Ten tips to prepare the NHS for a paperless future – at a more realistic pace

Although Jeremy Hunt has remained optimistic about the ‘paperless NHS’ target of 2020 set out in the NHS Five Year Forward View, it is a target scrutinised by many. Dominic Johnstone, head of information management services at Crown Records Management, says it’s time to admit the 2020 deadline for electronic patient records is in a bad state of health

DJohnstone RAs the NHS struggles towards a 2020 target for electronic patient records it may be time to ask whether the deadline itself is unhealthy. In a world where the amount of data is increasing exponentially, and demand for the health service is soaring, it’s easy to see why the government has been so anxious to modernise the way we keep records. But is such a tight deadline achievable – or even sensible?

Few people, whether patients or clinicians, truly believe paper-based systems are the best choice for the modern age; however, many hospitals and practices continue to rely on the old ways despite successive government campaigns to drag their systems into the 21st century.

Framing expectations

Finding a solution is going to require compromise. The government wants the electronic patient record in place within three years. Can it happen? Well, it looks a serious challenge.

In an ideal world, people would instantly choose the more modern and efficient electronic patient record option. In the real world of resource limitations and legacy patient records – not to mention ingrained working practices – a simple switch over is unlikely.

Foundations for the future

It may also not be ideal because technology is moving so fast that further opportunities lie ahead. For example, in a future world where machines talk seamlessly to each other, an ambulance arriving on scene may have instant access to vital health information from a patient’s wearable technology – so simply turning paper records into digital records is only half the story.

Eventually doctors may be augmented by intelligent systems which bring a whole new set of processes and cultural challenges to healthcare worldwide but, before we get there, we need to rework the NHS and all the types of information it currently uses.

At the moment there is no single big bang technology fix available to digitise records quickly so recognising that those legacy systems and processes will be around for longer than most people would like is key.

Will we be paperless by 2020? It’s unlikely. It’s time to live in the real world and make paper and digital work seamlessly together – while preparing the NHS for the even greater changes which lie ahead.

Ten top tips on the long road to a paperless NHS:

  1. The first priority should be to examine the options of ‘digital first’. Is it possible to combine paper and digital in the short-term to future-proof data in healthcare but without making a painful impact on service?
  2. Analyse where digital can be most easily and effectively utilised to cope with modern demands and improve the standard of healthcare.
  3. When a patient appointment is made it can kick off a process to recall the necessary paperwork. Rather than being delivered on paper this could be scanned and made available at the necessary time. Over time only the most recent electronic records would be needed but for now a hybrid approach in some areas should not be discounted.
  4. Consider storing records offsite, releasing space for core activity. Outsource the management of onsite records to an expert.
  5. Convert as many physical records into digital records as possible but beware of assuming that scanning all records is the answer. This is an expensive option and, as it does not often undergo OCR/ICR (text recognition), a scan is not always searchable. Without careful indexing and metadata being added (often a costly exercise) this creates significant problems.
  6. Consider the implications of the forthcoming EU General Data Protection Regulation. This regulation provides extra rights for European citizens to ask to see their data and to ask for it to be edited so one of the biggest hurdles we face is how to make data shareable and searchable.
  7. Utilise systems to link physical and digital records.
  8. Utilise new systems to link consultants’ diaries to accessible patient records.
  9. Think about future technology and how it might affect record keeping in years to come. Health-tracking apps and web resources offer huge potential to the health of the population, as do smart buildings and wearables with sensors built into our living environment. New systems need to be able to cope with these innovations.
  10. Put systems in place to prevent data breaches. Trusts probably won’t admit they lose records, but they do – not in the sense that they are left on the streets or on the Tube – most are lost somewhere inside a hospital or practice. Many NHS employees don’t see this as ‘lost’ or a as a data breach – but patients and the regulators may think differently.
About the author
Dominic Johnstone, head of information management services at Crown Records Management 

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