The importance of technology in the NHS
Digital Health Beverley Bryant, Director of Digital Transformation at NHS Digital on the importance of technology in the NHS.
Beverley, how do you view the current state of technology in health and care?
I think that, historically, people have sometimes used technology to solve information gaps at a system-wide or organisational level. That’s looking at things the wrong way, without enough thought paid to the end users - the people that really need to use this information or these systems.
Everyone in health and care, including suppliers and developers, all need to be coming at this from the same angle - how you are going to solve a problem for the end user?
That means three things:
- Technology has to be useful. What’s the problem it’s going to solve? How does it help the clinician or manager do their job?
- The next is usable. Modern design principles need to be adopted to make sure tech is as intuitive and easy to use as possible.
- The third lens is that it must be used. We need to train and coach people to become comfortable with technology, or there’s no way they’ll give up their clipboards and paper.
The current buzzword is interoperability, which I prefer to think of as joined up information. We need to make sure that when information passes from one organisation to another it does so through a common interface that improves accessibility. If getting access to information means going through multiple interfaces, each with different screens and logins, it starts to get burdensome, and frankly, is unlikely to be used
Timely information is also a priority. Having things like booking information, referral information or discharge information transferred in a timely manner starts to feel like good customer service. For example, patients are sometimes told to attend their GP for a follow up appointment after leaving hospital. Yet they get there only to find out their discharge letter hasn’t been received by the GP, and they have to come back a few days later. That’s frustrating for everyone.
What would a joined-up health and care system look and feel like?
Information about the patient or citizen needed for diagnosis or care would be available at the fingertips of the clinician or whoever is doing the caring every time. It wouldn’t matter where or when that had first been put into the system – potentially life-saving information would be available whenever and wherever it was needed and would be shared safely and with the right legal and security frameworks in place.
What technologies could help to realise this vision?
We have a mixed picture across the NHS. In primary care, everyone’s information is held in a computer system. That information gets reviewed curated and added to by the GP and forms the basis of their everyday work.
In secondary care – hospitals, mental health services and so on – a lot of information still swirls around on paper. It’s therefore quite difficult to achieve connectivity between primary and secondary care.
A big priority for me is getting everybody off paper and onto a standard digital format so that patient data can start transferring electronically.
Looking further into the future, what might we expect?
In the future, we’ll be able to work directly with the patient using telehealth, wearables, handheld devices and so on. For example, the patient could contribute to their own records and their own care by taking blood pressure readings and adding them to their records. Making the patient an active participant is what I’d like to do. Though we need to get the basics right in connecting health and care to itself first.
How do you feel the patient experience can be improved?
A simple one is referrals. Often, after a GP has referred you to hospital, patients get a letter saying “Your appointment is at X time Y date.” It’s difficult for a patient to say “that time is no good for me”. That results in missed appointments. The technology already exists to help put this right in the form of the national e-referrals system, but we need it to be used everywhere, by everyone.
How will digital health companies and suppliers help?
They will play a massive part. Our job in NHS Digital is to develop some of the national products and services that enable information to flow around the system – for example, the Spine and e-referrals system I just mentioned. But it’s really a federated system, and the NHS needs to be working with the market to help them design products that interact and interoperate with these national systems. We’re not here to do it all ourselves or to force a one size fits all approach. I think that there’s a lot of good innovation coming out of the private sector, particularly SMEs. The TSA and Tech UK are working with us to help us reach those innovators and introduce them to the NHS so that they can really add value.
How can technology make healthcare more cost efficient?
People often think technology is the answer to the efficiency question. And to a certain extent, it is. But for me, that’s not the driver. The driver is improving the quality of clinical information at the point of care. When a patient’s sitting in front of you, and you know instantly whether you can or can’t administer a certain drug, that’s potentially life-saving information. Getting things right first time, decreasing the number of times a patient has to be seen does introduce efficiencies. But the main reason we need to get health and care joined up is so that that clinical quality, patient safety and the patient experience can be improved.