The first, How Should Fed HIT Dollars Be Spent? Cat vs. Dog POV from the e-CareManagement blog highlights a politico-philosophical problem that affects the approach to procurement being wrestled with in the US.
The second two, from the UK, illustrate how ‘government-think’ in terms of multi-million contracts works to exclude the smaller, potentially more vibrant companies from the table but, owing to over-ambitious scaling, undermines the probability of success.
Tories consider IT contract cap from the BBC and MPs call for national care record programme to be abandoned from HealthcareRepublic.
The fourth, Local thoughts from abroad from egovmonitor, is a reflective piece on why central government in the UK makes local government so ineffective – a constant complaint of people who want to bring about telecare/telehealth change more quickly and something often privately recognised by people working within councils themselves.
The author, Roger Gough, puts his finger on an essential truth: “Our local authorities have quite wide-ranging functions, but a narrow funding base: that is their core problem.” However, he omits to mention that, based on councils’ track record, central government, despite its rhetoric about the importance of local decision-making, doubts and distrusts local government’s ability to deliver services that are up to date, let alone forward-looking. Fuelled by the low funding base, these contrary forces create a vicious circle of over-demand and under-performance.