Comment: Why NHS trusts should slow down to move more quickly towards a paperless NHS

In this article, DR ANDREW LITT, chief medical officer at Dell, gives his opinion on why trusts should become paperless, how the NHS can assess its technology use, and why paperless is important to patients

Health Secretary, Jeremy Hunt, has laid out a vision for a paperless NHS by 2018. That’s a laudable goal, because moving from paper to digital record keeping will increase access to information for both patients and healthcare providers and improve both patient health and patient care.

In response to this vision, many local trusts will look to new technology to meet that goal. But there is an important reason that local trusts need to hold off making decisions about new technology investments - limited budgets.

If you don’t have much money to invest, you need to carefully consider each purchase and make sure that it will have lasting value. Hasty decisions may result in money wasted and slower progress toward the paperless goal.

If you don’t have much money to invest, you need to carefully consider each purchase and make sure that it will have lasting value. Hasty decisions may result in money wasted and slower progress toward the paperless goal

It’s important to remember that better patient care and better administrative operations (which are the benefits of the paperless goal) are not necessarily a result of technology investments. But efforts to improve both clinical and administrative operations can shed light on where technology investments can be most effective. That’s why it is critical to spend time assessing your current use of technology before making decisions about new investments. By slowing down investments, trusts are more likely to make real progress toward the paperless goal.

Before making technology investments, local trusts should optimise the technology they currently use.

The first step in this process is to do a thorough assessment of current technology, led by a joint team from the clinical and technical staffs. It is critical that this assessment NOT be done solely by the technical staff or solely by the clinical staff.

In my experience with healthcare IT, I’ve learned that technology projects that are led exclusively by the technical staff almost always miss important clinical factors. IT professionals are experts in software and infrastructure, but they often lack understanding of how technology affects patient care workflows, and they may not ask the right questions. Clinical staff, on the other hand, will understand the workflow issues, but often misunderstand the capabilities of the technology. They may overlook opportunities because they don’t know exactly what the technology is capable of.

A joint effort by clinical and technical professionals, on the other hand, offers the broad perspective of clinical needs and technological capabilities. This is a powerful force in the pursuit of an optimised technology environment. Clinical staff members almost always learn about technology capabilities in the system that they didn’t know were there, and technical staff members almost always learn about unintended consequences that the technology causes in clinical workflows.

In my experience with healthcare IT, I’ve learned that technology projects that are led exclusively by the technical staff almost always miss important clinical factors. A joint effort by clinical and technical professionals, on the other hand, offers the broad perspective of clinical needs and technological capabilities

It’s also important to get input from patients. They are the ones that move across the system, and they are the ones who can see the inefficiencies clearest. They’ll tell you how many times you ask for the same information, and how cumbersome your registration and scheduling procedures really are. It may be possible for the technical staff members to tweak the current applications to improve service and efficiency. And, if you want to get rid of paper, patients can usually tell you which pieces of paper are redundant. While this knowledge may not move you closer to an all-digital environment, it will surely help cut down the amount of paper used in your system.

Once you’ve assessed your organisation’s technology capabilities in light of the clinical and operational goals, you can update your clinical and operational workflows and optimise your use of current technology. That’s the point at which you’ll be able to see what you really need and be able to make more-effective technology investments.

Whatever system you use to do the assessment, by taking the time to gain this understanding you will move much more swiftly toward the goal of a paperless NHS.