Comment: A work in progress. How far along is the NHS in its digital make-over?

Published: 2-Oct-2013

How far along is the NHS in its digital make-over? Mark Clark, vice president at Imprivata thinks that electronic patient information is slowly, but surely supporting much-needed change


In its role as the shining light of the UK public sector and global healthcare market, the NHS is under constant scrutiny to ‘keep up with the times’ and ensure that it is offering the best level of care possible by making the most of the very latest in technology.

Traditionally, the healthcare sector has been slower in taking up the technology revolution than other industries, but with the introduction of the Information Strategy the NHS has a new lease of life. Though is it succeeding?

The move away from paper-based records is slowly but surely starting to ripple through the NHS, with many lessons being learnt along the way

One core component of the Information Strategy , which Imprivata has watched closely over the past 18 months, has been the path to digitised patient information. The notion of an electronic patient record (EPR) which offers a holistic view of patient data at the point of care has promised to result in better-informed clinicial decisions. The very positive picture that I’ve just painted isn’t, however, exactly true to fact. There are dozens of considerations that need to be made to fully benefit from EPRs: security, interoperability with other IT systems, clinical engagement – the list goes on.

The move away from paper-based records is slowly but surely starting to ripple through the NHS, with many lessons being learnt along the way. With changes afoot, there has been obvious and widespread demand for more structure, guidance and incentives to accelerate adoption. E-health Insider ’s Big EPR survey showed that 80.5% of respondents wanted clearer guidance from NHS England on the best route to take.

St Helens & Knowsley Health Informatics Service (StHK HIS) and Oxford University Hospitals NHS Trust (OUH) are two great examples of customers that we have seen embark on this change. StHK HIS was one of the first healthcare organisations in the UK to ‘go paperless’ and e-Health Insider ’s Healthcare IT Champion of the Year 2012, Neil Darvill, who works as director of information at StHK HIS, led that change. Dr Paul Altmann at OUH has also spearheaded significant change and through adopting the role of Chief Clinical Information Officer (CCIO), he has brought clinical and IT experience together to implement IT projects that are manageable for clinical users, ensuring that they fully understand the benefits and drivers behind those changes.

With NHS services freely available to the UK’s 63.2 million residents, transferring, maintaining, storing and safely authorising access to electronic patient records is a huge undertaking. So why have certain organisations been so successful in juggling this almighty task? First and foremost, they have accepted that new online systems often introduce more complexity in the short term and that has to be managed very carefully to ensure long-term success. For example, new IT systems supporting electronic patient records invariably mean new passwords to users already overburdened with remembering credentials. Multiple log ins/out, user lock-outs and time spent calling the help desk can frustrate users, strain relations between clinicians and IT, and jeopardise critical projects.

Clinical stakeholders will ultimately act as the litmus test to gauge the success of any IT project in the NHS. If they don’t buy into the change, it isnt going to work – simple as that

In order for GPs, nurses, A&E doctors or surgeons to embrace these new electronic systems, they must be at least as easy to use as the paper records they have relied on for years. It’s an added bonus, but a realistic expectation, that EPRs will in fact streamline the way that clinical workers go about their business, which could lead to improvements in the standard of care that can be provided. Ultimately, that goal is the biggest driving force behind the NHS’s digital revolution.

With simplicity of access being a key driver in the move to EPRs on the one hand, security has been one major question mark on the other. Pulse Today recently carried out a survey which showed an increase in the number of data breaches within the NHS over the past year, clearly indicating that there is a problem that needs addressing quickly, particularly as more and more information is stored online.

But is data really more or less secure in EPR format? With the right systems in place, I would argue that EPRs can definitely be more secure. We’ve seen customers implement our healthcare IT security solutions alongside EPR projects because data privacy is so crucial. Importantly, better and more secure ways of accessing that sensitive data can also improve productivity which wins over doctors and nurses. Those clinical stakeholders will ultimately act as the litmus test to gauge the success of any IT project in the NHS. If they don’t buy into the change, it isnt going to work – simple as that.

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