(BJ-HC/ Vox Pop) – The size of projects and lack of funds is often a cause of slow implementation of technology in the NHS says digital healthcare consultant Louise Wall. Technology should support and enhance working processes and clinicians should be given time to review, develop and implement new ways of working.
Why have healthcare organisations generally been slow at investing in technology to help nurses do basic tasks more efficiently?
There are a number of reasons. Many of the IT projects are looked at on a considerable scale, and rely on large numbers of people to be engaged and co-ordinated- often not knowing where to start. The current Sustainability and Transformation Plans (STPs) are encouraging large scale change and technology adoption but this will need to be balanced with the requirement for successful engagement and robust implementation plans at a local level. The key to success in many cases is where projects can be broken down into smaller more manageable work plans and there is clear accountability for incremental change which eventually leads to system wide adoption.
Many IT projects require significant upfront investment in order to deliver cost savings, improve outcomes and ultimately enhance patient experience. Lack of available funding is a key contributor for slow technology implementation. With the NHS about to post one of the largest deficits in its history, focus is on tackling the immediate financial and operational pressures. There is a risk that funding set aside for technology investment will be re-routed to alleviate the individual deficits as well as potentially changing the destination of funds from the centre. According to Wachter, the funding set aside by the government is ‘insufficient’ and there is a need to make more funding available outside of the £100m set aside for the Digital Exemplar sites.
Culture also plays a huge part in this area of discussion. There is regular commentary regarding the cultural fear of failure in the NHS. Many successful companies outside of the NHS embrace failure and take calculated risks in a bid to deliver successful change. They tend to recognise that effective change is a process of iteration and learning. There is a need for strong leadership and for the digital exemplars to share best practice on a wide scale if healthcare organisations are to be successful on their digital journey.
Despite programmes such as NPfIT, as recently as 2014 a study identified the amount of paperwork and repeated paper form filling as a serious concern to nurses across the country. Why is this still an issue?
It is recognised that our nurses are overly reliant on paper-based processes in an age where technology can replace many of these to deliver enhanced efficiency and productivity.
We cannot forget that the key focus for clinical staff is to deliver the best care to the patient and they are often under immense time pressures. Whilst the appetite is there for a move to become more digitally advanced, the gap remains between the vision and finding the time to initially review and ultimately deliver some of these technology projects.
The move away from paper will rely on the ability to achieve successful clinical engagement in order to truly understand clinical requirements as well as that of the patient experience. Technology should be rolled out to support and enhance working processes, whilst at the same time giving the clinicians time to review, develop and implement new ways of working. With the current strain on resources, the question remains at which the speed of digital maturity and the ‘Paperless 2020 initiative’ will be met by the NHS as other factors take precedence.
What are the key factors in adopting technology that truly benefit nurses and the care they provide to patients?
There is no question that much of the technology widely available will enhance the working practices of the clinicians and the lives of the patients they treat. Safety and quality of care are high on the list of potential benefits, with a range of technology available to help prevent “never” events and reduce errors.
Healthcare outcomes can also be improved with the move towards patients taking an active role in their own health and care, leading to less reliance on the current under resourced healthcare system. Technology plays a vital role in this shift of responsibility, meaning nurses can support the patient with remote monitoring, faster and more accurate diagnosis and treatment plans.
New technology can be used to enable nurses to deliver integrated care by having systems that can share information across care settings. The speed in which clinicians can access important patient information to inform and facilitate treatment is also a significant benefit to adopting available technology.
We live in an age where clinical staff should have access to the best available technology in order to work more efficiently and effectively, to deliver care in a safe and resourceful manner.
Louise Wall is the managing director of e18 Consulting. She started her career in the private sector where she was responsible for the account management of some of the largest UK retailers, such as Tesco and Waitrose. Wall moved into the healthcare industry over 10 years ago and in 2015 set up her own consultancy business. The company partners with sector leading companies offering innovative digital solutions in order to deliver both direct and indirect savings to the NHS.