The NHS must radically overhaul the way it collects and shares data if patients are to be treated safely and effectively, according to a new report by the Academy of Medical Royal Colleges.
The report, titled i-care: Information, Communication and Technology in the NHS, sets out seven key challenges for achieving the technology revolution within the NHS.
The report has been developed in answer to the Secretary of State for Health’s ambition to make the NHS ‘paperless’ by 2018.
The seven key recommendations state that:
- Patient record must be both the cornerstone of integrated patient care, and the main source of data to inform the service.
- Patient record systems must be focused on the individual, not on the disease, intervention, service or the organisation in which the patient is seen, in order to provide an integrated picture of their problems and the care they receive.
- Clinical data quality and ease of data capture must be of paramount importance
- The structure and content of records must be standardised across the NHS
- Patients should be given appropriate, standardised access to their records
- The NHS must learn from the information it collects in the course of everyday care
- Professionals and patients need access to reliable information, from both the individual record and the knowledge base of healthcare.
While noting examples of good practice in hospitals, clinics and doctor’s surgeries, the report also reveals a healthcare system in which information is dispersed across sites in incompatible formats which are too often focussed on the illness rather than the patient.
In some cases, even electronic data transfer remains stuck in the 1990s, with some GPs unable to receive an email which is larger than 5mb. The result, all too often is poorer and less effective patient care and greater costs to the NHS as information is sent by post, courier or sometimes even via the patients themselves.
The report builds on a statement produced four years ago by the Royal College of Physicians and adopted by the Academy of Medical Royal Colleges which set out the ‘case and vision for patient focused records’. As the culture of openness and choice develops within the NHS the report says patients and their carers must also have greater online access to their own records, enabling them to be kept up to date and involved with decisions about the care they are receiving.
Commenting on the report, Professor John Williams, Director of the Royal College of Physicians Health Informatics Unit, said:
"Information is absolutely critical to the NHS. When you visit your GP, when you attend hospital, when you undergo surgery; all of it relies on high quality information. Today’s NHS information systems are way off the mark. This document sets out how we can realise the technology revolution.
"The Francis Report and Berwick Review both identified that the NHS has lost its way, and must be reoriented to deliver patient-focused, compassionate, safe care. Central to achieving this is the availability of real-time accurate information that focuses on the patient."
Professor Terence Stephenson, Chairman of the Academy of Medical Royal Colleges said:
"If the NHS is to continually improve patient care and safety it is essential that we bring our IT and communication systems into the 21st Century. Computer technology plays a huge part in medicine and is key way in which we can strengthen the patient experience. Poor systems could disempower staff leaving them fighting to deliver care effectively.
"The Academy is committed to working with Department of Health, General Medical Council and NHS England to produce and maintain informatics standards. But, it’s clear for the findings that doctors, clinicians, nurses need to raise their game too, and we are dedicated to ensuring that the necessary skills are acquired so that the Academy’s vision can be realised."
Health Secretary Jeremy Hunt said:
"It is deeply frustrating to hear stories of elderly dementia patients turning up at A&E with no-one able to access their medical history, or doctors prescribing the wrong drugs because they don’t know what drugs a patient is already on. We need to put this right.
"That's why one of my top priorities is helping the NHS meet the challenge of going paperless by 2018. Technology is key to helping our A&E staff meet the massive demand they face as the population increases and ages.
“We welcome this report - it will help make a paperless NHS a reality, and as a result it is set to make a real difference to NHS patient care.”
Download the Academy report here