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After a series of costly contracts, failed deliveries and shifting goal posts, the objective of electronic patient records for everyone in the country looks set to be abandoned. After nine years and £2.7 billion, the National Audit Office has reported that the National Programme for IT has failed. However, the NHS remains tied into contracts whilst hospitals, ambulance crews, mental health units, community care teams and doctors’ surgeries still wait for working computer systems.
KEEPING PATIENT DATA SAFE
The National Programme for IT was developed in response to concerns about the need to safeguard patient data. But with £4.3bn remaining to be spent by 2015-16, the NHS faces a decision whether to stop development now or continue with a failing project.
The Department of Health has already abandoned the original scheme’s aim of storing all NHS information in a single system, spanning thousands of separate NHS organisations. It has opted instead for one set of common rules so that disparate systems can share what information they have, a proposal that was originally on the drawing board when the DoH first embarked on the National Programme for IT scheme.
From a public perspective IT and the NHS have had a rather troubled history, particularly in recent years. E E Analytics in healthcare is currently very poor, and despite the clear and verifiable benefits it can provide, it simply hasn’t been a priority for key decision makers. There are some core processes that are being transferred from manual tasks to automated and algorithmic decision making systems, but for the most part people in this area are just playing catch-up.
One of the biggest challenges is building sufficient data for predictive analysis. While there is usually plenty of historical data, in most cases it is tied up in legacy systems – requiring huge, and often error-prone data extraction and migration projects. Furthermore patient data is frequently spread across multiple systems, so even managing to maintain consistency in a local environment can be difficult, never mind trying to migrate or synchronise that information between trusts or different health departments.
However, it’s not all doom and gloom. There are steps that can be done to help NHS departments to get more from their IT implementations. As with any significant project, the key is to take a step-by-step approach rather than trying to the tackle such a mammoth task in one fell swoop.
First and foremost people should identify the low-hanging fruit – look for the processes that can be easily automated and the data that is the simplest to extract and analyse – and then start looking at more complex additions such as business intelligence, reporting and predictive analysis.
This helps to avoid the loss of focus that usually arises when a project becomes too large and unwieldy and also delivers some quick returns-on-investment, which is vital for the continued support of users and management alike. As the NHS remains answerable to the public purse, visible success and fast returns are essential if they are to retain public support.
SHARING BEST PRACTICE
Next, it’s important to remember that healthcare is universal, and so sharing lessons learnt across the sector as a whole is vital. For example, some hospitals in the Netherlands are doing length-of-stay predictions based on the conditions presented by patients. This helps better map and analyse the impact on each ward and improve levels of space and staff utilisation.
However, IT personnel within the NHS can also look to other industries for cases of best practice. There are plenty of examples of projects within sectors such as banking or retail that can be adapted to deliver significant improvements to the healthcare industry. Single customer view (SCV) projects share many of the key elements involved with patient data integration programmes. Many SCV projects have been successfully implemented on a vast scale across huge organisations with multiple legacy systems drawing parallels with the size and scope of the NHS. The continued evolution of technology within the healthcare sector is vital to helping overcome the many challenges we face, especially as we continue to live longer.
Cost is not necessarily the defining factor here. It’s about being smarter with the information we have. If the NHS is to make the most of the technology to streamline operations while improving patient care, it needs to break out of the cultural narrow-mindedness that currently plagues it and look outward for examples of best practice and inward for ways of making better use of the data to hand.