LONDON, UK – (HealthTech Wire/ Opinion by Phil Greenwood) - It was a result that many had foreseen, but September 2011 effectively marked the end of the NHS's centrally controlled journey into digitisation. The decade-long move to transform England’s medical records from physician’s scrawl to digital document was finally abandoned and NHS trusts are able to plan their own paths.
The truth is that digitisation is not an exact science. So it comes as little surprise to many records management specialists that a blanket approach to implementation did not deliver. However, it is important to remember that the problems encountered by the government were not a direct result of the decision to go digital. Put simply, the one-size-fits-all approach was just not a perfect fit. Effective digitisation, which sees the transformation of paper-based documents to digital files, very rarely requires digitisation of every single document in an organisation’s archive, and the NHS is no exception.
Each trust is unique
Just like every patient, each NHS trust has specific needs. Each requires specialist care and deserves a considered and informed resolution to its specific information management problems. Like a patient living with a chronic condition, each trust knows more about its problems than most consultants. Unfortunately, a ‘one size fits all’ system offers the exact opposite.
Simply deciding to digitise every single paper document in your possession is often as unnecessary as it is daunting. For digitisation to be effective, frequently accessed documents should be scanned and immediately available; whereas rarely accessed documents are more suited to being scanned on demand. This approach minimises digital conversion costs while still meeting access requirements.
While this system sounds relatively straightforward, working out which data needs to be digitised, and up to which point, varies dramatically from trust to trust. For digitisation to work at its best, the specific needs of each trust need to be properly assessed. For example, many trusts have found digitising records in A&E to be beneficial, as the quick access to records matches the fast-paced needs of the department.
Unfortunately, a failure to understand specific needs, especially if you have lost sight of the benefits of digitisation, often leads to a project that gets very expensive very quickly. Thankfully, the benefits of digitising the NHS have not been thrown out with the bath water. In tandem with the government’s decision to scrap the ‘one size fits all’ approach, a new strategy based on regional needs has now been announced.
This method is not only cheaper, but will be a much better fit for the majority of NHS trusts, allowing local health trusts and GPs to develop or buy individual computer systems to suit their needs. This freedom will naturally create a more bespoke solution and deliver a more successful outcome as a result.
Sometimes, when a mistake has been made, it is easy to lose sight of the good intentions. The government did not enter into the field of digitisation to make headlines or create extra paperwork — they did it because the NHS was seen to be haemorrhaging money, and digitisation was one way to stem the flow. Our tax-funded healthcare system may be a source of pride, but it does not come cheap. For the government’s ‘one size fits all’ approach to be deemed successful, it had to deliver £20 billion in savings.
Essentially, digitisation does save money, but it is not an overnight process. The trusts that are making digitisation work are implementing long-term strategies, often over a period of three to four years. This more gradual approach gives time for the savings to become apparent and the investment, and patience invested here can really pay off.
Money is not the only benefit to digitisation, especially in a profession which bases its very foundations on confidentiality. To put it frankly, there is no substitute for the peace of mind properly stored digital data offers. When in hospital as a patient, the security of your personal information is never going to be the main priority, but by looking after the basics, the bigger issues can take priority.
Evolution helps revolution
Change is always going to be met with some sort of resistance, and going digital is no exception. Often people see the switch to digital storage as a simple electronic conversion, when it should really be viewed as an evolution of record management. Most industries have relied heavily on paper documents since their conception, so a certain amount of reluctance is understandable. But when you are in the business of saving money, the old ways of doing things have to be challenged to keep up with the digital revolution.
As with all major changes, the benefits have to be apparent to be considered a success. Once completed, digitisation offers a trust lightning-fast access to its most essential medical records, while also reducing any reliance on long-term physical storage. In Britain, space always has been, and always will be, at a premium. If an average-sized trust moved all of their files off site, it could free up space for as many as 200 hospital beds.
Digitisation is not a simple business. It is not a simple change, and it is not an easy decision to make. It does not have the impact of hiring nurses on the front line, or the drama of trialling a new drug. But investing in patient care does not stop at buying bandages and medicines - it’s about seeing the whole picture and planning for the long term. The NHS needs to grow and evolve with technology in order to fulfil its main purpose – fair, fast and effective treatment for everyone.
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Source: Iron Mountain
Phil Greenwood is Director of Iron Mountain UK.
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