Military doctors report IT failures cause more stress than Afghanistan deployments amid healthcare digitisation push
UK defence medical services pursue ambitious digital transformation despite current systems creating operational challenges for personnel care
Colonel Glynn Evans has treated gunshot wounds in Iraq, managed mass casualties in Afghanistan, and performed emergency surgery under mortar fire. None of it, he says, has caused him as much professional stress as logging into a computer.
The military doctor who served five combat tours since 2002 now chairs the British Medical Association's armed forces committee, where his biggest headache isn't battlefield medicine—it's Britain's failing military healthcare IT systems. When one colleague told The Times that "nothing that has happened [in my career], including deployments to Afghanistan, has caused me as much stress as the IT issues," they captured a crisis hiding behind the Ministry of Defence's glossy digital transformation plans.
While senior officials promise a future of seamless electronic health records and AI-enhanced medical care, military doctors face daily battles with systems that crash mid-consultation, display wrong patient information, and lose critical medical data. The £80 million Defence Medical Information Capability Programme isn't enhancing military medicine—it's actively undermining it.
This breakdown sits at the heart of a troubling contradiction. As the UK military pursues one of the most ambitious healthcare digitisation programmes in its history, the technology meant to save lives is making doctors' jobs harder and potentially putting service personnel at risk.
Digital promises meet analogue failures
The September 2023 "Digital Direction for Healthcare" reads like a Silicon Valley manifesto translated for Whitehall. Air Marshal Clare Walton's 75-page strategy promises "maximised medical deployability" through becoming a "data-driven learning organisation" equipped with artificial intelligence and seamless international connectivity.
The vision is seductive, military medics armed with cutting-edge digital tools that enhance their life-saving capabilities from garrison clinics to forward operating bases. An eight-step methodology promises to guide transformation. Eleven "Critical Themes" will coordinate implementation. Integration with NHS partners and NATO allies will create unprecedented medical interoperability.
Yet this glossy future collides brutally with today's reality. Since April 2023, Evans' British Medical Association has documented a litany of system failures that would be farcical if they weren't dangerous. Patient records vanish when doctors try to save them. Critical information appears on screens for the wrong patients. System crashes interrupt urgent consultations. Perhaps most bizarrely, patient records get sent to printers in entirely different cities.
"If I can't access the previous health record, I can't see what drug to prescribe," Evans explains with the weary frustration of someone fighting a losing battle. "Because prescriptions are issued electronically, it becomes very difficult to prescribe." When basic medical functions become obstacles courses of technical failure, something fundamental has gone wrong.
The institutional challenges run deeper than glitchy software. The £250 million CORTISONE programme—intended to replace these failing legacy systems—has already stumbled badly. In 2017, procurement collapsed entirely, forcing officials to admit they needed to "rethink their approach." This wasn't bureaucratic delay; it exposed problems in managing complex digital transformation while keeping critical medical services running.
When pixels become more dangerous than projectiles
Military doctors now spend precious consultation time wrestling with unresponsive screens instead of examining patients. They've begun rationing medical appointments not because of clinical demands, but because unreliable technology makes each consultation unpredictably lengthy and frustrating.
This represents more than inconvenience—it threatens the healthcare of 138,100 Regular Armed Forces personnel who depend on Defence Medical Services. When Evans describes DMICP problems as "the number one issue in my in-tray," he's articulating a system where technology designed to enhance medical care has become its primary enemy.
The psychological toll compounds professional frustration. Military medical personnel already work under intense pressure, knowing their decisions affect operational readiness and potentially lives. Adding technological unreliability creates additional stress layers that veterans of actual combat deployments now rank as worse than battlefield medicine.
This breakdown carries historical weight. During Operation HERRICK in Afghanistan, UK medical services treated 7,800 personnel between 2006 and 2014, managing 456 deaths and 275 traumatic amputations. These statistics aren't abstract—they represent lessons learned about the critical importance of reliable, immediate medical information flow when lives hang in the balance.
Military medical professionals who survived these operational crucibles understand viscerally what civilian healthcare administrators often miss, medical IT systems aren't nice-to-have upgrades, they're mission-critical infrastructure where failure has consequences measured in human suffering.
The integration impossibility
Defence Medical Services' digital strategy hinges on seamless integration with civilian healthcare, particularly the NHS. The logic seems obvious, military personnel frequently require NHS services, whether stationed far from military facilities or needing specialist care unavailable within military systems.
But this integration dream faces an inconvenient reality—the NHS struggles with identical digital transformation challenges. Expert panels rate NHS digitalisation as 'inadequate'. The health service suffers its own legacy system problems, workforce shortages, and implementation delays that mirror military healthcare's difficulties.
NHS England recently abandoned plans for a dedicated digital workforce strategy originally promised by late 2023, then "imminently" by March 2024, now delayed until 2025. With 10% vacancy rates in technical roles and 43% of positions unfilled for over six months, the NHS lacks the expertise to fix its own digital problems, much less support military integration ambitions.
The technical complexity multiplies when considering operational requirements. Military medical systems must function across security domains—from routine garrison healthcare to classified operational environments where civilian network connections are impossible or prohibited. Creating systems that maintain NHS interoperability while operating in complete isolation during deployments represents a formidable engineering challenge that current evidence suggests exceeds available institutional capabilities.
Neil Timms, Senior Vice President at CGI, diplomatically acknowledges this complexity. His company has managed over 700,000 military patient records for 15 years, providing continuity through multiple failed system transitions. "This will enable the military to take advantage of exciting developments in medical systems," he promises, but the gap between aspiration and achievement remains stubbornly wide.
Battlefield lessons lost in digital translation
Iraq and Afghanistan operations created institutional knowledge that current digital transformation efforts struggle to incorporate effectively. Those campaigns revealed specific military medical requirements that differ from civilian healthcare needs, "reach back" capabilities for deployed medics to consult home-base specialists, rapid medical intelligence sharing with international partners, and systems that function reliably under operational pressure.
The statistics from these operations—456 deaths and 275 amputations during Afghanistan operations alone—aren't merely historical data. They represent hard-earned understanding about what military medical systems must deliver when failure means operational compromise or preventable casualties.
Current digital strategy documents acknowledge these operational lessons through emphasis on "telemedicine reach back," "rapid diagnostics," and "deployed medical hardware." Yet the persistent failure of basic garrison medical IT suggests a troubling disconnect between operational requirements and implementation capabilities.
The Defence Medical Services' Critical Themes framework shows institutional awareness of deployment challenges through dedicated focus areas like "Deployed Power Generation" and "Deployed Local Networking." However, if basic medical record systems crash in comfortable garrison environments with reliable power and connectivity, the prospects for success in austere operational conditions appear questionable.
Military medical professionals who experienced these operational realities now watch digital transformation efforts with scepticism earned through bitter experience. They've seen the consequences when critical systems fail under pressure, and they recognise that current IT problems represent warning signs of deeper institutional capability gaps.
The credibility deficit
The eight-step transformation methodology outlined in official strategy documents demonstrates sophisticated understanding of complexity theory and change management principles. Drawing from the Cynefin framework, it acknowledges that military medical systems operate across different complexity domains requiring varied approaches.
This theoretical sophistication, however, must ultimately deliver practical results for frustrated medical professionals and the service personnel they treat. The widening gap between strategic vision and operational reality raises uncomfortable questions about institutional competence in managing large-scale technological change.
Multiple commercial partners—CGI, Atos, and others—now manage CORTISONE programme delivery, reflecting acknowledgment that Defence Medical Services lacks internal capacity for digital transformation. Yet coordinating complex multi-vendor programmes while maintaining operational medical capabilities presents challenges that 2017's procurement collapse suggests remain unresolved.
Recent announcements of £10 billion for NHS technology transformation provide broader context for healthcare digitalisation efforts while highlighting the resource requirements for successful programmes. For Defence Medical Services, the institutional challenge remains acute, maintaining current medical capabilities while implementing transformation programmes that promise significant improvements but currently deliver mainly frustration.
The testimony of professionals like Colonel Evans provides crucial reality-testing for transformation ambitions. When combat veterans report that IT systems cause greater stress than operational deployments, it signals misalignment between technological implementation and user needs that no amount of strategic framework sophistication can address.
The path forward requires acknowledging that digital transformation in military healthcare isn't just about buying better computers—it's about managing institutional change in systems where failure has immediate human consequences. Whether current efforts can bridge the gap between promise and performance will be measured not in strategic documents or theoretical methodologies, but in daily experiences of military medical professionals and the quality of care they can provide to those who serve.
Until then, Colonel Evans and his colleagues continue their double deployment, fighting to maintain medical care standards while battling the very systems designed to enhance their capabilities. In this conflict, the technology appears to be winning.
