As I roam the exhibition floors of Health IT conferences, I search for small innovative NHS-funded outfits as they often understand what it means to develop software that truly support clinical care. At EHI 2011 Live! I found OpenEyes.

Yesterday at HC2012, I found University Hospital Birmingham’s (UHB) Prescribing Information and Communication System (PICS) and I was not disappointed. Ok, perhaps I was slightly disappointed but more on that later.

I explained that I have heard good things about Electonic Prescribing in PICS from other doctors. A nice man who introduced himself as the head of software development promptly corrected me that PICS is much more than an electronic prescribing system but a whole Electronic Patient Record with ordering, results, medicines administration, discharge letters, clinic letters, referral management, handover, patient list management and electronic patient observation system underpinned by a robust rules-based engine.

I was hooked for the next 60 minutes!

This is a system that can:

• Automatically can prompt a nurse to consider not administering a medication if there is a recent blood result that suggest that this action might lead harm. This can happen AFTER the drug has been prescribed and without a doctor ever having seen the blood test.
• Suggest blood tests for the following day if blood results from the previous day was unexpectedly abnormal but won’t suggest it if this was a longstanding abnormality.
• Send automatic alerts to the urgent response team if a patient’s heart rate, blood pressure or temperature hit certain alert thresholds. If there is no acknowledgement or response it even knows to keep chasing the team!

The is integration at a level that I have only ever seen when I visited the US last year and observed the VA’s VisTA system in action. PICs however, takes the integration between clinical systems and information to a different level.

At UHB, the medical director supports IT development directly and distributes decisions about IT to the respective clinical directors. Here is medical leader who understands that you cannot remove IT decisions from the same people making clinical decisions at this hospital. Brilliant!

Then my inevitable question come up: Is PICS OpenSource? After all, it is developed by NHS staff funded by tax-payers.

Sadly not.

After spending quite a lot of money on development of PICs, UHB is keen on recouping its investment. They teamed up with a commercial company and gave it sole marketing and distribution rights.

Changing topic quickly, I asked a about new enhancements and upgrades. The man explained that they have a lot of amazing ideas but can only develop so much, as their manpower and skill set is limited. I then told the story on how OpenEyes, a fully OpenSource EPR harnesses the coordinated development effort of 3 teams in 3 different countries, collaborating for the benefit of all.

The nice man’s eyes then flicked across to a representative from the company commercialising PICS and said to me, ‘perhaps you should speak to him.’ So I did and was greeted with silence and a wry smile.

I thanked the nice man for entertaining me for the last 60 mins and left the booth thinking to myself, ‘the NHS has amazing people creating great IT, if only they are allowed to collaborate and work together. If only…..’