Tas Hind, director of technology at Essentia looks at the healthcare challenges in 2019 and what NHS CIOs should be focussing on in the New Year.
Since Matt Hancock took over as secretary of state for health and social care in July, he has pushed technology to the forefront of the transformation agenda. How are Trusts going to access the £487 million he has found to help boost technology in the NHS? And what other priorities should be on CIOs’ Christmas lists?
- Continuing to optimise electronic patient records (EPRs)
Many NHS Trusts are still using paper for documenting clinical information. It is inevitable that there will be pressure to digitise these in order to improve performance, quality of care and patient experience. There is also a great need to share this information electronically both inside and outside organisations.
- Improving eRostering and eReferrals
Use of agency staff continues to be at an all time high. The use of effective eRostering solutions can help improve workforce management which is at the top of any COO’s list. NHS Trusts need to continue focusing on this capability.
While electronic referrals from GPs into NHS Trusts have gained much momentum, a challenge still exists around referrals from Trusts to other follow-on services. Much work needs to be done to improve the exchange of this type of information electronically. This ensures that patients don’t fall between the cracks and that vital, quality services are delivered in a timely manner. One could ask why the e-RS solution on the national SPINE is not being used for referrals between organisations? Surely it can be enhanced to deal with that?
- Implementing bedside monitoring and self-check-in solutions
Bedside monitoring of patients is becoming increasingly popular. Several Trusts have already implemented independent solutions such as Nerve Centre, VitalPac and Sensyne, with great success. These require integration with Trust EPR systems, which is not always easy to do. However, EPR solutions are increasing offering these as a module, so it becomes a ‘no-brainer’ to implement it as funding becomes available. It’s very likely that these solutions will be adopted, as they are easy to use and the impact on working practices and patients tends to be high.
Similarly, self-check-in kiosks have been in use for a while in outpatient departments. They are also a common feature in many GP practices.
Some organisations have piloted them but haven’t rolled it out further. The benefits of such solutions are obvious and often it is time and resources that hold the Trusts back from deploying it wider.
There will be continued focus on these systems in 2019, as they are relatively easy to implement. If done correctly the impact can be significant, particularly if they are integrated into the Trust EPR systems and used for more than just checking in and wayfinding.
- Implementing ePrescribing across the Trusts
This must be the jewel in the crown. Trusts that have implemented this capability successfully, have demonstrated how they can be adopted clinically and generate great benefits in working practices and patient safety. This will continue to be a key focus in 2019, and rightly so.
Prescribing electronically in GP practices is a common practice and most solutions in Trusts focus on inpatients. However, it is important that it is also adopted in outpatients and in the community.
There have been documented instances of where patients have continued to take medications as community staff were not aware that they should have been stopped. It is only when the prescribing information is shared electronically across the Local Health Economy (LHE), will we have patient care that is truly safe and can be relied upon.
- Improving infrastructure, Wi-Fi and making systems compliant
Many Trusts have continued to focus on improving their infrastructure and Wi-Fi access. Whilst great strides have been made in this area, it will continue to be a key priority in 2019. This will be driven by pressure from staff to continue to access systems inside and outside their own localities. If they are being expected to record and access information electronically, it is essential to have a modern and reliable infrastructure.
Nearly every Trust has a plethora of systems that they need to access in order to treat patients. That includes those with wall-to-wall EPR systems.
The biggest challenge remains the ability to access and update information in between systems. While Health Level Seven (HL7) messaging has gone a long way to address this, there are limitations. It is essential to have systems that are compliant with Fast Health Interoperability Resources in order to bridge these gaps.
This is particularly important where there are LHE-wide shared care records. Implementing these as read-only solutions is not good enough. Trusts need to be able to update the information bi-directionally (i.e., information flowing two ways, from GP to acute and acute to GP). Although this can be a big step forward, it is essential that it is implemented in areas with the greatest impact and that patient data is not compromised.