My experiences of the NHS so far have been mixed, but recently, I’ve come across instances of bad information management. A perfect example of this was when I tried to get copies of my medical records - let’s just say that the bureaucracy of the Vogons in Douglas Adams’ The Hitchhiker's Guide to the Galaxy came to mind.
I know that this is not the case for everyone. Some people experience fantastic care and support from the NHS. We also don't seem to feel it is right to complain about a free service.
But, the NHS is paid for through general taxation, and as such, we are all customers and surely we should demand a more consistent, higher quality service delivery?
I believe that the delivery of healthcare services could be drastically improved if there was a more robust digital infrastructure to facilitate information management. The problem, it seems, is that the NHS is vast and many trusts currently rely on paper-based records and an ageing IT infrastructure.
However, there is a glimmer of hope; some recent schemes making the most of new technologies show the real scale of opportunity for the NHS. A system that electronically records a patient’s vital signs and combines the data with individual lab test results has prevented 397 deaths at the Queen Alexandra Hospital in Portsmouth, and reduced the number of patients with Norovirus by 90%. Trials have also shown that the electronic prescription system can reduce medication error by 50%, reduce average length of hospital stays and help save 20,000 lives a year; but is only commissioned in a mere 12% of hospitals.
Although not yet widespread, these types of schemes are helping the NHS to save money and improve patient outcomes (and more). There are so many benefits, but with a health system as large and complex as the NHS, effective delivery and nationwide scalability is difficult to accomplish.
The above examples were successful because they were developed in-house; a collaboration between clinical and technological experts to find a solution that would suit the clinical needs of a specific environment.
When looking at past and current initiatives to make the NHS ‘more digital’, it seems like technology has just been plastered over existing processes and workflows, with no real user benefit. Delivering digital in healthcare goes way beyond procuring hardware, software and training.
Although the research piece ‘Delivering the benefits of digital health care’ covers some crucial points around data privacy, public acceptance and continuous learning, for me the most salient element is user-centred design (UCD). It’s so important that digital services are developed in a way that meets the unique clinical needs of each healthcare environment - so we can reach a new way of working, facilitated by technology, which meets users’ needs and makes all of our lives easier.
In an organisation this vast, there is no ‘one-size-fits-all’.
My opinion is that we should start with the nation-wide patient records and electronic health record (EHR), which would play a pivotal role in any digital strategy; getting this right would be a good first step towards successfully developing an interoperable digital NHS. Following this, local organisations can lead more independent transformations towards digital healthcare with user-centred design at its heart.
Interestingly, a joint venture team has been working to create nhs.uk Beta - currently NHS Choices, the most visited health information website in Europe. Their strong focus on user-centred design is the type of approach needed for the successful delivery of digital services across the entire organisation. This way, they could develop solutions that better serve their customers, helping professionals deliver a better quality of care whilst saving costs - which is something that ultimately benefits all of us.