chandrasekaran et.al.,2014).

Generally, information system projects have system failures during implementation of new system mainly because they are not used properly as planned. Most projects fail to meet the needs of the business which does not allow the new system to increase business performance. To properly manage a project, you need a highly qualified project manager. The role of a project manager captures the scope of the project and plan activities that create a work breakdown structures. Which indicates all the activities that must take place and tract the time of deliverables and manage the budget. The project manager will implement necessary tools and techniques to meet the project objective. Of all the requirements that the implementation of the system requires.

Organization Britain’s National Health Service Jettisons Choose and Book System was not properly implemented it failed to meet the time line of the project and went over budget significantly. The new system was implemented in 2004 to provide citizens of Britain easy access to book outpatient medical appointments with assistance of their doctor. The system was set up for a patient to enter their referral number and code to the system to set up their outpatient appoint online or call a centralized booking system. The implementation of the system was estimated to cost 200 million dollars it went over budget and the timeline was not meet. The new system was initiated to decrease the timeframe for referral process, to go paperless and have patients manage their health appointments. The new system allows patients to manage their own health appointments to decrease loss of patient no shows which was yearly costing Britain’s 1.6 million dollars each year.

Britain’s National Health Services failed to meet the initial information system plan the system had lots of glitches and it was not user friendly for patients nor doctors to use. The Choose and Book system failed to meet the initial goal of 90 percent of Britain’s citizens booking their referral appointments online or using the call-in system by 2006. The new system failed tremendously four years after implementation the new system booked appointments were at 54 percent. The project failed to meet the defined deliverables and mitigate risk in the implementation of the new system.

Questions

 

1. Clarify and describe the problems of the NHS Choose and Book System. What management, organization, and technology factors were responsible for those problems?

All parties are responsible for the failed information system. The managers of the project not properly managing the project from beginning to end allowing the overruns. The stakeholders of the organization failed to obtain a detail risk analysis to decide if any issue that occur they can plan accordingly to fix the problems of the failed system. The technology that was designed slowed the system down and it was not user friendly and it was not compatible with other systems that it needed to interact with to pull patient data to make out patient referrals through the system.

 

2.2. To what extent was Choose and Book a failure? Explain your answer

 

Choose and Book was a failure because it failed to provide the convenience of referral appointments. The new system was supposed to get 94 percent of all GP surgeries but only booked 54 percent of the appointments. Choose and Book promoted incentive to doctors to get them to use the service online or by phone. They offered 100 million dollars’ incentive plan and doctors were not interested in using the system because the system was not user friendly. Doctors failed to stop patients from traveling long distance to outpatient care facilities. The system was running slow and had lots of glitches and were not compatible to another system like Patient Administration System and GP and clinical system were not compatible.

 

3.3 What was the economic and social impact of Choose and Book?

The economic impact cost Britain 356 million dollars which went over the budget by 156 million dollars. There were so many problems with the system thou doctor and patients wanted the service but they wanted the system to be user friendly. The glitches in the system included missing appointment letters, system canceling them appoints, phone bills increased because the time on the phone making appointments. Which made citizens very disgruntle with the free health care system.

 

4.4 Describe the steps that should have been taken to make Choose and Book more successful.

 

They should have identified what the scope of the project in more detail. They should have included a plan to test the interface system to ensure the system could talk to each other. They should have a more realistic work breakdown structure showing the deliverables and identify the critical path to getting the project completed on time and on budget. They should have had a more detail risk management plan to identify the possible risk of the project and define the correct mitigation for the sluggish delays in the system, the unfriendly user application to the system that made users disgruntled. If they had an experience information system project manager could have identified the issues of the implementation of the system.

 

 

References:

· https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/1472-6947-8-36

· http://www.computerworlduk.com/applications/nhs-warns-of-33-known-issues-with-e-referral-service-launched-today-3615745/

· Laudon, Kenneth C., Jane Laudon, Management Information Systems: Managing the Digital Firm, 15th Edition. Pearson Learning Solutions, 01/2015. VitalBook file.

 

 

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