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Biggest IT Disaster Ever?
Posted by
kdawson
on Tue Nov 14, 2006 01:39 PM
from the I-can-top-that-one dept.
from the I-can-top-that-one dept.
lizzyben writes, "Baseline has a major story about a major IT disaster in the UK: 'In 2002, the English government embarked on a $12 billion effort to transform its health-care system with information technology. But the country's oversight agency now puts that figure at $24 billion, and two Members of Parliament say the project is "sleepwalking toward disaster"... In scale, the project... (NPfIT) is overwhelming. Initiated in 2002, the NPfIT is a 10-year project to build new computer systems that would connect more than 100,000 doctors, 380,000 nurses and 50,000 other health-care professionals; allow for the electronic storage and retrieval of patient medical records; permit patients to set up appointments via their computers; and let doctors electronically transmit prescriptions to local pharmacies.'" An Infoworld article from earlier this year sketches some of the all-time greatest IT meltdowns.
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Healthcare Giant Faces IT Nightmare 342 comments
Joan writes "Kaiser Permanente, the largest HMO in the U.S., has spent about $4 billion on an unreliable electronic medical record system that is impacting patient care, according to a 722-page internal report revealed by Computerworld. The CIO resigned after the news came out, and CEO George Halvorson is telling the media that the goal is an alarmingly low 99.5% uptime and that all the problems are really just power outages. Yesterday, Slashdot covered a story about the possibility that the NHS in the UK could now claim the 'biggest IT disaster' prize, but Americans, fear not: so far, the Brits are running a much more efficient failure at $24,000 per physician per year, while America's KP is spending $76,920 per physician, per year on its failing project."
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Honorable Mention (Score:5, Interesting)
So, $170 million/3 years = $55 million/year while the article seems to imply an oversight of one billion per year on the NPfIT [wikipedia.org] which is outrageous. I'm confused how one would even spend that much money on an IT project for a country the size of England--were they laying expensive new shiny fibre wire devoted for medical records only to every facility?
Far far bigger - IT sourcing bug killed a country. (Score:5, Interesting)
The biggest IT disaster every was due to choosing the wrong vendor for
sourcing software, in which
deliberate bugs were planted [fcw.com]
Resulting in major collapses of Soviet infrastucture.
Some may argue it's not an IT disaster -- but the root of the problem was that people sourced buggy software from closed source vendors and couldn't get their bugs fixed. -- The same thing happens all the time on a smaller scale when people buy Windows.
Parent
Re:Far far bigger - IT sourcing bug killed a count (Score:4, Insightful)
More importantly, perhaps, was the fact that the CIA was also screwing with the HARDWARE at a manufacturing level.
Frankly, your entire argument doesn't make sense at any level. If the Soviets had the people to check the software in-house, it would have been far more reasonable and realistic for them to make the software in-house too. Instead, the entire REASON the KGB was stealing this software was because they COULDN'T develop it themselves.
For god's sake, the KGB was stealing American technology and the CIA introduced purposeful bugs to counter them. That's got abso-fucking-lutely nothing do to with IT and everything to do with spycraft.
Only an absurd zealot would be in able to connect that somehow to Microsoft being bad.
Parent
Re: (Score:3, Informative)
Re:Honorable Mention (Score:4, Funny)
Parent
maybe next the Air Traffic systems? (Score:5, Informative)
The article:
It's unfortunate but common to look at "under-investment" as root cause. Britain's problem could have been vastly improved even as a paper system by just getting their arms around communication, procedures, standards, etc. (I'm not talking about IT standards here, they're about as worthless as the electrons they spin on.) And then to be tantalized by Gates himself that technology (probably especially Microsoft Windows, sigh) would solve the problem.
I've seen amazing organization and communication among systems with simple low speed modem and dialup connectivity. It's not the technology, it's the grasp of the subject matter and how to organize it. Britain's example looks to be one of classic "good money after bad".
Get a bunch of people in a room who know what they need (sounds like they didn't) and put them together with a bunch of people who know how to do it (sounds like they didn't). It really is that simple, and it's not as hard as they made it.
The evidence?:
Though in the next paragraph the "CfH" denies that (why is it always organizations "denying" something, come on someone, step up and take accountability), I'm guessing the accusation is accurate.
When projects like this get going and the emphasis should be on subject matter experts (SME), the projects usually get expendable high-level highly paid deadweight -- I've seen it too many times. One project I was on we got assigned two SME's, one was so oblivious to the statement of the problem we even wondered if he (or she) had ever worked in the industry.
Other evidence the project was ill-conceived and guaranteed a disaster?: from the article:
I'm guessing $24B spent to get an X-ray in one minute instead of four begins to be diminished returns.
Also:
This just reeks of cronyism and idiocy. If for no other reason, I'd vote Blair out of office for this -- it's insane. Bill probably walked away from this pretty happy though. Aside from the questionable broad brush technology choice, "Microsoft is develop
Re:maybe next the Air Traffic systems? (Score:5, Insightful)
From the article:
That last sentence made my jaw drop. How someone in his position could so blatantly avoid consulting anyone with any technical acumen is beyond me. Yes, it's possible, that no single vendor was capable of creating such a system alone. But the vast majority of a project like this is about creating a single process for every use case that the system is designed to handle. As such, the project shouldn't ever be broken down into groupings like number of patients in the system. Computers are great at handling really large numbers when the software is designed up-front to scale to really large numbers. The system should have been broken down into separate processes for which individual vendors would handle that single process (or grouping of processes) for everyone in the country.
The X-Ray example is a perfect one. Why would anyone in their right mind have 5 separate vendors all attempt to implement a solution for the problem that was only applied to the region they managed? At best, one region would end up with a solution that was better than every other region. However a competant management decision would have been to look for a vendor that could handle *only* the process of integrating the country's X-ray facilities with the country's high-speed data network. Another vendor would be responsible for supplying and maintaing that network. Still another vendor would be responsible for maintaining the huge data center (or centers) where information was housed. Just off the top of my head, GE could be responsible for the X-Ray integration (I know they have the necessary expertise), BT could handle high-speed network (among others, but why use foreign expertise when a UK company could handle it). And there are any number of competant vendors that could handle a high-availability server environment with a massive database.
Basically, had they had anyone with have an ounce of technical acumen, they would have devided the project up along functional boundaries of the application rather than regional boundaries of the country. That way, even if some of the projects went horribly over-budget, at least some of the project would be useful. Now, because of the inept management decisions, the whole thing is a train wreck.
Parent
How British... (Score:4, Insightful)
I say wait until the project's finished before kicking it to the ground.
Re:How British... (Score:5, Insightful)
> I say wait until the project's finished before kicking it to the ground.
No, I think after it's gone 100% over budget and wasted $12 billion (that's 6-8 billon sterling) of taxpayer's money seems a perfectly good time.
Parent
depends on how you look at it (Score:5, Insightful)
I imagine if you're the company getting paid the $24 billion, the project is a tremendous success.
a simple equation (Score:3, Insightful)
(massive govn't project + taxpayer money)^(at least cubed for govn't bloat) + corporate contract = One VERY happy corp.
Equation is defined in the domain {All big govn't}
catchy name (Score:3, Funny)
NPfIT
Clearly all that NPfIT needs to increase political buy-in and remain on schedule and under budget is a catchier name for the act. A good catchy feel-good name can bury a lot of dead bodies. Take USAPATRIOT for example. When in the private sector, adding punctuation or coining a new non-cultural word has its benefits too. Consider Cue:Cat: and Flooz.
Fifth Largest IT Disaster (Score:5, Funny)
You Try It Sometime (Score:4, Insightful)
Oh wait, then there's the legacy system vendors.
Easy, in fact, too easy to take shots at programs like this.
They stand such a high rate of failure that incremental change should have been adopted in the first place. The politicians behind this one have all disowned the project by now I'm sure.
Re: (Score:3, Funny)
Overarching (Score:5, Insightful)
In fact, the most successful large scale projects always seem to be grown out of combinations of smaller architectures rather than a single massive architecture. Look at the Internet for an example. The protocol was architected. The routing design was architected. The information delivery systems were architected. The network itself? Grown with tender loving care, and Lots'o'peering agreements.
If you want to solve an issue like modernizing Hospital IT, start small and work your way up. Design each technology independently, but not monolithically. Keep an eye toward standards rather than specific implementations. (Standards will allow you to plug in a few competing implementations, giving you "best of breed" options.) Then use those technologies to build out a few test sites. Work out the kinks, then start deploying at a few more sites. Keep doing that, and the economics of scale will begin to take hold. (i.e. The more you do of something, the less expensive it gets to do it.) With any luck, the project will get done within a reasonable budget and timeline.
Never mind what I just said. There's your answer right there.
i work on this project (Score:5, Informative)
This project is far from being a "disaster" as the British newspapers (little better than tabloids) like to tout it as. And the project has very little to do with Microsoft or Bill Gates. Most of the software my company is delivering is C/C++/Java running on IBM AIX.
If you want the opinion of a software developer on the inside of this thing, take my word for it: this article is trash. Like any huge project, it's just moving along slower than anyone first anticipated.
In the end, the British healthcare system is going to be faster and cheaper because of Connecting for Health.
Re: (Score:3, Insightful)
$24 billion better?
Oh look, the pigs are flying in such a pretty formation today.
Given that the NHS is now laying off Doctors and Nurses for lack of cash, I think there are better ways to spend that amount of money. And I'm not talking about PFI.
Re: (Score:3, Insightful)
If it works. And if it couldn't have been done for less than $24B...
So do I.. (Score:4, Informative)
Now the core NPfIT product (I take it you've had your training; The product is pretty shoddy. I managed to register several patients in the same bed (woo hoo, except you really don't want that happening), registered a male with a diagnosis of prolapsed uterus (all from the point and click menus for god's sake), crashed the front end application several times, and picked holes in their data model on several occasions.
Their system of data aliases is broken. Relying on a hospital to have a working internet link to even access their own patient data is nuts! Now a simple snip of a couple of fibres can stop a hospital in it's tracks. No local data caches.
This project was never truly specified correctly, and it's implementation is broken (did you know a few hospitals have refused to go live yet because of too many outstanding failures in the product, which the consultancy company has had to raise it's hands and say "You got us. Yes, it's broken.".)
So, speaking as a front line implementer (I'm one of the systems admin team for a hospital rolling this stuff out), I'd say there's a lot of meat in this article. NPfIT scares me.
Posting anonymously for the obvious reason that I'd rather like to keep my job.
Parent
Re:i work on this project (Score:4, Informative)
Parent
It's failing because good IT people will avoid it (Score:5, Interesting)
Re:It's failing because good IT people will avoid (Score:3, Insightful)
~Pev
NSH IT's a security disaster too (Score:3, Informative)
The Government claims that especially sensitive data can be put into a "sealed envelope" which would not ordinarily be available... except that NHS staff will be able to "break the seal" under some circumstances; the police and Government agencies will be able to look at the whole record -- and besides, this part of the database software doesn't even exist yet, and so the system will be running without it for some time."
Security Research, Computer Laboratory, University of Cambridge [lightbluetouchpaper.org]
A different spin (Score:5, Interesting)
The current state of development tools is hideous. We have some very nice powerful languages, Java, C#/.Net, some very powerful databases, but we still have to spend hideous amounts of time making them work together.
These large applications (the FBI and this Health Care system) take soooo long to spec out and build that by the time they are done the requirements have changed, the technology has changed and the developers are always having to restart the process. I will admit, I do not like web applications. They are very limited in robustness. Developers resort to hacks like AJAX to make them somewhat useable. And it makes me mad that in the 21st century I have to resort to using a text based editor to design Graphical UIs. How dumb. Yes there are some WYSIWYG editors but they NEVER get you to where you want to go. Any good web application (of which I guess there 3 or 4) had the HTML written by hand. I had hoped XAML was going to change that. It will not, at least initially. It provides much better user experience potential, but in order to develop a real application you are still going to have to code text by hand.
What went wrong? The dBase III of the 80s was a far better development environment than what we have today. We have taken several steps backwards. Yes the end products that we develop today by hand scale enormously, but they take too long to develop. We spend at least 80% of our time coding plumbing that we shouldn't even had to think about.
If you can cut the development cycle, then maybe you can get a large application developed and delivered before it is out of date. Vendors need to wake up. If someone ever comes out with a real dBase/Notes/Delphi/early VB type product that can deliver large scale applications (hopefully not on web) they would put the others out of business.
Flash: Here is your chance!
Big surprise... (Score:5, Interesting)
I was involved in the early stages of this. Even from the beginning it had screwup written all over it - so bad that many of those who looked and examined it walked away. Rather than define standards it defined a monolythic entity that was then broken into 6 blocks, given to separate contractors, and then they were told they had to fit together. Then they held a competition to force prices down, played even more tricks to force the price even further down, and gave it to the lowest price bidder. The few weeks around that time were nuts with people taking the most shiny, most optimistic assumptions to beat the competition. 20% off best and final tells its own story.
We haven't even got to the part yet where things really go wrong, they are further down the line. However we already have large firms doing anything to get out and taking large losses to do so.
It is a huge disaster in the making and should be canned as soon as possible. What will be delivered will be an embarassing mess in comparison to what anyone here would expect from a 21st century health system. I'm trying to make sure my data goes nowhere near it
Dying for Data (Score:3, Informative)
[I can't link to the full text of the article, because that issue is not longer current. IEEE members can log in and view it, however.]
Per capita... (Score:5, Informative)
~Pev
There's also a serious privacy issue at stake here (Score:5, Interesting)
The government has also passed legislation that will allow anyone on the system to release confidential information about a patient when it is seen to be in 'the public interest' (a deliberately vague term). Previously personal information could only be released under specific circumstances with the consent of a patient's GP or specialist. You can imagine how insecure this will be and what a tempting target for blackmailers and scum-sucking journalists looking for dirt.
Despite these concerns the government is proceeding to upload personal information on to the Spine using a system of 'implied consent' - that is, if you don't opt out, your data will be put on to this privacy nightmare. Once the information is on the Spine you cannot ask for it to be removed, nor amend it where it is found to be incorrect. The Guardian has produced the most readable to this [guardian.co.uk]meltdown [guardian.co.uk] and has also published a guide to ensuring your personal data is not put on to the spine [guardian.co.uk].
One GOOD example of healthcare + government + IT (Score:5, Interesting)
Although many people are not aware of it, the Veterans Health Administration (otherwise known as the Veterans Affairs/VA hospital network) in the United States has progressed from a backwards, poorly-kept system in the 1980s to the best, most advanced medical organization in the nation. Read more here [charlestonbusiness.com], here [washingtonmonthly.com], or this reprint from Time Magazine [va.gov].
It's proof that government + healthcare + technology does not always equal disaster.
Canadian Gun Registry (Score:3, Interesting)
The project which was meant to cost approximately $119 million ended up costing over a billion dollars to implement. Documents obtained by the Canadian Broadcasting Corporation now estimate the program cost at $2 billion.
I don't get how it can cost so much when its just a simple database app that most of us could write in a day. However I have heard that noncompliance of gun nuts was a cost. Eg flushing rolls of toilet paper to cause a flood.
Re: (Score:3, Insightful)
Either way, I'm not sure how things work in the UK but in the US, if WebMD were to suddenly gain the US Government as a customer, the government would require that WebMD suddenly adapt to a bunch of contractor regulations that they probably aren't following at the moment.
Plus, politicians could put one of two things on their campaign fliers: "...and strongly worked to get our great nation a site license for WebMD" or "...and strongly worked to build the national physicia
Re:Keywords: Government. Health Care. Disaster (Score:4, Insightful)
And excellent steak analogy, but you forgot to include the circumstances that prompt the need for a government managed health care system in the first place -- what happens when the restaurants sell so many burgers and so few steaks that they need to manipulate their pricing structure until those burgers become the price of steaks? Or when they decide to just stop serving burgers entirely and choose instead to offer a 'name brand equivalent' like maybe some ground buffalo, which tastes just the same, but costs a whole lot more? And what happens to the individuals who desperately NEED those steaks but can only afford a small side salad? There's a big difference between 'subsidizing irresponsibility' and sharing costs to help treat people with terminal and degenerative diseases who are incapable of generating a full-time income.
It never ceases to amaze me that there are people who will apply the "pull yourself up by your bootstraps" mentality to those suffering from Muscular Dystrophy, ALS, Leukemia and all of those others afflictions that obviously afflict far more than just the 'lazy' and 'irresponsible'. Is this compassionate conservatism in action?
Parent
Re: (Score:3, Interesting)
It never ceases to amaze me that there are people who will apply the "pull yourself up by your bootstraps" mentality to those suffering from Muscular Dystrophy, ALS, Leukemia and all of those others afflictions that obviously afflict far more than just the 'lazy' and 'irresponsible'. Is this compassionate conservatism in action?
I don't use an AMA Doctor in the States, I use an AAPS Doctor. He doesn't accept insurance, Medicare, Medicaid, or any third party payment, and neither does anyone in his clinics.
Re:Keywords: Government. Health Care. Disaster (Score:4, Informative)
Interesting that you should bring up MS, since my frame of reference is with the same disease.
My mother is a single woman who was diagnosed with MS when I was around eight years old. Her disease is a progressive one, and as such, she gradually lost the ability to operate for periods long enough to sustain a full-time income. Since she was unemployed (and married) at the time of her diagnosis, she was not covered by any private insurance fund, and thus, after her divorce, she fell into the questionable hands of Medicare.
Since that time, I've witnessed our family tossed into bankruptcy proceedings to cover hospital bills that Medicare claimed were out-of-scope. I've witnessed months and years where she was unable to pay for her medication and fell into serious regression. Most recently, I've witnessed her taking part in a completely bogus marriage to a man she barely knew simply so she could be added to his military insurance plan. These are the sort of things that the poor in our country deal with when they have chronic or terminal diseases.
Your friend and you are very lucky to find the sort of treatment that he did, but that's certainly not a commonality, or even a rarity. I would say that's a goddamn miracle -- and I certainly would not assume that because you were accepted for insurance with kidney stones that somebody with a terminal disease would have an easy of a time as you. I've been gainfully employed for years and have been frantically searching for a 'family plan' that would also covered my disabled mother and have been greeted routinely with incredulity and flat-out "no, we don't do that"s.
So, yes, I think I can justifiably use the "what about the poor" argument since that's the reality I know. I'm not sure how the system appears to those who don't actually need it -- I just know the dismal reality of attempting to get health care without money in this country. Regardless of what the rhetoric states -- it's not easy, or pleasant, and most of the time, it's impossible. I thank the powers that be daily that I'm now in a situation where I can provide financial support to my loved ones instead of expecting them to rely on a broken system to keep them intact.
Parent
Re:Keywords: Government. Health Care. Disaster (Score:5, Interesting)
A friend of the family had a particularly severe form of multiple sclerosis.
Over roughly a decade, she went from walking with a stick, to using a manual wheelchair, to using an electric wheelchair, to having nerves in her legs cut to stop the spasms, to undergoing many, many operations and treatments to lower the pain and to keep her comfortable, to dying.
She was in her thirties. Everyone was amazed she lasted that long.
I seriously doubt the treatment from the NHS was remotely near perfect, but she had all necessary drugs, equipment and carers provided - her house was fitted with stair-lifts, bed-lifts, bath-lifts, ramps and so on, replaced as needed while her disease progressed. Many visits from carers to wash her, dress her, and later change her colostomy and catheter bags, supporting both her and her husband. (Somehow, they managed to turn a blind eye to the 'tomato plants' on her window-sills.)
Parent
Re:Keywords: Government. Health Care. Disaster (Score:5, Insightful)
You forget. The compassion in compassionate conservatism is the lovely warm feeling one gets in one's heart when scattering breadcrumbs at Christmas to those poor, adorable, starving orphans.
Charity will help out the most needy, remember?
Fuck anyone who's suffering from an unfashionable or distasteful illness; they only brought it upon themselves. The good old mom-and-pop doctor will solve everything else - that's what capitalism is for!
Parent
Compassionate Conservatism (Score:5, Funny)
"Why are you eating grass?" he asks.
"I don't have any money for food," the poor man replies.
"Oh, well, you can come with me to my place to eat!"
"But I have a wife and two children."
"Bring them along too!"
So they all climb back in the limo. As they're driving along, the poor man says "Sir, you are too kind. Thank you for taking all of us with you."
"No problem, I'm glad to do it," says the Compassionate Conservative, "The grass at my place is almost a foot tall!"
Parent
Re:Keywords: Government. Health Care. Disaster (Score:5, Insightful)
The article has no less than eleven of those warning signs.
transform
Accenture
Gartner
government
Microsoft
management consultant
Computer Sciences Corp.
in the world
comprehensive
leading-edge
I am not at all surprised that this is a gargantuan boondoggle.
Parent
Re: (Score:3, Interesting)
should you choose to have one.
If you keel over in London you should get a paramedic equiped
with defibrilator within 10 minutes, quite often an actual doctor
will be traveling with the paramedics. If its serious and traffic is bad you
get a chopper to the hospital where serious case are treated immediatly.
You can get to the operating table within an hour.
And all this without a single check for medical insurance or endless
calls to your HMO t
Re: (Score:3, Insightful)
He lives in Canada.
My proposition: So, you go out skiing and screw up your knee. Doctor pops a brace onto it and sets you up for a specialist, who recommends scoping the knee, fixing it, and a physical therapy regimen. How long until you get surgery in Canada.
His answer: 6 months.
If I wasn't out of physical therapy inside of 6 weeks I'd be finding someone to sue.
Our system in the US is way more expensive. It also works, it works quickly, an
Re: (Score:3, Informative)
http://www.pittsburghlive.com/x/pittsburghtrib/s_3 07614.html [pittsburghlive.com]
Among women with breast cancer, for example, there's a 46 percent chance of dying from it in Britain, versus a 25 percent chance in the United States. "Britain has one of worst survival rates in the advanced world," writes Bartholomew, "and America has the best."
If you're a man diagnosed with prostate cancer, you have a 57 percent chance of it killing you in Britain. In the United States, the chance of dying drops to
Re:Keywords: Government. Health Care. Disaster (Score:5, Insightful)
Then you talk about universal health care? What does that have to do with TFA? If I had to guess I would just say you read the title and picked out some of your favorite arguments that had nothing to do with TFA and strung them together to get a +5 insightful. Congradulations you know how to play to the mindless sheep.
Parent
Re:Keywords: Government. Health Care. Disaster (Score:5, Interesting)
So what you are saying is that poverty must exist in order for you to maintain your high standard of living.
-matthew
Parent
Re:Keywords: Government. Health Care. Disaster (Score:4, Interesting)
I would normally agree with you (big government bad, free market good), but you're forgetting one small thing: The Veteran's Administration.
Here was a crappy, failing hospital system run by the US government that has completely transformed itself in the last couple of years. It has successfully deployed a completely electronic patient bookkeeping system (a nurse friend has told me that most of the (privately owned) hospital she works at runs off 3x5 notecards). The administrative overhead is comparable to private hospitals. It is able to negotiate much deeper drug discounts than Medicare and other private hospitals. It works closely with medical schools so its personnel costs are much lower, yet it has experts in many veterans-related fields (things like PTSD, making fake limbs, etc). It rates as one of the top hospitals in quantitative healthcare surveys (which measure things like, "For patients with X, how many of the standard operating procedures Y are usually followed").
In fact, it's done its job so well that - while the costs of private healthcare have *far* outpaced inflation the last couple of years - its budget has been increased at a *slower* rate than inflation.
Of course, like any other large chain of hospitals, there are surgery mistakes and lawsuits. The mistakes are much lower than the national average but, because it's run by the government, are much higher profile when they do happen.
The VA is a good case study of how the government could do healthcare much better than private industry. Its success should be analyzed, studied, and possibly replicated at a much larger scale.
Parent
Private sector failure, not government (Score:3, Interesting)
It is a project paid for by the government but not a government project.
From TFA:
"Accenture proved the big winner ... Computer Sciences Corp. (CSC) was awarded Northwest with West Midlands; BT beat out IBM to get London; and a Fujitsu-led alliance won the Southern region. BT was also given the contract to build both the N3 network and the National Spine, while yet another vendor, Paris-based I.T. services provider Atos Origin (formerly SchlumbergerSema), was commissio
Re: (Score:3, Informative)
When I used to do LIM systems, I once did one for a UK-based pharmaceutical R&D company. The work broke down to roughly 40% effort to make the software function correctly, with the remaining 60% going towards w
Re:Keywords: Government. Health Care. Disaster (Score:5, Insightful)
Parent
Re: (Score:3, Insightful)
Only if they truly have more government. If you look at total cost of government there really isn't any nation in the world which is as expensive as the US. If you diligently keep track of your taxes--on your paycheck, at the cash register, at the pump, extras for sin taxes and luxury items, real estate, utilities, taxes on shipping which
Windows troll? (Score:3, Funny)
Obvious. Droll.
Redmond tops neither
The IRS hole
Or a clean and sparkling soul.
Burma Shave