A paperless NHS: Paper is only the tip of the iceberg

Female doctor using ipad while working in hospital

A paperless NHS: Paper is only the tip of the iceberg

14:45 28 July in Industry news

Female doctor using ipad while working in hospital


Health secretary Jeremy Hunt’s much-vaunted ambition is for the NHS to be paperless by 2020 (the original target of 2018 seems to have quietly fallen by the wayside). As a result, many initiatives are being rolled out to achieve this, including, for example, GP practices turning to electronic health records.

While Mr Hunt has set his sights on a paperless future, the behemoth that is the NHS needs to look way beyond the simple act of printing and what’s on paper if it’s to speed up progress down the paperless road.

Shifting away from paper is all about digitisation, which for an organisation the size of the NHS is a huge task. On a practical level, when the Pennine Acute Hospitals NHS Trust embarked on its digitisation initiative, it predicted it would be scanning 100 million patient records in the first year of the project, creating up to 450 million images that would need to be stored. That’s a massive amount of data – from just one of the 350+ trusts across the UK.

The biggest hurdle

That said, the sheer scale of digitisation is not the major IT issue facing the NHS. Nor is paper usage. So what is the biggest obstacle in the way of a digital revolution?

Put simply, the organisation needs to start joining up its thinking and start working together – and pretty quickly too – if it’s to enjoy effective digital transformation. Any successful digital transformation – whether it’s the adoption of a digital workflow or a cloud solution in pretty much any organisation of any size – needs a cultural and technological shift to engender the sharing of data throughout the organisation.

There are signs that progress is being made. The National Information Board shows signs of successfully improving information sharing in four key NHS pathways – end-of-life care, complex long-term condition management, mental health and urgent emergency care – to help patients as they are moved through these areas of the NHS and reduce the amount of paper in the process.

Currently however, the bridges that are being built span only half the gap. For the paperless NHS to become a reality a wider strategy needs to adopted. The focus needs to move away from simply digitising paper records to rethinking the whole service so that we avoid the scenario where automated electronic medical records are used in hospitals but don’t feed down into GP practices.

All about the data

The lack of data sharing between NHS organisations has been a long-standing problem, with GPs, ambulance services and hospitals often lacking sufficient historical data on a patient’s medication, ongoing conditions or previous visits. For example, when an ambulance arrives on a scene, paramedics need to ask patients their details. There are signs that this is changing though.

A major review into the health service’s use of technology is set to be published in June 2016 by Bob Wachter, which should provide the joined-up roadmap needed to achieve a paperless NHS and so much more.

“There’s a lot of paper floating around, and that’s unhealthy,” Wachter told The Telegraph. In GP clinics “the implementation of digital patient records has gone quite well.” But it’s been “much spottier” in hospitals.

“There are hospitals where doctors are using digital tools, but also still using paper tools, and having to do the work twice,” he said. “It’s not unreasonable to believe that by 2020 the system can be essentially digital.”

The Government hopes that, as early as 2017, its digital transformation will result in at least 10% of patients using apps and online services, like click and collect prescriptions, to access GP services. That will only happen if the left hand starts talking to the right, data starts to be shared and an integrated approach to document management and the digital transformation is rolled out.

Austin Clark

Austin Clark

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