Changing our digital culture and safeguarding patient data

Source: NHE Jul/Aug 2017

Joanna Smith, chief information officer at Royal Brompton & Harefield NHS FT (RBHT), says that as the NHS becomes more digital it has to get better at supporting and funding the consequential impacts on IT infrastructure.

Like all of my colleagues in the NHS we are striving to upgrade our IT infrastructure, reduce paper and help improve patient care and collaboration through the wider use of digital solutions – against a backdrop of increasing risk from cyber-attacks and the constant need to secure and protect our patients’ health information. All this at a time when money is sparse, with many trusts facing financial deficits and the impacts of GDPR and Brexit looming large in our minds. 

Since I joined in 2013, following a long career in the pharmaceutical industry, our trust has been engaged in a major overhaul of our IT platforms. Although pharma tends not to be at the ‘bleeding edge’, it is typically a fast follower of new ideas and technologies and this has proved invaluable experience for my move into the NHS. 

Our trust executives are committed to transforming how we deliver patient care, recognising that extending our services beyond our physical boundaries and collaborating effectively with other healthcare providers are key. Over the last three years we have redesigned and upgraded our networks, migrated off XP and started to move out of our on-premise data centres, leveraging managed and cloud services. We have introduced Skype for Business, a new patient administration system (PAS), an electronic document management system (EDM) and an electronic patient and administration system (EPMA). This year, we will migrate from our old PBX switchboard platforms to Voice over IP (VOIP), including unified communications and an iMessage app alternative to physical bleeps.

This has not been without its challenges for our staff; there is a sense of ‘IT fatigue’ in some areas as people have had to move from a largely manual and paper-based way of working to one where data has to be entered in real time. This has been particularly testing on some of our wards where previously admissions and bed moves were done by ward clerks on Monday mornings following weekend activity. 

As a specialist trust, we have favoured a ‘best of breed’ approach with a number of niche solutions. The digitisation of patient case notes and the new EPMA have brought great benefit to the trust as a whole but can, for a busy consultant in clinic, feel like another change and new thing to have to deal with. 

The importance of communication and education 

The cultural change and impact of new ways of working is immense, particularly for busy clinicians whose primary concern is, quite rightly, the direct and immediate care of their patients. It will take time to embed new processes and demonstrate the true value – and this is critical if we are to transform how we work to deliver greater productivity and cost optimisation. 

At the same time, we must safeguard our patients’ data. Whilst this is nothing new, the scale of the risk and impact from the digital landscape is enormous. Where previously a simple mistake or careless behaviour could risk a small breach, digital magnifies this exponentially. Educating our staff whilst still enabling them to do their job is key. Some organisations favour using extreme technical solutions to mitigate risk such as banning access to personal email and social media from corporate devices. Some commercial institutions even disable the ability to save or send data whilst others prefer policy and education. Whichever approach you take, communication and education are vital. 

The NHS already has strong protections and governance in place through the Information Governance Toolkit, and this is planned to be enhanced to include more around cyber security. At RBHT, we run education and fake phishing emails in order raise awareness and reduce the risk of our staff clicking on fake links and entering their credentials. Whilst this is having a positive impact we will never fully mitigate the risk. We have invested in good perimeter and endpoint protection, as well as modern monitoring solutions to quickly identify and address unusual activity. Patching servers is easier now following the recent WannaCry outbreak, which fortunately didn’t affect us. However, there is always a balance to be found between frequent patching and the inevitable disruption to service. 

As the NHS becomes more digital, in line with the aspirations outlined in the Five Year Forward View, we have to get better at supporting and funding the consequential impacts on our IT infrastructure and human resources if we really want the NHS as a whole to become a global digital exemplar.




There are no comments. Why not be the first?

Add your comment


national health executive tv

more videos >

latest healthcare news

Lord Kerslake quits as trust chair in protest against NHS underfunding

11/12/2017Lord Kerslake quits as trust chair in protest against NHS underfunding

Lord Kerslake has resigned as the chairman of a major hospital trust in London in protest against historic underfunding in the NHS. The respect... more >
CQC praises ‘proactive’ Hartlepool services in care integration review

08/12/2017CQC praises ‘proactive’ Hartlepool services in care integration review

The CQC had praise for the health and care system in Hartlepool as it continued its programme of 20 targeted reviews of integrated care. The... more >
Government launches inquiry into Ian Paterson case

08/12/2017Government launches inquiry into Ian Paterson case

A national inquiry has been launched into the malpractice of Ian Paterson. Earlier this year the breast surgeon was sentenced to 20 years in pri... more >
681 149x260 NHE Subscribe button

the scalpel's daily blog

Ten lessons to support new care models locally

29/11/2017Ten lessons to support new care models locally

Anna Starling, policy fellow at the Health Foundation, offers the top 10 lessons for local leaders seeking to make systematic improvements across services, all based on first-hand accounts from vanguard officials. Redesigning health and social care services across traditional boundaries is not easy. Making change in complex environments, with differing professional viewpoints and varying organisational priorities while getting on with t... more >
read more blog posts from 'the scalpel' >


Cutting through the fake news

22/11/2017Cutting through the fake news

In an era of so-called ‘fake news’ growing alongside a renewed focus on reducing stigma around mental health, Paul Farmer, chief exec... more >
Tackling infection prevention locally

04/10/2017Tackling infection prevention locally

Dr Emma Burnett, a lecturer and researcher in infection prevention at the University of Dundee’s School of Nursing and Midwifery and a boar... more >
Scan4Safety: benefits across the whole supply chain

02/10/2017Scan4Safety: benefits across the whole supply chain

NHE interviews Gillian Fox, head of eProcurement (Scan4Safety) programme at NHS Supply Chain. How has the Scan4Safety initiative evolved sin... more >
Simon Stevens: A hunger for innovation

25/09/2017Simon Stevens: A hunger for innovation

Simon Stevens, chief executive of NHS England, knows that the health service is already a world leader when it comes to medical advances – ... more >

last word

The Refugee Doctor Initiative

The Refugee Doctor Initiative

Terry John, co-chair of the BMA & BDA Refugee Doctors and Dentists Liaison Group and chair of the union’s international committee, talks about a brilliant initiative that is proving mut... more > more last word articles >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital e... read more >

health service focus

Release full market value against surplus and decommissioned assets

28/11/2017Release full market value against surplus and decommissioned assets

Advertisement feature: Oliver Pearson, sal... more >
Operation Barcode: selecting technology to succeed

22/11/2017Operation Barcode: selecting technology to succeed

The benefits of Scan4Safety have been widely ... more >