News

Getting IT right for the NHS

There is growing pressure on NHS bodies to find ways to utilise their IT systems effectively. National Health Executive spoke to Brian Derry to find out more

One of the key issues in healthcare at the moment is efficiency and how to achieve it without compromising on the quality of services provided to patients.

This is a question which is being addressed by NHS managers as they brace themselves for cuts in funding and is one that is being tackled at this year’s Smart Healthcare Live show.

“The main issue for the NHS is now about maintaining the quality of care, whilst increasing productivity and efficiency,” says Brian Derry, speaking as chair of the Association of ICT Professionals in Health and Social Care (ASSIST), which is part of BCS, the Chartered Institute for IT.

“It is widely recognised that information and information technology are both fundamental to that goal. Technology will enable services to be delivered in different ways, for example telehealth, which enables patients to be better supported in their homes using things like remote monitors. The digital world will enable different ways of delivering care which is both better in terms of quality and patient outcomes, whilst also more efficient and cost effective for the NHS.

“Similarly, information itself helps us to track what is happening in terms of quality, productivity and efficiency, whilst also helping us to identify where there are opportunities for improvement. It also reinforces accountability in the health service, whether that be at board level or even in parliament.”

Despite the great advantages which IT based technology such as telehealth can offer to the health service, there have been some concerns that certain groups of patients may find it difficult to accept these new forms of healthcare delivery.

“I think that change is always difficult but that is why IT should be seen as an enabler of that change, rather than a means of imposing change. Yes, we must respect and respond to the views of the public, but it wasn’t that long ago that people were uneasy with all aspects of technology. It just takes time for people to become comfortable with trusting that technology.”

One of the main issues which healthcare informatics professionals have to deal with is the series of high profile cases, where data and therefore patient confidentiality has been breached.

“I think that these cases, along with the slightly excited way in which they were reported by the media, have created a lot of concerns in the mind of the public and some of these concerns might perhaps be beyond what is appropriate.

“Security and confidentiality is absolutely critical, there is no doubt about that. Whether the loss of an encrypted laptop compromises that is another matter.”

Data security glitches are not the only IT issue troubling the NHS. There is a growing perception, mainly driven again by negative publicity around the National Programme for IT, that the NHS may be commendably ambitious in its IT aspirations but sadly lacking in its ability to implement them.

“This is because they are not just straightforward IT projects. Unless you have got backing from clinicians and managers, you will not achieve the change you want. The notion that people can just stand back and expect their IT professionals to implement an entire system and change an organisation all on their own is ludicrous.

“These things have to be done in partnership and it is hard work, particularly when you are implementing a major new system in an environment where you only exist to care for patients. You cannot simply just shut those services down whilst work is going ahead. It is like trying to change the wing of an airplane whilst it is in flight.

“In this situation the risks are so great that everything must be done with the greatest of care. It is not like a payroll system going down, which will cause annoyance to staff but no one dies. If a critical hospital IT system goes down, then you do run the risk of harming people. The amount of care taken, along with the training given to staff and the resilience built into the system, is extremely important and means that it is very hard work. Carrying out this task on a tight budget is even harder.”

Brian believes people seem to not take into account the true amounts of money which are needed to implement these huge IT systems.

“People only seem to notice the amount of money which you need for the hardware and software. Very few seem to take into account the money needed for training, implementation, service redesign and other transitional processes which are just as important as the system itself. You cannot have one without the other.”

This problem is also compounded by the fact that the NHS is going through a period of very limited public spending.

“It is going to be tough, but the public sector has to do its bit for the wider economy, there is no argument about that. We just have to ensure that the money goes to the right projects which will deliver the right benefits.”

Despite the current economic situation, the future looks bright for IT led healthcare, with computer operated system influencing almost every part of healthcare in the future. So which will be the most influential?

“Mobile devices of all kinds,” says Brian. “I think that telecare in the widest sense will become much more important. I also think that remote access to information to support care processes will also become more prominent as we are now in a world where care is delivered by lots of people for an individual patient. For example, that patient will first be seen in a GP practice, then in an outpatient department, then an inpatient department, then in community services and then perhaps even social care.

“That individual will, quite rightly, see that as one piece of care whereas at the moment it is structured as lots of independent blocks. As this happens more and more, it is going to be really important that all of the people within those blocks have access to the information which they need.”

So does this mean that Brian thinks that electronic patient records are necessarily the future?

“I hesitate to use that term, because I think that it is probably going to be different in concept, in that I do not believe that it will be a single physical image of a digital record, rather a way of gathering various chunks of patient information from a variety of sources. Almost like a set of Google widgets.”

This approach would avoid the need for large, monolithic systems which, given the current situation with NPfIT, would be a welcome change.

Tell us what you think – have your say below, or email us directly at [email protected]