Tech
Electronic health records are still creating issues for patients | Computer Weekly
Every NHS trust in England needs an electronic patient record (EPR) system in place by March 2026, as part of a government push to digitise the healthcare system.
In many ways, this is long overdue: some trusts have still been using pen-and-paper record-keeping until very recently.
EPRs have the potential to massively improve efficiency in the NHS. If working properly, they allow doctors to keep all of their records in one place, speed up prescribing and diagnostics, and make it easier for patients to access their own health information.
But these roll-outs have not been without problems. Concerns have been raised about how far these benefits can actually be realised. Some NHS trusts have experienced issues with integrating new systems and training staff on how to use them.
In the extreme, there have been reports of EPRs creating new problems for hospitals, with evidence suggesting these systems may have contributed to serious harm and even deaths among patients.
NHS trusts have been put in charge of procuring their own EPRs, meaning there are numerous different technology companies involved. Some providers of these systems are large US firms. This includes Oracle Health, provided by the Larry Ellison-led tech giant, and Epic, a tech firm based in Wisconsin.
Contracts can run into nine figures: Guy’s and St Thomas’, a trust in South London, launched a £450m system from Epic in late 2023. Some parts of the NHS have been using them for more than a decade, but a handful are still set to miss the government’s March deadline.
Data access
Pritesh Mistry is a fellow at the King’s Fund, where he researches the impact of digital transformation in the NHS. He says it has had “both positive and negative impacts”.
“In the last few years, we’ve seen doubling down on the focus around digital records,” says Mistry. These are now in place in more than 90% of all trusts, and every GP practice.
“That means we’ve now got [new] data that’s within the healthcare system, which allows us to do other things, like treat populations, and understand and track patient safety,” he says.
Despite this, he cautions some patients are still struggling to get hold of their own data.
“We’ve got a lot of data that’s in silos,” says Mistry. “It doesn’t flow. That’s the biggest challenge: making the data accessible and usable for patients and healthcare professionals to be able to provide care in a way that is joined up and meets with modern expectations.”
He says complaints with new technology haven’t just come from patients.
“We need to recognise that staff are really frustrated,” says Mistry. “Software often crashes. Computers are really slow, and technology adds to their workload, instead of simplifying things.” He caveats that some parts of the NHS are better than others on this.
Safeguarding patient data
Mistry adds that there are safeguards in place to ensure patient data isn’t ending up where it shouldn’t be – such as through data protection rules and procurement requirements.
However, he warns that “we need to make sure we move with the times in terms of what technology is available”. Mistry is more concerned about medical staff inadvertently putting personal information into a large language model, for instance.
“Digital exclusion remains a barrier as well,” he says, adding that these systems have the potential to widen inequalities in healthcare. Those less able to use new technology might struggle to access their records.
“People tend to assume it’s old people [who are most impacted], but that isn’t necessarily true,” says Mistry, instead highlighting the impact of poverty and deprivation, with some still unable to afford internet access.
He argues the NHS should be working to meet people where they are, and provide more “tailored” technology services.
Patient safety
Nick Woodier is a doctor and investigator at the Health Services Safety Investigations Body (HSSIB), which looks into issues with healthcare in the UK. He sees problems arising from how EPRs are deployed by trusts, especially when medical staff overestimate their capabilities.
He uses the example of prescribing medicines: “There’s an assumption that these electronic prescribing systems will stop you [from] doing something catastrophic.”
But this isn’t always the case. In one investigation, the HSSIB found a child had been prescribed nearly 10 times the recommended dose of an anti-coagulant medication, with doctors having assumed the EPR would flag an issue. The child ended up with a bleed on their brain.
Woodier also worries hospitals are not always picking up on when these systems are at fault.
“We will often see where incidents have happened and the contribution of the electronic system has not been recognised,” he says.
Woodier sees this as coming from a culture which prefers to put the blame for safety failures on individuals.
A 2024 investigation by the BBC found there were more than 126 instances of serious harm registered by NHS trusts across 31 trusts, including three deaths related to EPR problems.
The HSSIB has also encountered problems from patients being unable to access their digital records.
“We’ve seen in general practice, for example, some patients telling us that they’ve gone without care – because in their mind, they thought the only way they could access their GP was to fill in an electronic form,” says Woodier.
A spokesperson for NHS England says EPRs are “already having a significant impact on improving safety and care for patients”, for instance, by helping to identify conditions such as sepsis, and preventing medication errors.
“They have replaced outdated and often less-safe paper-based systems, and we are working closely with NHS trusts to ensure they are implemented safely alongside other systems with appropriate training – and are used to the highest quality and safety standards,” the spokesperson adds.
Interoperability
The EPR roll-out has also been criticised for problems with “interoperability” – the ability of different programs and modes of data collection to converse with each other. The patchwork of different systems used by different trusts means data stored in one system might not be useful for a system used by a different part of the NHS.
Woodier says this often happens in communications between hospitals and GP surgeries. This can involve someone manually inputting information from one system to another, which can create risks when data is not being transferred properly, or is missed completely.
“When you introduce a manual operation, that risk increases,” he warns. “The odds are that at some point, somebody won’t do the right thing, because that’s the reality of being human.”
Alex Lawrence, a fellow at the Health Foundation, describes interoperability as a “significant challenge”, which the NHS and technology companies have been “grappling with for a really long time”.
“Some trusts have found it much harder to access their own EPR data than they anticipated, because of where that data is stored,” she adds, referring to research the organisation carried out in 2024.
“If it’s taking you days to pull the data that you need, then it’s already not going to be useful for a lot of the purposes that you might want it for.”
However, Lawrence adds that there have been some steps made in the right direction, notably with the Data (Use and Access) Act, which was passed last year.
“The government is making information standards mandatory for EPR providers, as well as trusts, with the Secretary of State potentially having more powers to enforce those standards,” she says.
The longer term
Going forward, Lawrence would like to see a system involving “patients being empowered with access to their own data, and as far as appropriate, clinicians being able to see all of the history that they need for their patients”.
In an ideal system, different parts of the healthcare system would be able to “share a patient’s data where necessary and appropriate, in an easy and timely way”.
She says they have the “potential to offer enormous value”, but much of their functionality is going unused. “What our qualitative research suggested was that a lot of these systems are still functioning as digital notebooks,” says Lawrence.
Matthew Taylor is the head of the NHS Confederation and NHS Providers, membership bodies for healthcare organisations.
“NHS leaders say the gap between trusts on digital maturity is still stark – and it’s shaping how quickly organisations can move to modern EPRs,” he says.
This gap – combined with the organisational complexity of the healthcare system – means interoperability has “long been a thorn in the NHS’s side”.
Taylor adds that EPRs are not a “once-and-done” job, and argues they will result in savings in the long term, but that it may take around five years to see the benefits.
“Hospitals are housing a huge amount of paper records, and the cost of storing, retrieving and managing those records can run into millions of pounds each year,” he says.
These systems are part of a larger picture, and one facet of the conversation, around the use of artificial intelligence in the NHS. AI models for areas such as research and diagnostics will require extensive and standardised medical data.
Mistry warns these AI tools operate on the basis of “garbage in, garbage out”.
“There is a risk that we roll out AI tools without the underpinning data quality it needs,” he says, adding that this could exacerbate inequalities or biases from using AI.
As Woodier puts it: “We’ve got organisations who are still using archaic computers, have got infrastructure that’s not working, are still on old web systems, or have EPRs that don’t talk to each other. A few [trusts] don’t have EPRs.
“So, actually, are we trying to run before we’ve even managed to walk?”
Tech
OpenAI Had Banned Military Use. The Pentagon Tested Its Models Through Microsoft Anyway
OpenAI CEO Sam Altman is still in the hot seat this week after his company signed a deal with the US military. OpenAI employees have criticized the move, which came after Anthropic’s roughly $200 million contract with the Pentagon imploded, and asked Altman to release more information about the agreement. Altman admitted it looked “sloppy” in a social media post.
While this incident has become a major news story, it may just be the latest and most public example of OpenAI creating vague policies around how the US military can access its AI.
In 2023, OpenAI’s usage policy explicitly banned the military from accessing its AI models. But some OpenAI employees discovered the Pentagon had already started experimenting with Azure OpenAI, a version of OpenAI’s models offered by Microsoft, two sources familiar with the matter said. At the time, Microsoft had been contracting with the Department of Defense for decades. It was also OpenAI’s largest investor, and had broad license to commercialize the startup’s technology.
That same year, OpenAI employees saw Pentagon officials walking through the company’s San Francisco offices, the sources said. They spoke on the condition of anonymity as they aren’t licensed to comment on private company matters.
Some OpenAI employees were wary about associating with the Pentagon, while others were simply confused about what OpenAI’s usage policies meant. Did the policy apply to Microsoft? While sources tell WIRED it was not clear to most employees at the time, spokespeople from OpenAI and Microsoft say Azure OpenAI products are not, and were not, subject to OpenAI’s policies.
“Microsoft has a product called the Azure OpenAI Service that became available to the US Government in 2023 and is subject to Microsoft terms of service,” said spokesperson Frank Shaw in a statement to WIRED. Microsoft declined to comment specifically on when it made Azure OpenAI available to the Pentagon, but notes the service was not approved for “top secret” government workloads until 2025.
“AI is already playing a significant role in national security and we believe it’s important to have a seat at the table to help ensure it’s deployed safely and responsibly,” OpenAI spokesperson Liz Bourgeois said in a statement. “We’ve been transparent with our employees as we’ve approached this work, providing regular updates and dedicated channels where teams can ask questions and engage directly with our national security team.”
The Department of Defense did not respond to WIRED’s request for comment.
By January 2024, OpenAI updated its policies to remove the blanket ban on military use. Several OpenAI employees found out about the policy update through an article in The Intercept, sources say. Company leaders later addressed the change at an all-hands meeting, explaining how the company would tread carefully in this area moving forward.
In December 2024, OpenAI announced a partnership with Anduril to develop and deploy AI systems for “national security missions.” Ahead of the announcement, OpenAI told employees that the partnership was narrow in scope and would only deal with unclassified workloads, the same sources said. This stood in contrast to a deal Anthropic had signed with Palantir, which would see Anthropic’s AI used for classified military work.
Palantir approached OpenAI in the fall of 2024 to discuss participating in their “FedStart” program, an OpenAI spokesperson confirmed to WIRED. The company ultimately turned it down, and told employees it would’ve been too high-risk, two sources familiar with the matter tell WIRED. However, OpenAI now works with Palantir in other ways.
Around the time the Anduril deal was announced, a few dozen OpenAI employees joined a public Slack channel to discuss their concerns about the company’s military partnerships, sources say and a spokesperson confirmed. Some believed the company’s models were too unreliable to handle a user’s credit card information, let alone assist Americans on the battlefield.
Tech
Don’t Risk Birdwatching FOMO—Put Out Your Hummingbird Feeders Now
Though most people associate the beginning of March with the hopefulness of spring and the indignities of daylight saving time, there’s another important event taking place yards all over the country: hummingbird season.
While many species of hummingbirds can be seen in regions year-round, others are migratory, and this time typically marks their return from wintering grounds in Central and South America. These tiny birds can lose up to 40 percent of their body weight by the time they arrive here after having flown thousands of miles, and since many flowers haven’t bloomed yet, nectar feeders can be a source of essential fuel.
Though I test smart bird feeders year-round, I don’t use hummingbird feeders as often as I should, as it’s imperative that they be cleaned and refilled with new nectar every two or three days (a ratio of 1:4 granulated sugar to water is best, and avoid any dyes or additives) to prevent deadly bacteria and mold, and I don’t always have the time.
But if you are going to invest the energy in maintaining a hummingbird feeder, right now is the best time, as you have a chance to see migratory species you might not otherwise encounter, such as black-chinned hummingbirds. A smart feeder helps you ID them, whether they’re stopping at your feeder on their way north or arriving at their final destination.
Birdbuddy’s Pro is the smart hummingbird feeder I recommend and use myself when I’m not actively testing. The app is easy to navigate and sends cleaning reminders, the built-in solar roof keeps the battery charged, and, unlike other feeders, only the shallow bottom screws off for refilling. No having to pour sticky nectar through a narrow opening, or turn a giant cylinder upside down and risk spilling.
Note that it’s not perfect; the sensor is inconsistent and doesn’t capture every hummingbird that visits, but for the camera quality (5 MP photos, 2K video with slow-motion, 122-degree field of view) and ease of use, it’s a foible I’m willing to put up with. If you already have another Birdbuddy feeder, the hummingbird feeder images and videos will integrate seamlessly into your app feed.
Right now, the feeder is 37 percent off on Birdbuddy’s website—a deal I usually don’t see outside of shopping events like Black Friday or Amazon Prime Day. Note that the feeder only runs on 2.4 GHz Wi-Fi, and while it is fully functional without a subscription, a Birdbuddy Premium subscription will let you add friends and family members to your account so they can see the birds as well. That’s $99 a year through the app.
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Tech
The Controversies Finally Caught Up to Kristi Noem
After a tenure marked by controversy and a contentious week of Congressional hearings, secretary Kristi Noem is out as head of the Department of Homeland Security.
President Donald Trump announced in a Truth Social post on Thursday that Noem would be replaced by senator Markwayne Mullin of Oklahoma, a staunch Trump ally and immigration hardliner. “The current Secretary, Kristi Noem, who has served us well, and has had numerous and spectacular results (especially on the Border!), will be moving to be Special Envoy for The Shield of the Americas, our new Security Initiative in the Western Hemisphere we are announcing on Saturday in Doral, Florida,” Trump wrote. “I thank Kristi for her service at ‘Homeland.’”
DHS did not immediately respond to a request for comment.
The agencies under DHS include Immigration and Customs Enforcement, US Customs and Border Protection, the Cybersecurity and Infrastructure Security Agency, the Federal Emergency Management Agency, US Citizenship and Immigration Services, the US Coast Guard, and others. It’s a sprawling network whose vast responsibilities and rapidly expanding budget have put it at the center of the Trump administration’s radical overhaul of immigration and border policy.
Speculation has swirled around Noem’s departure for months. Critics have assailed DHS’s aggressive immigration enforcement tactics, while Noem and figures like White House border czar Tom Homan have reportedly been at odds over how to execute the administration’s mass deportation agenda, with Noem and senior adviser Corey Lewandowski said to have emphasized sheer numbers of arrests and deportations above other considerations.
The relationship between Noem and Lewandowski has itself been a subject of controversy, with CNN reporting that a September meeting between the two and president Donald Trump grew “contentious.” Last month, the Wall Street Journal reported that Lewandowski attempted to fire a pilot during a flight for failing to bring Noem’s blanket from one plane to another during a transfer.
The ousted secretary faced mounting scrutiny over the deaths of US citizens during federal operations in Minneapolis, including the killings of Renee Good and Alex Pretti by federal agents under Noem’s employ. In both cases, Noem publicly labeled the deceased “domestic terrorists,” framing echoed by Trump and other key administration officials. Video evidence, witness testimony, and an independent autopsy contradicted the agency’s claims, including early assertions that Pretti brandished a firearm.
Scrutiny of Noem’s tenure extends beyond the fatal shootings in Minneapolis to a broader pattern of aggressive enforcement tactics, warrantless raids, and mass detention camps. A secretive policy directive issued in May 2025, first reported by the Associated Press, authorized ICE agents to forcibly enter private residences without a judicial warrant. The memo, signed by acting ICE director Todd Lyons, instructed agents to rely solely on an administrative removal document to bypass Fourth Amendment requirements. The policy led to multiple documented instances of federal agents entering the wrong homes, including a January raid in Minnesota where agents removed a US citizen at gunpoint with no legitimate reason.
A record 53 people died in ICE or CBP custody last year, according to House Democrats on the Committee on Homeland Security. Concurrently, Noem has initiated a $38 billion procurement effort to buy and refurbish up to 24 warehouses across the country, aimed at converting them into mass detention camps for people awaiting deportation.
Noem’s tenure has led to controversy at other DHS agencies as well. Her insistence on approving any contracts or grants over $100,000 at the department have caused particular strain at FEMA, which has experienced a massive backlog of funding that has slowed normal processes at the agency. A report issued from Senate Democrats Wednesday found that Noem’s vetting process at FEMA has caused more than 1,000 contracts, grants, and awards to be held up. Multiple FEMA employees have told WIRED that this process has made the agency less ready to respond to disasters and threats.
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