NHS information: Revolution or evolution?

The UK's coalition government has proposed an ‘information revolution’ to underpin its National Health Service (NHS) reform in England. The core of this proposal focuses on boosting the flow of information throughout the NHS and improving information management and exploitation by use of integrated electronic health records (EHR). In this light, we consider the history of health information systems in England's NHS, and also draw upon our findings from a longitudinal evaluation of implementation of EHRs in English hospitals. We propose important lessons that can be learned, and on this basis present a set of principles for actions in support of the revolution. Our account emphasizes envisioning the information revolution as a long-term journey, part cultural shift and part cultural reaffirmation.

► Information management is at the heart of the coalition government's attempt to reform the NHS in England. ► Any information strategy must reflect the NHS' history and the deeply ingrained culture. ► Transformative power of information requires changing clinical stakeholders' relationships with patients and work practices. ► The innovative NHS informatics policy must not be thrown out with the turbulent experience of NPfIT. ► NHS information reform is a long-term project, part cultural shift and part cultural reaffirmation.