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Clinicians told to embrace digital technology
Doing nothing is no longer an option when it comes to clinicians embracing digital technology and information.
That was the clear message from Beverley Bryant to the Sustainable Healthcare Conference staged at the King’s Fund.
NHS England’s Director of Digital Technology told delegates: “There are two jobs: to put technology into the hands of patients and to make sure health and care is joined up to itself.
“We already have 100 per cent of General Practices digitised so they have electronic records. And we have eight million people signed up to getting GP appointments and repeat prescriptions online. The third area we are looking at is offering patients access to their records. We are working to drive this digital service up.
“This is giving GPs more time by allowing patients to manage their own conditions.”
But she sounded a word of warning, adding: “We need to embrace technology. Clinicians need to use it. We need to get rid of fax machines and white boards and paper.
“It’s no good anymore to sit back and do nothing. There is no point in putting technology into the hands of patients if, when they see their doctor, they get asked all their details over and over again. We are going to make this a priority and the NHS is waking up to it.
“Patient information needs to be transferred into social care settings so it is available when people leave hospital. It’s a hard slog, it’s not going to be easy. But it’s about transformational change and we need to do this for the benefit of our patients. We need to move to a paperless healthcare system.
“This is not about replacing face-to-face consultations for patients and doctors, it’s about adding to them.”
The conference came as a one-year-on progress report was issued by the Sustainable Healthcare Steering Group.
In its update, the Steering Group calls for:
- A fully funded plan for how NHS digital systems will be made interoperable.
- The creation of a list of NHS endorsed apps
- Enabling people to navigate the health and care system so patients always know who their main point of contact is to meet their changing health and care needs.
- Patients being able to access and co-manage their own health records, and allow records to be accessed by other health or care workers when appropriate.
- Health professionals have the tools and training to encourage both shared decision-making and supported self-management, particularly for people with long term conditions.
Dr Martin McShane, NHS England’s Director for Long Term Conditions welcomed the report, saying: “It’s an exciting report and says all the right things. It will help create a far more sustainable NHS by moving care upstream, by moving the focus towards individuals, communities, prevention and pro-active care. “
Dr McShane also took part in a panel debate at the conference, telling delegates: “I’m a big fan of digital technology. It is redefining the professional role and we need a whole new range of skills and a way of working.
“We need to invert the system and move away from conditions, specialisms and specialists. We must move towards the Patient Activation Management system and have clinicians support this. What I’ve seen in the 21 century has been exciting and has seen clinicians coaching patients and making them a co-producer in healthcare.”
Baroness Julia Cumberlege, who is a co-chair of the Sustainable Healthcare Steering Group, and is currently heading the Maternity Review, said she agreed with the coaching of patients.
She also sounded a note of warning over bureaucracy surrounding the NHS, saying: “We have been looking at maternity care in Sweden – the safest place in Europe to have a baby. But Sweden doesn’t have a GMC. It doesn’t have a CQC. It doesn’t have Royal Colleges. We have all of these organisations on top of us and I don’t think we can afford all these organisations anymore.”
For digital technology to work across a “NATIONAL” NHS, to support staff caring for patients that can and do move around the country, we need shared, defined and agreed data standards and a robust infrastructure. Infrastructure can be resolved with money (something the NHS doesn’t have!) but getting agreement on data standards, specifically for clinical data, is a much bigger hill to climb.
The Royal Colleges could justify their position in a digitally enabled future health service by creating, managing and owning the data standards for their disciplines.
Digital technology slows down my OPDs, makes it harder to deal with multi-morbidity – and I work in a speciality dealing with multisystem disease. It is a total disaster for my work. If I only deal with one problem – as GPs increasingly do – then I fail my complex, immunosuppreseed patients with lidfe threatening disease. Yet it is becoming imossible to access Resp / ophthalmology / gastro / neuro letters on the same patients due to the impossibility of finding them in the digital morass. Tis like Google – no-one looks beyond the first page. The filing of digital letters is also a disaster zone – with the people who couldn’t file paper now unable to ‘file’ electronically.
The old whiteboards didn’t need electricity – didn’t stop working in a power cut (we recently had 4 hours with no access to a list of patients on the ward / who was in each bed, right after another day with the same for 6 hours). Darn sight better for global warming…….
We send discharge letters electronically – and patients come and tell us GP’s never received them.Fax machines work. People physically receive the letter and even better – act on it, as opposed to just another ignorable bit of digital overload.
Paperless = faceless numbers = uncaring. See NEJM articles re the impact of electronic records on the quality of patient interactions – interestingly, one was written by one of the founders of the electronic systems in USA.
I have not yet seen any improvement in care other than in access to Xrays. The quality of referral and discharge letters has fallen – they are no longer worth reading on many occasions. Patients are shocked when they do access them – because there is no longer any useful information in them. So yes – quick – uninformative and useless.
Oh and the reason for asking details again – they are frequently recorded incorrectly eg the lady who had 2 hysterectomies 20 years apart, the lady with one child – who actually had 4, and the man whose carcinoma wasn’t included – so he burst into tears when I asked re past history. And the Dr / nurse who has just got it plain wrong – or taken the history from the inadequate discharge letter written by a person who had the wrong history……..
May I please have a link to the report?