Helping the NHS focus on what matters: how to free up back-office manpower

Hospitals across the UK transformed their working practices this spring in order to cope with the massive surge in patient numbers that resulted from the COVID-19 pandemic. Non-essential surgery was postponed, wards were divided into “red” and “green” zones to avoid cross-contamination, and the new Nightingale field hospitals were constructed to accommodate less serious cases of the virus.

The UK government relaxed some reporting requirements in an attempt to relieve hospitals of some of their administrative burdens, but with many staff self-isolating or sick, this still left a great deal of paperwork to be managed by smaller teams. Patient records needed to be accessible by both clinical and back-office employees – never more so as an increasing number of hospitals established special teams to handle the queries that flood in from concerned families and friends – while documentation relating to equipment orders, invoices and deliveries became more crucial than ever.

This process has been easier for those organisations who had already begun to implement programmes of digital transformation before the coronavirus outbreak. A number of NHS Trusts had already recognised that at the heart of achieving an efficient, shared online record system lay the ability to capture the right information in the first place.

Not just a scan

Although many health organisations had already adopted scanning systems in order to store all paper-based documents electronically, this frequently consisted of simply capturing the image of the document. Without the manual input of contextual data such as patient record number, invoice number or some other identifier, the image would be completely useless. A clinician might scan in an update to a medical record, but further human intervention would be required to link this to a patient, a doctor, a laboratory or an entirely different medical unit. In the meantime, a letter from a GP relating to the same patient might arrive by email, requiring an equal level of manual intervention.

The same problem can apply to other unstructured documents. Invoices, purchase orders or delivery notes also arrive in a variety of different formats and demand time from back-office staff to convert them into meaningful information.

Make AI do the filing

Real efficiency can only be achieved when everything from admission forms to discharge summaries, and from purchase orders to delivery notes, can be categorised automatically. The technology to do this uses Artificial Intelligence within the scanning process. Instead of simply capturing an image, the software can look at the document, compare this against its own knowledge base and draw a conclusion about what type of document this is. In a clinical context, that might encompass anything from anaesthetic notes to referrals and observations.

The next stage is to extract essential information from the document. In the case of medical records, these might range from NHS number or case note number to date of birth or even pharmaceutical reference codes. Using text recognition technology, the software can capture these details and convert them into linkable fields, thereby adding the context that transforms a two-dimensional image into three-dimensional information. In the words of one NHS Trust IT manager, “Now you can tell that X is the same as Y.”

Putting it all in context

Artificial Intelligence is not instantaneous; it takes time for the software to build its understanding of different types of documents and to learn the range of identifying codes, text or numbers. As it does so, however, the amount of intervention required decreases steadily, until finally, it’s possible to put a record into a scanner and simply press “go”. Anything that the software is unable to identify definitively will be flagged and passed to a human for verification.

The result is a bank of electronic information, not simply a folder full of images. Instead of time being spent pulling files off shelves and delivering them to the other side of the hospital, it can be devoted to scanning, validating and reviewing patient records. Administrative staff can devote themselves to delivering smoother patient journeys, while clinicians can be confident that they have all the information that they need about a patient in one place, instantly. And that means better patient outcomes.

A vision for the future: collaboration across all services

Ultimately, we believe that the integration of records across the entire healthcare community will be achieved – between hospitals, GPs, social care, hospices, community services and possibly others. We still have a long way to go, but the COVID-19 crisis has reminded us how much we depend not only upon our NHS but upon our care system – and we owe it to the frontline staff to give everyone the infrastructure they need.

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