Is the NHS reaching the peak of its data mountain?

Health Business investigates how successful the NHS has been amid the growing volumes of content and the ongoing push for paperless hospital environments.

The technological age that is raging through healthcare is changing many things, but one thing that remains a constant is that patients depend on correct medical records to get the right treatment and that clinicians rely on them to provide it. Health Secretary Jeremy Hunt has claimed over and over again that a fully paperless NHS would save billions and increase efficiency, setting a target of 2018 to have a paperless health system. But, as we settle into 2016, the question remains – are we any nearer to a paperless NHS?

The idea of a ‘paperless’ NHS was first introduced by Health Secretary Jeremy Hunt in a speech at the Policy Exchange in 2013, planning for all patients to have read/write access to their own records by 2018. In that speech, he stated that everyone will be able to get online access to their own health records held by their GP by March 2015, the heavy adoption of paperless referrals, clear plans to enable secure linking of these electronic health and care records wherever they are held, so there is as complete a record as possible of the care someone receives, and for those records to be able to follow individuals, with their consent, to any part of the NHS or social care system, and that by April 2018, digital information to be fully available across NHS and social care services, barring any individual opt outs.

Growing confidence
While full adoption is still a way off, a belief that it is possible is growing. Last year, the Digital Health Intelligence NHS IT Leadership Survey surveyed members of the Health CIO Network and CCIO Leaders Network and in November printed their results, claiming that 67 per cent of respondents were ‘quite confident’ or ‘extremely confident’ that the NHS could significantly reduce paper and reach paperless targets by 2020.

Only 14 per cent said they were ‘not at all confident’ or ‘not very confident’ of achieving the target. Furthermore, 28 per cent said they were confident that patients would have this read/write access to their records, with 53 per cent saying they were not confident.

Since Hunt’s declaration much has been done to integrate digital care records. The ‘Safer Hospitals Safer Wards’ fund, with the key priority of enabling information flow across care settings was created, and was shortly renamed the Integrated Digital Care Fund.

Digital roadmaps
Talking to visitors at the 2015 InterSystems connected-healthcare conference, Inderjit Singh, head of enterprise architecture at NHS England, said: “On one hand we talk about the ability for patients to be able to access the information online, but on the other hand we still have discharges being sent through the post in a significant number of organisations.

“We talk about technology as an enabler, but we need to move beyond that and really translate what this means for key clinical pathways and key focus areas the healthcare service is looking at.” One of the reasons why NHS trusts are struggling in the paperless quest, and still having ‘discharges sent through the post’ is the vast number of records that need digitising and the overwhelming cost associated in doing so. Singh suggests that every local area would be required to create an annual digital roadmap outlining how they plan to achieve paper-free status through an open interface which should be underpinned by key standards.

At the NHS Innovation Expo, a dedicated Digital Zone showcased how new technologies are supporting commissioners and providers in achieving local digital roadmaps and learned about how digital innovations are transforming health and care services for patients. Speaking before the Expo, Tim Kelsey, who views 2020 as the time when paper should be absent from patient records, said: “The NHS in England must end the unnecessary reliance on paper in the treatment of patients. It’s key to making services safer, more effective and more efficient.

“As well as saving precious resources, technology can dramatically reduce errors. Urgent action is a moral imperative where paper is the currency of clinical practice.”

Top of the mountain
With 2018 only two years away, Jeremy Hunt’s aims seem more and more ambitious. However, Kelsey’s determination to be document-lite by 2020 seems more likely. The Pharmacy Informatics Forum highlighted the speed at which electronic prescribing is growing within UK hospitals.

Figures shared at the show revealed that 13 per cent of UK hospitals have a fully implemented electronic prescribing and medicines administration (EPMA) system and 50 per cent are in the process of implementation.

Implementation is set to grow with the aid of The Integrated Digital Care Fund and with a determination to see savings made. Additionally, Hunt has recently announced that £4 billion worth of funding will be set aside to improve the use of technology across the NHS. Although details of the investment have not yet been finalised, it is expected to be used for areas such as electronic records and online appointments, prescriptions and consultations and removing outdated technology such as fax machines, meaning that perhaps 2016 will be the year that the paperless dream becomes more realistic.

Further Information
www.gov.uk/government/uploads/system/uploads/attachment_data/file/384650/NIB_Report.pdf