PATIENT SAFETY
Frontline staff can help build digital health
Few would disagree that the most effective way to transform healthcare is to utilise the full benefits of digital technology – and indeed full digitisation could bring about new data-derived medical practices on both an individual and population-wide level. However, warns Phil Colbourne, Hyland EMEA healthcare director, these benefits will only be realised with the correct approach.
This summer, Britain’s Royal College of Nurses (RCN) published the results1
of a
consultation with nurses and midwives on what is needed for nursing to play its full part in the digital transformation of healthcare. The results were launched at a roundtable attended by digital experts and nurse leaders from organisations including NHS Improvement, Health Education England and the Council of Deans of Health. The RCN says that until the NHS takes full advantage of the expertise and views of nurses – the largest single staff group in the health service – it won’t be able to realise all the benefits digital technology can bring for patients and staff.
Almost 900 nurses and midwives took
part in the RCN’s online consultation earlier this year, with more than 100 more attending five in-depth focus groups held across the four countries of the UK. The results concluded that full digital health would remain “a pipe-dream” unless managers, technology providers and IT staff take more account of the views of nurses. The College’s eHealth lead, Ross
Scrivener, said: “In the weeks leading up to the 70th anniversary of the NHS, we’ve heard a succession of health care leaders arguing that the best way to transform health care in the UK is to utilise the full benefits of digital technology.
“But our consultation shows that that aim will remain a pipe-dream unless managers, technology providers and IT staff take more account of the views of nurses. “The responses to our survey reveal some depressingly mundane barriers to nurses’ full participation in digital transformation, from wifi that doesn’t work, to computers that take too long to log on. “The single most important theme to emerge from the consultation is that involving nurses in the design and implementation of programmes and
that resides in radiology. Data may be shared, but it’s the clinician that’s doing the sharing, not a system.
This is not just inefficient in terms of staff time. It inevitably means that a patient’s records are not fully available in digital form, and therefore valuable information will regularly be missed. Even in a hospital or clinic where all staff are committed to sharing data, most current systems simply don’t support many of the formats being used. This approach can never produce the kind of 360-degree patient view that a digital healthcare system requires. In order for patients to benefit from the advanced diagnostic possibilities – which machine learning and AI applications are starting to offer, for example – full interoperability is essential.
systems to improve patient care is not an optional add-on – it is absolutely vital.” The RCN is right. Indeed, if a digital transformation that is truly meaningful to both patients and the sector itself is to be achieved, it should be built by practitioners. Top-down solutions don’t work well in IT at the best of times. On a scale like Britain’s National Health Service, it would be a disaster.
Modern healthcare organisations
As a starting point, let’s consider where modern healthcare organisations are now in terms of digitisation. Enter any modern hospital and you’ll find that most specialist departments still operate a mixture of paper records and proprietary data storage systems. Often, the information they want or need isn’t available in the Electronic Medical Record (EMR), but trapped in separate data ‘silos’ in other departments, such as a CT scan
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It is helpful to define interoperability in a healthcare context. According to HIMSS, interoperability is the “ability of health information systems to work together within and across organisational boundaries in order to advance the effective delivery of healthcare for individuals and communities”. These fully interoperable systems should be developed with the patient in mind, and with care needs and excellence of practice at their centre. The real key to designing and implementing these, however, are the practitioners who currently use data systems and already have a need for improved sharing capabilities. For most organisations, the biggest stumbling block centres on imaging. Departments, including cardiology, radiology, ophthalmology and gastroenterology, manage their images in siloed systems, such as radiology picture archiving and communication systems (PACS), the cardiology PACS or other ‘mini’ PACS. The challenge with a PACS-focused strategy is the proprietary design and code sets of these systems. While DICOM has
NOVEMBER 2018
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