What IT can learn from Citizen Kane

I recently overheard a couple of colleagues chatting to one another at a regional meeting of the Society of IT Management.

"How is the new financial system getting on?" asked one.

"Well, we are making some changes at the moment," replied the other. "When we're finished, the new system will work exactly the same as the old one - and our users will be very happy."

Thinking of new innovations in terms of older phenomena is a long-standing problem. When motion pictures were invented, for example, they were thought to have a limited lifetime.

People who worked on the original movies were photographers, and they used photographic techniques to provide moving images.

It took latter-day geniuses, such as Orson Welles, to exploit the real power of the movie camera. Welles brought radical new techniques into movie making, which included using camera angles, sound and lighting as editing devices.

Incremental change is great for continuous improvement, but this sort of step change calls for new, lateral ways of thinking. And this, unfortunately, is not happening with public sector IT, especially with regard to central government projects.

In the same way that many early pioneers only saw film as moving still images, decision makers in the public sector still see IT systems as only providing the basis for the computerisation of paper records.

Documents that attempt to describe NHS systems are filled with references to 'records'. Examples include the Integrated Primary and Community Electronic Patient Record, the Electronic Care Record and the Integrated Child Care Record.

But concentration on patient records and their electronic manifestation means that underlying service and information management processes are being ignored. And what use is data if it ignores the way people work?

Take, for example, the work of health visitors. They need to make use of workflow to make referrals to other agencies after visits, and they also need off-site mobile access to the information systems.

These IT needs are not about patient records, yet they are just as important to get right. If suitable computing facilities are not available to health visitors, they will instead complete most of their work on paper and over the telephone.

This type of technology requirement provides an opportunity for the NHS to start from service-information processes.

Rather than fitting processes around pre-existing patient records, NHS technologists have a chance to take the well-trodden path of business process re-engineering to maximise efficiency, effectiveness and economy.

Another example is email, which falls outside the highly structured conception of record management. Reference to the deployment of email is nowhere to be seen in the documentation published by the NHS Information Agency.

However, the impact of email, in terms of data sharing and successful communication between professionals and the public, might prove to be far greater than that caused by a records-based approach.

These items are outside the domain of consideration for civil servants engaged in this process. Their IT brief appears to be stuck in the simplicity of the electronic records systems of the 1970s and 1980s, when we essentially did on computer what we did on paper.

We need to be clear about information and the more important communication needs. We also need to have a well-informed view of IT, so that there is a reasonable match between requirements, specifications and technology.

Given the vast intellectual capital of the Civil Service, this should not be difficult provided that there is an appreciation of the level of dependence between information, communication needs and IT.

We can then look forward to sophisticated and realistic tenders going out - and sound technology being provided by the supplier community - so that we can provide our citizens with a first-class public health service.

Fahri Zihni is chief IT officer at Wolverhampton City Council, and vice president and education officer at the Society of IT Management.