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Health secretary Matt Hancock recently emphasised the importance of scanning technology in improving care and safety throughout each touchpoint in the patient journey. Glen Hodgson, head of healthcare at GS1 UK, explains the benefits of standardising this process by using GS1 barcodes
Digital transformation in healthcare has become one of the most talked about topics in recent times. Technology’s potential to revolutionise patient care – both from an operational and clinical perspective – is clear, and there is countless evidence to demonstrate its value. It is no surprise that many of the national strategies that have been set by government and NHS national bodies, have centred on the adoption and use of technology.
NHS England’s recent release of the NHS long-term plan in January is one such strategy and is testament to the commitment to digital transformation across the NHS.
A nationwide strategy
The release of the NHS long-term plan addressed the need for integrated care across England and placed digital maturity at the centre of delivering this goal.
As part of this, the plan aims to implement integrated care systems (ICSs) across England by 2021, to make health and care records accessible to all necessary staff and patients, and to continue to drive digital excellence in acute care through the blueprints generated from the Global Digital Exemplar (GDE) programme.
Further support for digital progression came in the form of the Topol Review which was launched in early February after a speech delivered by Matt Hancock, secretary of state for health and social care. During his address, Mr Hancock voiced the need to develop the digital skills of staff across the NHS, to ensure they are equipped to deal with the evolving digital healthcare landscape.
He also emphasised the importance of scanning technology in improving care and safety throughout each touchpoint within the patient pathway. He warned that without standardised data, the NHS would continue to face an uphill battle on the road to achieving true interoperability.
At this point, he praised the exemplary work of the Scan4Safety programme, stressing the significant impact it has had on the delivery of better and safer patient care. Given its successes, Hancock expressed his wish to see the programme’s standards and processes implemented by every acute trust in England.
Without standardisation, the healthcare sector will continue to function in an environment where it is unable to share vital data between systems and organisations, struggling to breakdown existing operational silos. To break through this barrier, the implementation of open standards needs to become an integral part of healthcare – this is where the work of GS1 UK makes an invaluable difference.
Originally introduced in retail, GS1 standards are now being applied in healthcare settings worldwide to improve patient safety and supply chain efficiency. GS1 UK works with key stakeholders – manufacturers, suppliers and trusts – to facilitate the adoption of unique identifiers based on GS1 standards, for every person, product and place.
This one-of-a-kind classification provides organisations with increased end-to-end visibility throughout the entire healthcare pathway, allowing people, products and assets, to be accurately identified, tracked and located in real time and at any stage. The Scan4Saftey programme was built on this very concept from its inception in 2016.
GS1 standards in practice
The six Scan4Safety demonstrator sites started off with the implementation of three core enablers applied to three primary use cases. By implementing the core enablers: the Global Service Relation Number (GSRN) for patient wristbands, the Global Trade Item Number (GTIN) for catalogue management, and the Global Location Number (GLN) for location identification, each trust was able to achieve numerous improvements in patient safety and operational efficiency across inventory management, purchase-to-pay and product recall.
Three years after adoption, the value of standardisation and the use of scanning technologies in healthcare has been clearly evidenced. Motivated by the results and outcomes that GS1 standards have achieved in practice, several additional acute trusts in England have since begun their own implementation journeys.
Standards in pharmacy
One area where the implementation of standards has perhaps had the greatest impact on patient safety has been in acute pharmacy settings.
In pharmaceutical manufacturing and supply, scanning technology is being used to authenticate medications by tracing the unique product serial number throughout the supply chain.
The Falsified Medicines Directive (FMD) has recently come into force as a global measure to help prevent falsified medicines from entering the supply chain in the first place. Standardisation at this level, provides better visibility and traceability. Should any medications need to be recalled, they can be done so efficiently, minimising the likelihood of risk to the patient.
GS1 standards also provide an additional layer of safety by enabling closed-loop prescribing. Using scanning technologies, medications are checked at each reference point prior to, and at the point of, administration. This ensures the right patient is prescribed the right medication, at the right time. In doing so, pharmacists and clinicians can ensure that the treatment they are administering is both correct and safe.
The success in pharmacy has been evidenced in Royal Cornwall Hospitals as part of a project led by chief pharmacist, Iain Davidson. With real-time prescribing and dispensing data received from each scan, pharmacists were instantly notified by a technical check alert to any potential errors when prescribing or dispensing.
Overall, prevented error rates in dispensing were reduced from 0.78 per cent to 0.19 per cent, with dispensing time reduced by an average of five seconds per item, releasing valuable staff time and capacity.
Standardisation in procurement
Inventory management, ordering stock and managing product recalls within a trust is no easy feat. E-procurement and inventory manager, James Mayne, at University Hospitals of Derby and Burton NHS Foundation Trust, led a team to adopt GS1 standards for theatre optimisation.
Each time a piece of equipment or a product was scanned to be used during a procedure, the data was captured and kept on record. This also applied to all the staff in the room and the location itself, which were also scanned to enable them to trace each element of the procedure.
Their inventory management, product catalogue and financial systems were also integrated so that each was automatically updated in real time, and an order generated for the supplier. This improved stock visibility, allowed them to keep a tighter control on costs and reduce wastage. The result was a total saving of £2.8 million by the end of April 2018.
Standards for the patient journey
At Leeds Teaching Hospitals NHS Trust, GS1 standards were applied to facilitate real-time patient tracking throughout the hospital. Stuart MacMillan, then Scan4Safety programme lead for the trust, managed the allocation of Global Location Numbers (GLNs) to each of its 22,303 trust locations.
On scanning both the patient and the location identifier, the patient location was automatically updated on the electronic ward whiteboard in addition to the patient record via the trust’s electronic patient record system.
As a direct result, traceability and patient safety were improved, saving valuable clinical and administrative time that would usually be dedicated to updating records or physically locating patients.
Live case studies
Taking place at the Radisson Blu Edwardian at Heathrow on 9–10 April, the GS1 UK Healthcare Conference will bring together national leaders and senior-level trust executives from trusts across England who are leading the way in standards implementation.
With more than 60 speakers and 30 sessions and practical workshops across both days, the two-day agenda is made up of a mix of keynote speakers who will be reviewing the overarching strategy for the NHS, along with operational and clinical staff working in front-line care to bring these case studies to life.
Aligned with the current developments in national strategy, day one focuses on the theme of patient safety through open standards adoption with day two building on this to cover the use of technology in supporting patient safety.
Professor Sir Terence Stephenson, former chair at the General Medical Council, will open by highlighting the importance of standards in improving patient safety, a theme that with will underpin the rest of the core conference content.
The morning will then continue with keynote presentations from Matthew Swindells, deputy chief executive at NHS England, and Tom Denwood, director of data and integration at NHS Digital. They will both be sharing their perspective on the value of standards in healthcare.
Six esteemed chief executives from trusts and ICSs will then take the stage to discuss the importance of GS1 standards to the trust board, before handing over to a panel chaired by Professor Andrew Goddard, president at the Royal College of Physicians. The panel will seek to explore what wider standards adoption will mean for the clinical workforce.
Day two will begin with a keynote address from Professor Ted Baker, chief inspector of hospitals at Care Quality Commission, providing a regulatory view on driving standards within hospitals.
Lord David Prior, chair at NHS England, will then follow to deliver a state-of-the-nation address before moving on to keynote case studies and a live CCIO roundtable.
Afternoon breakout sessions scheduled for both days will focus on specific application areas where standards have been adopted, providing a detailed view of the present use and future potential of open standards in healthcare.
GS1’s role in healthcare’s future
Implementation of GS1 standards is a critical component required to successfully future-proof the NHS. As the focus on integration in healthcare gains momentum, the work of GS1 UK will become central to enabling the standardisation of data across systems and organisations, facilitating widescale interoperability.
These open standards enable organisations to make greater cost savings by increasing visibility of inventory management processes and streamlining purchase-to-pay processes.
Through the unique identification of every patient treated, every product used, and every medication administered, GS1 standards provide clinical staff with an additional patient safety measure.
Ultimately, organisations can ensure they are getting their processes right on the first time of asking, preventing delays in supply and patient care.
The beauty of GS1 standards lie in their simplicity: a single scan captures data that can be used on multiple occasions. Better care really can cost less, and the benefits are achievable for all.
Mid Cheshire NHS Trust’s ageing IT estate was causing significant problems. Amy Freeman, the Trust’s Associate Director of IT, identified a number of challenges that needed to be addressed when she joined the organisation in 2016.