Some interesting electronic patient record decisions on Digital Health.net this week. Wye Valley NHS Trust has become the second to announce that it is planning to use IMS Maxims’ open source EPR, openMaxims.

As well as being an apparent vote of confidence in the open source approach, this might be taken as an indication that the North, Midlands and East market is starting to open up, as the end of the National Programme for IT contract with CSC comes into view.

Except that figures from the Health and Social Care Information Centre indicate that most trusts are planning to stick with the ‘interim’ systems that they received from the programme when the ‘strategic’ Lorenzo ran into repeated delays.

Now, there will be good, practical reasons for this. As the HSCIC pointed out last year, if all the trusts due to come off national contracts on 7 July next year went out to market at the same time, it could not cope. CSC is, naturally, encouraging its customers to stick with it.

The current financial climate hardly encourages big IT investments. Even so, given the unremitting criticism faced by the programme, it might have been expected that more trusts would have been desperate to shake its dust off their heels at the first opportunity.

Perhaps there will be more action over the next couple of years. Meantime, Salisbury NHS Foundation Trust has chosen CSC as its preferred bidder for an EPR, suggesting that CSC is right when it says it can win business for Lorenzo, outside as well as inside the NME.

NME to retain most NPfIT-era systems

The end of NPfIT contracts in the North, Midlands and East looks unlikely to trigger an immediate, large-scale change in IT systems, with the HSCIC and industry contracts predicting that 60% of systems installed by CSC will be retained.

Wye Valley second trust for openMaxims

Wye Valley NHS Trust has signed a five-year deal with IMS Maxims to implement its open source electronic patient record openMaxims.

Salisbury selects Lorenzo

Salisbury NHS Foundation Trust has chosen CSC as preferred bidder to provide its Lorenzo electronic patient record system.

Camden takes 'quantum leap' with iPads

Staff at Camden and Islington NHS Foundation Trust will access patient records on iPads following the introduction of a new electronic patient record system in September.

Barts cancer patients use Skype

Cancer doctors at Saint Bartholomew’s Hospital are monitoring patients from home via Skype video link.

As is well known, the start of August is when medical graduates start work as junior doctors. To mark this year’s change over, the Guardian got together an interesting set of reflections on what it is like to set foot on the wards for the first time; with – or in too many cases without – much help and support from consultants and other staff.

One poor soul had a terrible time. “The power came back on, but the computer keyboard was broken. The computer printer was broken. The passwords given to us at induction didn’t work. I couldn’t call IT because the telephone was broken.” Still, his nightmare wasn’t all IT’s fault. “The day got worse from there.”

“As a wise old project manager once said to me: ‘There is nothing as permanent as an interim solution that works.’ Even so, it is shocking that the interim solutions were never replaced with the intended, promised, full-functionality systems within the duration of the contracts.”

“This trust has really struggled to invest in IT, so this is a fantastic opportunity that we are going to push forward with.”

Simon Lind, project and portfolio manager at Wye Valley NHS Trust, which is deploying openMaxims.