Tech mandate puts information management high on NHS agenda
Written by Louisa Wetton
Electronic patient records and digitised casualty admission cards can help Trusts meet NHS information management objectives and improve operational standards, says PHS Data Solutions managing director Anthony Pearlgood
The first Mandate between the Government and the NHS Commissioning Board has been published, setting out the ambitions for the Health Service over the next two years. From a technology standpoint, a key objective within the Mandate is to ensure that, by 2015, everyone will be able to book their GP appointments, order a repeat prescription and talk to their GP online.
This latest Mandate follows numerous other technology and data handling initiatives. These include The Nursing Technology Fund, aimed at supporting NHS staff with new technology paid for by a £100m allocation and the £260m NHS England ‘Safer Hospitals, Safer Wards’ Technology Fund, both of which were fully approved in December 2013.
A key aim of most of these initiatives is to support a move away from paper-based systems for patient notes and prescriptions towards integrated electronic care records and the development of e-prescribing and e-referral systems.
Improved care through better information management
In some hospitals, this shift towards digitisation of patient records is already underway, with the joint objectives of accelerating patient care, cutting waiting lists and enabling more straightforward information-sharing between departments. Crucially, the latest Mandate between the Government and the NHS Commissioning Board aims to prevent situations where patients have to repeat their medical history because the hospital does not have access to their records.
In addition, the technology underpinning the changes could help staff deliver a better quality of patient care. Specifically, it has the potential to reduce time spent trawling through patient notes and help get the correct insight to the relevant practitioner at the right time. This particular objective is a key aspect of Government policy aimed at ‘making the NHS more efficient and less bureaucratic.’
Step-by-step approach
While digitisation will clearly have an important role to play in improving current document and records management processes in healthcare, the requirement to work with some legacy paper records will still remain.
When embarking on such wide-scale technology initiatives, a further challenge for healthcare professionals is that, while there is clearly a strong business case for electronic patient records, the challenge of moving away from largely paper-intensive processes may be daunting. According to data obtained from a recent Freedom of Information request currently, around 61 per cent of nurses still use handwritten notes, charts or verbal communication to share patient details, medication notes and discharge instructions.
Rather than replacing paper entirely, a ‘paper-lite’ system involving document scanning and classification technologies could therefore offer a less disruptive means of improving information management in healthcare. The scanning aspect of the technology digitises paper documents, eliminating the need to continually transport cumbersome files around hospitals.
Meanwhile, using easily-configured classification software to automatically read and classify paper records, clinicians and administrators can look back at specific correspondence or case areas within a pre-specified timeline, saving time and increasing access to information on an ad-hoc basis.
Used alongside an archiving solution, document classification software also guarantees that the correct retention and disposal policy can be quickly identified and data cleansing can be carried out on existing records. This approach ensures compliance, while further increasing the level of process automation.
Meanwhile, for those many documents which do not have to be physically retained, a secure on-site or off-site shredding service would ensure that confidential documents are disposed of in a controlled and fully-compliant way.
Efficient framework for casualty records
As part of the national programme for the rollout of electronic patient records, Trusts will also need to digitise casualty admissions cards. In turn, this will enable authorised users within the organisation to access records efficiently from any PC within the department.
For those yet to implement a Trust-wide electronic system, the introduction of a basic imaging and document retrieval can be an effective first step. This solution allows completed documentation to be scanned, indexed from pre-printed barcodes and stored in a document repository for easy future access.
If this retrieval solution is based on open standard technologies, the data can also easily be migrated at any future point – most likely when an organisation-wide solution is underway. This low-risk approach is therefore well-suited for Trusts piloting the use of scanning, or looking to make A&E administration more efficient, while at the same time finding cost savings.
Case-specific prescription
In a busy NHS Trust, it’s unlikely that any single technology solution or records management can be seamlessly implemented with no disruption to practice. As such, instead of limiting choice to an in-house solution or a purely outsourced service, it can make more sense for Trusts to have the option to combine both approaches in order to meet the exact needs of the organisation.
By gradually automating document and records management processes and adapting them to suit the individual requirements of each Trust, time and cost-conscious healthcare providers will be better equipped to achieve the Government’s vision for a digitally-enabled healthcare service.