One of the biggest shake-ups of NHS IT is about to take place after Health Secretary, Jeremy Hunt, challenged trusts across England to become completely paperless by 2018.
In a speech to the Policy Exchange, Hunt said the NHS could not be ‘the last man standing’ when it comes to embracing the technology revolution and described it as ‘crazy’ that paramedics, for example, could not access the medical records of a patient when an ambulance is called to an emergency and that GPs and hospitals still struggle to share digital records.
We are all used to online banking, shopping and social media and healthcare has lagged far behind
This, he said, had to change and he has set a number of challenges for trusts to enable them to reach full automation within five years.
He said: “Previous attempts to crack this became a top-down project akin to building an aircraft carrier. We need to learn those lessons, and in particular avoid the pitfalls of a hugely complex, centrally-specified approach.
“Only with world-class information systems will the NHS deliver world-class care.”
It is vital that we don’t repeat the mistakes of the NHS National Programme for IT and try to do too much at once, with people not understanding the benefits or having confidence in the system
His comments come following the publication of two reports demonstrating the potential benefits of making better use of technology. The first, from Price Waterhouse Cooper found that measures such as using text messages for negative test results, electronic prescribing and electronic patient records could improve care, allow health professionals to spend more time with patients and save the NHS billions of pounds. It suggested a potential £4.4billion could be put back into the NHS through better use of information and technology. A separate report by the Department of Health’s National Mobile Health Worker team reported on a pilot study introducing laptop computers at 11 NHS sites. It found that through mobile working supported by technology, the NHS could see significant increases in productivity, an increase in the time healthcare staff have to spend with patients, a reduction in unnecessary journeys, a reduction in travel time and significant savings in referrals and hospital admissions.
The idea of a paperless NHS was first mooted more than a decade ago and was one of the key aims of the now-defunct NHS National Programme for IT. This largely failed, with just a few trusts having gone completely paperless to date. Now, in order to kick-start the rollout afresh, Hunt has set out a five-point plan he wants trusts to follow.
This starts with a deadline of March 2015 for all patients who want it to have online access to their health records. Trusts will then have to adopt paperless referrals, followed by the creation of clear plans to enable secure linking of electronic health and care records wherever they are held. There will also need to be a process for health records to follow patients, with their consent, through any part of the NHS or social care system. The efforts will culminate in April 2018 with the deadline for digital information to be fully available across all NHS and social care services.
But, while Hunt’s challenge has been welcomed by healthcare staff and industry, there are warnings that it may prove difficult to achieve.
Julia Manning, chief executive of the health think tank, 2020health, told BBH : “Jeremy Hunt is right that it’s crazy that we don’t have electronic access to our health records. We are all used to online banking, shopping and social media and healthcare has lagged far behind.
To go digital and gain maximum benefit, the data quality has to be of the highest order and data integration across the entire supply chain has to be sorted
“It is vital, however, that we don’t repeat the mistakes of the NHS National Programme for IT and try to do too much at once, with people not understanding the benefits or having confidence in the system.
”The focus must be on electronic personal health records (PHR), over which patients have control and which they (or a nominated person) share with professionals. The NHS and social care services need to ensure our GP, hospital, dental, social care etc records can be viewed by patients through a PHR platform and that they can interact with professionals through this. A system which allows professionals to share information without the patient’s knowledge is no longer acceptable. A paperless system will flow from this, but this must be the focus.”
And Mikko Soirola, vice president of supplier, Liaison Technologies, said the accuracy of data was vital in ensuring the success of future systems. He added: “The savings potential of going digital is undeniable, but let’s consider the preparation process. To go digital and gain maximum benefit, the data quality has to be of the highest order and data integration across the entire supply chain has to be sorted. To be in a position to digitise those records in the first place this issue has to be resolved.
“However, in many organisations data is treated with scant regard and the term ‘rubbish in rubbish out’ is particularly pertinent. There are few NHS organisations which have a dedicated position of data manager. Which means no one checks if organisational data is correct and accurate. And if no one has responsibility, who ensures that data is cleaned, entered and stored correctly? The sad fact is that if you have poor data to work with from the start, you will never maximise your return or achieve best practice. We will see data integration becoming a hot topic in 2013.”
There are also concerns over how increasingly disparate NHS organisations, with individual powers as foundation trusts, will properly protect patient data.
Although this new government initiative is a welcome change, hopefully bringing with it multiple benefits for both NHS staff and patients alike, it does raise some important questions about how user privacy and patient records will be protected
Jason Hart, vice president of cloud solutions at SafeNet, said: “Although this new government initiative is a welcome change, hopefully bringing with it multiple benefits for both NHS staff and patients alike, it does raise some important questions about how user privacy and patient records will be protected.
“Its ambitious nature and the fact that it involves such sensitive information means it needs to be coupled with an equally bold approach to data protection. It’s especially important in terms of public trust that a migration to a paperless NHS goes hand in hand with improvements to security and privacy. Since the NHS has already experienced many data breaches with both paper-based and electronic records, and given the personal medical information that could be at stake, the public will not stand for any data protection strategy that is not of the highest standard.
“This calls for scalable and robust authentication and encryption solutions that can be easily managed and provisioned across multiple different user environments. Cloud-based authentication, for instance, is an innovative approach that provides unlimited scalability and simplified authentication management ensuring only authorised users gain access to patient records. This, coupled with comprehensive encryption of all patients data, will help to ensure that sensitive data is secured and rendered worthless should personal records fall in the hands of the wrong users.”
