EFFICIENCY
Brendan Major, healthcare consultant at Kainos Evolve, explains how mental health services must be integrated in order to improve.
If
the Government’s vision for transform- ing the nation’s mental health is to be
realised, services will need to be better joined up and patient records managed more uniformly and efficiently as they are passed between carers.
In February this year, the Coalition an- nounced a new cross-government strategy for improving the nation’s mental health. The ‘No health without mental health’ pro- gramme is considered a major step forward in removing taboos associated with mental illness. One of its main aims is to elevate the status of related conditions so that they receive the same attention as physical ill- ness and injury, in the way cases are priori- tised and assigned resources.
The new policy, which sets out to enable more decisions to be taken locally, takes into account the necessary interconnec- tions between mental health, housing, em- ployment and the criminal justice system, acknowledging that more natural collabo- ration between such organisations could transform outcomes for patients.
Investing to save
The ‘business case’ is robust. Poor mental health costs the economy £105bn annually. By intervening at an earlier stage, this fig- ure could be dramatically reduced. Success, however, relies on a more joined-up, con- sistent and efficient service.
Elsewhere in the NHS, similar initiatives are already well underway, many of them centred round the electronic patient record and a streamlined system for handling information digitally so that information bottlenecks and silos cease to be a problem.
At an acute level, this is relatively straight- forward to achieve, because the param- eters of care, the processes involved and the information being recorded are rela- tively consistent and predictable. There is typically a beginning and end to a pa- tient’s treatment, while the steps taken and prescribed treatment are typically finite and measurable. Once all of this has been flowed into an electronic document man- agement system, efficiency and patient care improvements inherently follow.
In the mental health field, the situation is
more complicated. Here, most services are delivered in the community, which means there isn’t an obvious central hub at which data can be consolidated. There are also more taboos associated with mental health, requiring that patient records are treated even more discreetly – and for that matter discretely, in that a patient may be happy for their GP to know they are bipolar but not the surgery nurse who is known to them personally. This requires data secu- rity and access to be managed at a granular, document-specific level.
Clarity from confusion
Then there are the records themselves. Diagnoses, treatment and ongoing moni- toring of mental health cases are likely to be based to a large extent on talking-based sessions, which result in free-form text such as handwritten note-taking, as the cli- nician or counsellor probes for indications of improvement or deterioration in the pa- tient’s condition. This information must be combined with records of any medication being prescribed. Care pathways may not follow an easily predictable sequence or have a clear end point either.
The value in applying more streamlined systems that harness digital technologies is potentially significant. The ability to con- solidate patient records in a single place, which is easily accessed by all authorised
clinicians and support workers dealing with an individual’s case, could transform that person’s care. Specifically, it would address information black holes, ensuring that the latest version of a patient’s file is readily accessible at the point of need at any given time (rather than lying in a brief- case in the back of a therapist’s car).
Any EDM solution will need to have been tailored to suit the unique needs of mental health care, to ensure that its capabilities are fit for purpose. Intelligent indexing of unstructured content, for example, could enable clinicians to identify patterns – say, in the language used by patients dur- ing talking therapies. Rules could be set to highlight repeated use of red-flag terms such as ‘violence’, ‘harassment’, ‘intimi- dation’ and ‘aggression’, recognising that these are all variations on the same theme.
That the Government has officially recog- nised the importance of the role that men- tal health services play in society is an im- portant milestone. The next step must be to work towards a more connected infrastruc- ture to join up complementary services in a more consistent, efficient and effective way so that evasive early action can hap- pen - and at a local level where the biggest benefits are seen.
FOR MORE INFORMATION
Visit
www.kainos.com/evolve national health executive Sep/Oct 11 | 41
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104