Electronic patient records key to NHS digital transformation

Rolling out digital patient file (EPR) programs to exchange paper-based workflows is key to reaching the federal government’s plan of “joined-up” healthcare within the UK, however the present state of digital maturity throughout the well being service is “patchy” at finest, say senior NHS officers.  

In February 2022, well being secretary Sajid Javid outlined the federal government’s digital transformation priorities for the NHS, which included the ambition to have EPRs up and operating in 90% of NHS trusts by December 2023.

Speaking throughout Digital Health Rewired 2022, an exhibition and convention programme organised by Digital Health, key figures within the NHS outlined how the roll-out of EPR programs will assist underpin the organisation’s wider digital transformation efforts.

Tim Ferris, director of transformation at NHS England and Improvement since March 2021, mentioned that within the 12 months since taking over the position, he has been stunned by the discrepancies in digital maturity throughout the NHS nationally.

“The current state is patchy – there are really amazing examples of digital excellence, but there are also places that actually have very few systems,” he informed convention attendees on 16 March. “I think 19% of acute trusts don’t have an EPR. That’s not OK in this day and age.”

Ferris mentioned that whereas EPR roll-outs and adjustments have been “never pleasant” from his expertise as a clinician, all of them have been essential and massively benefited sufferers by decreasing bureaucratic errors in addition to bettering communication between care suppliers.

Giving the instance of a single EPR that was rolled out to a community of eight acute care hospitals, Ferris mentioned it was “impossible” for them to be described as “on the same team” till the system was applied.

“Putting us all on a single instance of a single EPR immediately meant that we were all seeing exactly the same information, so there was no delay, there was no interoperability burden of exchanging data – we simply understood what our colleagues were doing with our patients, our shared patients, at a distance immediately,” he mentioned.

“That is the single most powerful thing that I have seen in healthcare for making sure that everyone providing care to patients is on the same page.”

Simon Bolton, interim chief govt of NHS Digital, mentioned in a separate panel dialogue that getting EPRs into all trusts, and getting them up to “a certain level of maturity” is foundational to delivering digitally enabled healthcare throughout the UK.

“We have to stop using paper to manage workflow in hospitals,” he mentioned. “We need to move into systems that enable us to get more efficient and deliver better healthcare.”

In order to transfer away from paper-based records and obtain higher communication between care suppliers, some NHS organisations have already begun engaged on EPRs collectively.

Speaking in regards to the joint EPR challenge between the King’s College Hospital NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust – a “moonshot” effort that has been dubbed Apollo – the CEO of the previous, Clive Kay, mentioned individuals is not going to imagine in 10 to 15 years’ time that hospitals have been ever run with out an EPR system.

“I’m not sure in this day and age how a CEO can run a hospital, or group of hospitals, safely without an EPR,” he mentioned. “There are lots of examples of how an EPR can significantly improve in-hospital care. It feels now that we’ve made the case, whereas some years back we had to persuade clinicians this is the right thing to do.”

Beverley Bryant, joint chief digital data officer (CDIO) for each trusts, agreed that most individuals within the NHS now see the necessity to get EPRs “for patient safety, for quality”, however mentioned the funding organisations on the centre – together with the Department of Health and Social Care and the Treasury – “are cynical and nervous” due to the broader NHS’s poor observe file in IT supply.

“The problem is, we’re not writing it down,” mentioned Bryant. “So we do achieve the benefits, but it’s difficult to point to the piece of paper, to the document that evidences that we’re actually getting your benefits out.” Metrics shall be baselined and tracked to gauge the success of the challenge going ahead, she added.

“In our Apollo programme, we are determined to drive through on the benefits. We want to set quality, safety and efficiency targets derived from our three business cases. If we write it down, and we are able to prove it, we create a blueprint for the NHS.”

In one other session, Dan West, CDIO for well being and care on the Department of Health in Northern Ireland, outlined how his organisation is deploying a single EPR system throughout acute care, psychological well being, neighborhood companies and social care to “create a single, longitudinal data system to support the delivery in all those disciplines of care across all five trusts”.

West mentioned the creation of the system was “our biggest investment” and can assist drive extra coordinated care throughout Northern Ireland. He added that a web based portal shall be created in order that sufferers can entry their very own care records.

On high of the necessity to roll out EPR programs to obtain a base degree of digital maturity inside the NHS, abilities have been additionally cited all through Digital Health Rewired 2022 as a serious digital transformation concern.

NHS Digital’s Bolton, for instance, mentioned there have been alternatives to work with the training sector to guarantee digital abilities have been constructed into healthcare coaching in the identical means that medical abilities are.

“Collectively, we are 10% of the UK economy – if we can’t fix the pipeline for digital skills in the UK, then nobody can,” he mentioned, including that the implementation of digital abilities “needs to be planned, it needs to be deliberate, and we really need to focus on it”, with a selected emphasis on “cyber and analytics”.

Bolton mentioned boosting digital abilities could be a serious precedence for the NHS going ahead.

Matthew Taylor, CEO of the NHS Confederation, additionally famous the significance of digital abilities, stating that the introduction of latest applied sciences is usually not adopted up with enough coaching on how to use them successfully.

“Often what we do is we innovate, but we don’t provide the training to people, we don’t provide the professional development,” he mentioned.

It is now 20 years because the NHS first launched a programme to roll out EPR. Known because the National Programme for IT, the challenge was scrapped in 2011 at a price to taxpayers of shut to £10bn.