There is absolutely no doubt which story got EHI readers commenting in 2013. When EHI invited readers to take part in The Big EPR Debate in April, more than 150 hit the comment button within a couple of weeks.

The debate was a response to health secretary Jeremy Hunt’s call for the NHS to go ‘paperless’ by 2018. Hunt’s initial call, made in a speech to the Policy Exchange think-tank in January, was supported by a paper from PriceWaterHouseCoopers.

This made some grand claims for the amount of money the NHS could save by implementing a rag-bag of IT ideas, from effectively completing the National Programme for IT in the NHS to adopting technologies that simply digitise its existing paperwork.

EHI was concerned that this could lead the NHS to abandon some of the goals that it had been pursuing for many years and lead to some poor investment decisions.

The Big EPR Debate invited readers to discuss the whole concept of an electronic patient record, the technologies that trusts should focus on at different stages of digital development, and where NHS England should focus its attention.

The 150 responses showed a desire for some fundamental thinking about what the NHS should be trying to do and how IT should help it to do it, continued support for the idea of intitutionally-based but connected records in which information can be recorded once but used many times, and a desire for the centre to enforce the standards that might make this possible.

In July, NHS England published guidance for trusts on how to bid for the first round of money from the ‘Safer Hospitals, Safer Wards: Technology Fund’, and urged trusts to focus on NHS Number, e-prescribing, scheduling and information sharing projects as the first step towards creating an integrated digital care record.

However, the outcome of the first round of bids, delayed until very close to the end of the calendar year, lack this kind of clarity. And the promised technology strategy that will set out the big picture has been put off until March 2014.

Otherwise, the list of ‘most commented’ stories on EHI in 2013 is dominated by responses to the many ideas of NHS England’s director of patients and information, Tim Kelsey, and the desirability – or otherwise – of using open source in the health service.

The second most commented story of the year concerned Kelsey’s suggestion that patients might learn to code and build their own apps, while the sixth most commented was about his prediction that 50,000 clinicians might go through the Code4Health programme.

Towards the end of the year, EHI learned that Code4Health has been scrapped; although NHS England says it is just being reviewed.

Meanwhile, the most commented Insight of the year was EHI editor Jon Hoeksma’s response to NHS England’s interest in anglicising the US Veterans Health Administration’s VistA open source EPR, while the news that a couple of companies are pushing ahead with doing just that was the eighth most commented news story.

Most commented news stories 2013:

Take Part in The Big EPR Debate

Patient coding with a twist

NHS Number to be mandated from 2014

Monitor blasts Rotherham’s EPR programme

50,000 clinicians to learn to code

NHS England buys 1600 iPhones

First cut of VistA for NHS developed

Hunt wants paperless NHS in five years

EHI launches hunt for EPR exemplars.

Putting aside the VistA debate, it was not so much one issue as one man that got readers of EHI’s Insight features reaching for their comment button.

Joe McDonald, the man who bills himself as the psychiatrist to the now-defunct national programme, had three of the most commented Insight items of the year.

Two related to his passionate support for chief clinical information officers, reporting back from the first summer school held by the CCIO Leaders Network, and calling for ideas for a manifesto for them.

The third concerned his need to find a non-intrusive way of keeping an eye on his mum, using a kettle, an iPhone, and some gaffer tape.

Most commented Insights 2013:

Open eyes to NHS open source (EHI editor Jon Hoeksma on VistA and alternatives)

Joe’s view from the school room (the one about the CCIO Leaders Network summer school)

A new view of VistA (Ewan Davis on the Veterans Health Administration system)

Can a big stick deliver EPR success? (editorial on quietly dropped plans to impose "severe penalties" on trusts that miss EPR targets)

Joe’s view of dreams (the one about Martin Luther King and a CCIO manifesto)

Joe’s view of telehealth for dummies (the one about the kettle and the gaffer tape)

Off the record (Lis Evenstad talks to NHS privacy campaigners)

Another view (GP columnist Neil Paul on the imminent arrival of

Code red (Mik Horswell of UKCHIP responds to stories of ‘fiddled figures’)

Dates with destiny (the first of EHI’s Target watch features).

Read a festive special of EHI’s Target watch feature, set up to monitor the many targets set for NHS IT and information, in today’s Insight.