PATIENT RECORDS
NHS crisis: beating the budget cuts
Digitising patient records is one sure-fire way trusts can deliver on targets to cut £850 million in costs by 2014. But the first step must be to create the business case for the switch from paper to electronic document management, says Sally Aquilina
W
ith a challenge to deliver savings of £850 million a
year by 2014, NHS trusts need to draw on every tool available to them - particularly those offering to make them more fleet of foot in delivering the required improvements in patient care, another key target.
It is no coincidence that electronic document
management (EDM) initiatives are rising sharply up the agenda for many trusts - given their ability to transform laborious and costly administration processes, while enabling step changes in the quality of healthcare provided. Currently, clinicians spend over 25% of their time finding, recording and communicating patient information, according to Audit Commission estimates.
The short-term challenge is justifying the budget to make the switch from paper to electronic document management. Yet this need not be an onerous task if trusts know where to look for rapid as well as longer-term savings.
Headcount reduction offers significant savings with
by multiple people at once - without administrative intervention.
EDM also plays an important role in income protection, too, avoiding the need to cancel or postpone surgery or clinics because of missing or incomplete notes. Similarly, it addresses problems associated with inefficient coding, enabling prompt access to patient notes immediately after treatment.
Strategic benefits
potential to reduce numbers of medical records staff, clinical administration staff and medical secretaries. This is because EDM removes the need to search for, retrieve, manage, file and transport files around the trust or to other sites, creating a significant saving in effort. A trust with 500,000 records and 30 full-time equivalent staff pulling files could expect to save more than £500,000 a year through headcount reduction.
Sally Aquilina Nov/Dec 10
Clinical administration staff spend a significant amount of time handling paper too, as they search for and track patient records. At a typical trust, over 30% of clinical administrative staff’s time will be spent on such activities. Medical secretaries, meanwhile, can spend more than a fifth of their time searching for and tracking notes. All of this time is being taken away from patient care and ensuring patient safety, where resources really need to be focused - and where government targets demand
more attention. By freeing up this time, trusts have more flexibility to redeploy resources and/or to cut from inflated administration overheads.
Saving on storage
A further significant area for savings relates to the creation, storage, maintenance and transportation of physical paper documents – an expensive and grossly inefficient business. Overheads addressed here include the cost of housing huge records libraries, use of physical off-site storage costs, transporting files between sites, and the cost of the physical files themselves, with the cost of individual folders, page after page of notes, the labelling and so on.
Not only are digitised files far less demanding of physical space, they are easier to back up and secure, quickly searchable and can be accessed from anywhere at any time,
In addition to the tangible productivity gains facilitated, digitising patient records provides a platform for the trust to meet important strategic objectives such as improving patient safety, clinical effectiveness and the patient experience – all of which have strict government targets attached to them.
Starting with an early ‘proof of concept’ is highly recommended as a means of testing expectations against reality, across all key points of benefits measurement, and ensuring that targets can and will be met. Successful EDM deployments rely on the right ratio of boldness to pragmatism.
The trick is to make the transition as natural and painless as possible, while staying focused on the end goal. A cast-iron business case is the Trust’s friend here, mapping out exactly where the wins will come and when, while keeping overly lofty expectations in check.
Sally Aquilina is a senior consultant at Kainos
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