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Coding for efficiency
The NHS is an integral part of British society. Many of us work in or directly with the service, pay taxes to fund it and will have experienced its services first hand. Therefore it’s a subject that most feel passionately about, particularly as many agree that the system is struggling. Dealing with a staggering one million patients every 36 hours, this will come as no surprise.
Over the 64 years the service has been in existence, it’s been no secret that the NHS has had its fair share of challenges. Resources continue to be significantly stretched, resulting in long waiting hours in A&E and missing records.
Despite doing an impressive job with these limited resources, The National Patient Safety Agency in the UK reported that in 2007 alone there were over 80,000 NHS medication blunders; a high number of errors that could be avoided using simple and cost effective solutions. With further warnings that the NHS will be unable to cope with the demands of having to make efficiency savings of £15bn to £20bn between 2011 and 2014, it’s now imperative that the NHS investigates all possible avenues for making cost and efficiency savings without negatively impacting patient care and safety.
Standards based procurement
Implementing basic data standards and automated identification systems, such as bar coded patient wristbands, equipment, medicine and even medical records, could have an extremely positive impact. This kind of basic technology can help NHS trusts to improve efficiency and at the same time save costs, precious time, staffing resources and most importantly - improve the quality of patient care. As the new government has pledged to ring fence resources to support the NHS, while all other public services are experiencing dramatic budget cuts, it’s even more important for money to be spent wisely.
The recent Department of Health publication ‘NHS Procurement: Raising our game’ calls for trusts to demand GS1 Global Trade Item Numbers (GTIN) from their suppliers as part of the procurement process. By doing so, NHS Trusts will be able to make considerable savings on admin and overheads without any knock-on effects on patients. By using a standards-based procurement and asset tracking system, NHS Trusts will also be able to see where any given item is at any time, cutting down the time staff spend searching for equipment and reducing wastage. By focusing cost saving initiatives on administrative and logistical efficiency rather than services, it is possible to maintain levels of care and ensure that the NHS makes the most of the money it has.
Not only is efficiency a key requirement coming from the UK, European and US governments, protecting patients from misidentified products – where poor illegible manual labelling systems or simple human error can result in massive risks to patient safety – is now also a key priority.
Bar code standards and Radio Frequency Identifier Data (RFID) technology have already been shown to reduce errors, track medication, improve the quality of patient care and prevent counterfeit medicines from entering the NHS supply chain. From an operational perspective, there are significant efficiency gains including less paperwork, reduced manual processes, automatic stock replenishment, cut time wasted by inaccurate data sharing, and access to centralised, accurate and standardised data. This means that doctors and nurses can spend less time on administration, and more time with their patients.
We have seen many NHS trusts, hospitals, pharmaceuticals and medical device providers successfully implement simple technologies and GS1 standards to save money, improve efficiency and importantly, increase patient safety. So who is successfully using these technologies?
One of the big issues facing many NHS Trusts. Work carried out at Leeds Teaching Hospital has saved over half a million pounds in a single department alone by implementing a GS1 standards-based automated stock control system. Over the course of three years, Leeds Teaching Hospital reduced surplus stock levels by £570,000 while simultaneously improving service levels to 98 per cent. The implementation allowed frontline doctors and nurses to spend more time with patients and less time finding and ordering basic equipment or even manual taking stock measurements. With full visibility of all orders and stock coming in, the Trust’s supplies team can see what items have been delivered to which ward.
The hospital’s receipting invoice disputes have dropped from 20 per cent of all invoices to just 2 per cent, saving a huge amount of administrative resources. If the model demonstrated by Leeds Teaching Hospital is followed in all departments in all hospitals across the UK, hundreds of millions of pounds will be freed up to invest in better patient care. Leeds Teaching Hospitals has already managed to save over half a million pounds in one department by doing so.
The use of GS1 standards on pharmaceutical products to enable unique identification and authentication of individual packs through the supply chain are recommended by the Department of Health for use in the healthcare system for manufactured products and coding systems. Coding enables the supply chain to improve patient safety, drive efficiencies and combat counterfeiting through safety features on individual packs to identify them, guarantee their authenticity and enable pharmacists to check whether the outer packaging has been tampered with.
Many markets, such as Turkey and France, have already begun to impose regulations requiring pharmaceutical manufacturers to include 2D Data Matrix bar codes encoded with GS1 standard identifiers such as the GTIN and expiry date to combat counterfeiting and reimbursement fraud.
Electronic asset tracking
Wythenshawe Hospital is using trusted and approved GS1 bar codes to track and trace surgical instrument trays, which has enabled staff to store historical information on individual items electronically. This information can be accessed easily in the event of a recall procedure. The tracking system also ensures that the right trays are returned to the correct hospital department. A similar system could be employed to track prescription medicines.
Medical Record tracking/tracing
Lead site Royal Bolton Hospital identified the potential to reduce the time spent looking for misfiles by 80 per cent whilst significantly reducing lost revenue due to coding time-outs by replacing the manual processing of returned records with an automated system that uses GS1 standards. Furthermore, by automating location tracking throughout the hospital it could save even larger amounts. Benefits like these will enable hospitals to meet their requirements of reducing costs and ultimately improve patient safety.”
Mölnlycke Health Care, leading providers of wound care and single-use surgical products and services to the healthcare sector, has developed a range of GS1-compliant product labelling as part of their continuous improvement to offer safe and efficient products to its customers as well as supply chain efficiency. As part of this initiative, Mölnlycke has updated policies and procedures to ensure ongoing compliance with new regulations and standards. In particular, using the GS1 Standards is enabling Mölnlycke Health Care to be ready for new NHS and global legislation for universal codes on medical products around traceability of products within the healthcare supply chain as well as efficiently managing product recalls. By having a single, globally accepted system for positive identification of medical devices and standardised identification system, patient safety has been safeguarded.
Savings without compromise
A global set of regulations will mean that hospitals and clinicians will have access to a reliable source of information about medical devices from their manufacturers, leading to fewer administrative errors affecting patient care and preventing counterfeit medication entering the supply chain. Through using joined up systems using GS1 identifiers for tracking and monitoring across a hospital, trusts can make huge savings without cuts to frontline services. Improved efficiency and increased savings in procurement and stock management will see more available money to invest in services and improved levels of care at the point of treatment. The examples given show how basic technology and trusted data can be used without compromising patient care or safety. In an era where the public sector is being asked to save money, combat counterfeiting, tackling drug and stock wastage issues, this could be a more cost-effective way for the NHS to make big savings.
Matching patients electronically to the right medication, the right bed, the right treatment to ensure patients have the right products available at the right time in the right place will stop many of the mismatches, which today cost patients’ lives. GS1 codes are a tool for patient safety.
What are the next steps?
The first step is to become a GS1 UK member, which is funded centrally for NHS trusts in England. GS1 data standards underpin all of the technologies that front line health staff are asking for, enabling the systems to operate at their best. The Department of Health fully recommends the use of GS1 standards throughout the healthcare system in the UK. It’s an important part of their ‘Coding for Success’ policy. Members of GS1 UK are inducted into the use of global and interoperable standards within their hospital, and gain free access to implementation guidelines, education modules and dedicated experts in their field. They also have the chance to define GS1 UK healthcare standards through working groups. With all of these resources to hand, there is no reason why health organisations can’t be cost effectively revitalised with improved patient care and greater efficiency.