The primacy of people in the digital health age
The business case to go digital and achieve Jeremy Hunt’s amended target of a “paperless” NHS by 2020, is not in question – either from a cost or, ultimately, a quality standpoint – the challenge is how to get there.
The current situation: the NHS is still full of paper driven environments – even some that have done big EMR implementations. Referrals are often done by means of letters or faxes. Many hospitals have no major EMRS installed, and large solutions are only now finding any traction in the UK. Patients still often have case folders, stuffed with paper, and ferried around by an army of trolley pushers.
The journey: look at how paper is used today as part of the overall blue print for a transformation, engage and listen to the users. Don’t assume paper will magically disappear (don’t wait for the utopia of the EMR – it might not be the be-all-and-end-all anyway). Don’t miss a trick with the technology - the historic proliferation of different capture and storage archives can lead to expensive and unwieldy technology estates. A single, integrated clinical content platform (consisting of VNA, EDRM, capture and digital workflow) makes things much easier and cheaper to manage, a catch-phrase from design thinking makes sense here: “Think big, start small, fail early and often, share always, scale fast.”
Start small: paper-lite through on demand printed packs that can be completed and scanned quickly back to the document archive using Multi-Function Devices in the department.
Think big: fully digital workflow with a single view of patient data from electronic patient records as well as document and image archives – as well as digital capture of data during patient interactions.
Scale fast: have a plan, and work with clinicians to take discrete processes and rapidly deliver benefits back to them that help them, and step by step scale out the digitisation across the enterprise.
This journey isn’t really about going paperless, or even about going digital. It’s about critically analysing the entire UK care model with respect to available tools, and implementing appropriate solutions for optimal health outcomes. Don’t just invest in technology – it won’t solve the problem. Technology is just part of the solution, so when you invest, invest in new care processes to ensure that expected benefits turn into delivered benefits. Care givers and administrators must also give due respect to economic sustainability in order to provide the best possible care for all the UK’s citizens.With the courage to think big and the wisdom to let process transformation be led by the needs of people, Jeremy Hunt’s 2020 vison becomes far more realistic. Please contact me if you have views o this and you’d like to discuss them further.