Despite recent announcements the NHS digital focus remains on 3 main areas… it’s clear it’s time to up our game and get on with the job!
Andy Kinnear, former NHS CIO and now Independent Consultant, reflects on how NHS England’s digital focus is now clearly rooted in 3 main areas, topics which were reflected at this year’s HSJ Digital Transformation Summit.
The key areas of digital focus of the soon to be published 10-year-plan are becoming clear and these topics were keenly discussed at this year’sHSJ Digital Transformation Summit in February. The 3 focuses are EPR Optimisation; the Federated Data Platform (FDP); and the NHS App. These have all been in play for a while but the emphasis is now moving from introduction to optimisation. The aim is to deliver the maximum benefits and ROI which have long been promised, and to address, through the effective use of technology, some of the main issues being faced across the organisation.
Enabling clinicians to be more effective
The better and wider use of modern technologies which have already been implemented is being seen as one of the key ways to address many of the performance issues identified inLord Darzi’s state of the NHS report from Autumn 2024. With EPRs now in use widely across the NHS in England, it is necessary that the NHS must now pivot from EPR deployment to EPR optimisation to maximise the investment in our installed base and improve the experience of our frontline clinical colleagues.
Darzi identified that “how long people wait, and the quality of treatment, are at the heart of the social contract between the NHS and the people”. The problems cited include the fact that “people are struggling to see their GP” and that ”waiting lists for community services and mental health have surged”. The optimised usage of the digital technologies we already have and the adoption of AI solutions, within ethical boundaries, can make a major contribution to improving performance, increasing efficiency and easing the burden on a fatigued workforce. There are increasing numbers of successful projects and case studies across the NHS in England and from healthcare providers around the world which can act as exemplars, we just need to take the leap of faith and get on with the job.
Go deeper and wider
The ongoing research studies from the KLAS Arch Collaborative, which focus on improving clinicians’ experience of EPR systems, identifies that clinicians are much happier and effective using EPR solutions if they feel that they have ‘mastery’ of the technology. With heavy workloads it is the path of least resistance for users to just skim the surface of the functionality provided by any IT solution, but with EPRs we need to go deeper to deliver the best outcomes.
As an example, think of your own usage of Microsoft Office products such as Word, Excel and Powerpoint or their equivalents. We can all ‘get by’ knowing the basics but this means we are not being as effective as possible nor are we maximising the efficiency-return from decades of investment in deepening the functionality available. Our performance is not what it could be and we are left with unease that we do not have ‘mastery’ of the solutions. This means we are not empowered to innovate our processes to address challenges such as waiting lists, enhancing face-to-face care and workforce burnout. It is the responsibility of IT professionals in the NHS and technology vendors to help drive the ‘mastery’ of their solutions into the workforce.
The evidence clearly demonstrates that organisations which invest emotionally and financially in helping their frontline clinicians to become expert users in the EPR have much higher rates of clinician satisfaction and reduced burnout. One of the great legacies NHS England leave behind is the KLAS Arch Collaborative survey results across the nation. With the 2024 survey results about to be published we are the only country in the world to have this nationwide picture of clinical satisfaction in EPRs. A very powerful tool if applied correctly. As well as going deeper by educating and encouraging staff to utilise more EPR capabilities, we can also go wider by increasing the application of solutions to more users, more processes and more locations. A prime example here is encouraging mobile access to EPR and other digital healthcare applications. Mobile takes solutions to the patients wherever they are ensuring data and functionality is available at the bedside and outside traditional hospital boundaries such as in clinics, ambulances and in social care contexts. This removes disconnects in healthcare processes and the lack of access to data for display or update.
Be bold… but safe!
As digital solutions have matured and proved themselves in real life situations around the world, it is perhaps the time for the NHS in England at national, regional and local level as well as regulatory bodies to be bold and increase their appetites for risk or we won’t gain the most efficiencies possible from the evolution of technology.
AI is increasingly able to perform more healthcare-related functions such as tests and diagnoses, so let’s be bold and build it into our checks and procedures, of course with the right safeguards and ethical guard rails in place. Ambient voice technology is coming on in leaps and bounds. The ability for AI to generate medical notes and follow up letters automatically in near real time could save so much time for clinicians, not only reducing their workloads but also enabling more face-to-face time with patients rather than tapping data into keyboards.
AI has to be deployed sensibly, carefully and within proven practices though. Patients could be forgiven for seeing an AI health system as a vague picture of cyborg doctors and robot carers, but it is just the next step in the evolution of process improvement enabled by IT which has been going on for over 70 years. Indeed, there has always been evolution and modernisation in healthcare and the ethical guard rails are there for us to follow. It’s true change may be accelerating but with the right ethical framework and openness to innovation we can make significant progress in improving our healthcare provision.
Removing the drudgery and reducing workloads for staff by being bold in deepening and widening the use of technology, much of which is already in place, can only be a good thing if ethical boundaries are adhered to. It’s not about replacing clinicians, it’s all about increasing their quality time with patients through the optimisation of what technology can add to processes. If we can substitute AI driven processes in a way that supports a clinician to spend more time caring for the needs of the patient then this is a good thing all around.