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On April 30, 2018

By Shane Tickell

With 2020 now firmly cemented in our minds as the target to achieve the paperless NHS agenda, it’s easy to forget that 2018 was initially identified by government as the year in which our beloved health service would relinquish its use of paper.

Whilst the deadline has moved forward and there has been some tremendous progress with the agenda – clearly outlined in the updated Five Year Forward Plan – my vision for the health service hasn’t changed. I still don’t want an entirely paperless NHS, just yet anyway.

To aspire to this goal in two years is to misunderstand how the NHS operates and how it should interact with some of its most vulnerable patients. It’s also short-sighted when it comes to adopting technology, and why we caution our customers against it. Digital is not an end in itself, but a tool to redesign clinical pathways, respond quicker to service demand, integrate with other health and care services and ultimately, future-proof the NHS.

What we need to achieve is digital blueprinting – the widespread adoption of NHS success stories that are delivering truly transformational change.

Paper vs software

As a father, husband, and patient I have seen and experienced many different parts of the NHS. I have always been humbled by the passion, commitment and selflessness displayed by staff; from the nurses who cared for my parents in their end of life, to the midwives and obstetricians who ensured my wife and four children survived pregnancy and childbirth, and the hundreds of NHS Ambassadors making small-scale changes for large-scale impact during The Academy of Fabulous Stuff’s Fab Change Week.

Having also worked with the NHS for around 25 years, I know first-hand how tough it is for staff to meet ever-increasing demands on services under such significant financial and operational challenges. And how technology is already helping overcome many of these challenges across the country.

So why is it, that some of my most intimate interactions with the NHS have been in care settings that are ‘paperless’, yet they have healthcare professionals using paper towels and post-it notes to record observations and write out medical notes?

It’s because these organisations – who are aspiring to meet #Paperless2020 – have lost sight of the real goal, and in turn, overlooked the purpose of digital.

It shouldn’t simply be about replacing paper with software. This evolutionary step won’t deliver the changes required to drive out unwarranted variation, improve workflow and productivity, and ultimately give our doctors and nurses more time to care for their patients. Instances where it is simply used to improve current ways of working, are instances where you see staff reverting to type and developing paper-based workarounds, like post-it notes and paper towels. There is no excuse for using paper where digital is readily available, but if people prefer paper, then the digital solution is not yet good enough! And either doesn’t map to the needs of the user, or the users have not adapted to more efficient modern ways of working.

Controversially, we will hit Paperless2020, HIMMS Level 7 in some areas of the country, but adoption and saturation will inevitably take longer, and that is okay to a point. We are trying to digitise not just one of the biggest organisations in the world, but also how it interacts with thousands of other agencies associated with the lifelong care and support of tens of millions of citizens, over many decades. With no two individuals requiring the same treatment. The computational maths of this is mind-blowing!

Revolution not evolution

What’s required is a revolutionary change. In the same way that the iPod completely transformed the way we use, consume and buy music, electronic patient records must be used as a tool to redesign the way healthcare professionals triage, diagnose and treat patients.

It’s why ‘revolution, not evolution’ is part of our mantra at IMS MAXIMS.

It is what led us to make our EPR software open source in 2014. It was a business risk given the minimal understanding of open source in the NHS at the time, but a calculated one made with the courage and vigour of a company committed to encouraging innovation. We have spent several years working with the NHS community to bust myths and inform providers of the advantages of taking a different, revolutionary approach to digital. And I am delighted to see it paying off with pioneers such as Taunton and Somerset NHS Foundation Trust, Wye Valley NHS Trust and Blackpool Teaching Hospitals. They are reaping the benefits of a paper-light environment designed around a programme of transformation, as envisioned in the Five Year Forward View, and now can achieve over £100 million of service benefits and cash savings.

With similar intentions, we developed our first Bedside management app just ten days after the launch of the first iPad in 2010. We wanted to give nurses and doctors a new and better way to manage their caseload and treat their patients. Our app was the number one downloaded health app across the globe at the time, and eight years on, we’re rolling out multiple apps, designed by clinicians, for clinicians and patients.

Our preference is to succeed fast, as opposed to fail fast, and improve from there. This has allowed us to provide a product platform with a world-class baseline standard of which each individual organisation can then use to improve upon, benchmark from, share best practice locally and internationally.

But technology alone isn’t enough. In fact, drawing on a famous quote from Steve Jobs, ‘Technology is nothing {without} people…if they’re good and smart, and if you give them tools, they’ll do wonderful things.’ The point being, that innovative technology must be useful and usable if we are to see a step change in the user’s mindset too.

Blueprinting for transformational success

It’s why initiatives like the Global Digital Exemplar (GDE) and Fast Follower programme are so important. The scheme presents a significant and tangible opportunity to change the current mindset by helping NHS staff see how technology can unify and transform services.

Charged with this opportunity as a GDE partner, we have been working with our customers to develop an IMS Blueprint that can be easily adopted at pace and scale. A tried and trusted model, based on 32 years of partnering with the NHS, that gives healthcare providers the necessary technology and change management support to achieve the intended benefits of the ‘paperless’ agenda in a truly transformative fashion.

Specifically, our Blueprint will:

  • Support trusts in becoming digitally mature – up to HIMMS Level 7 – quickly and cost-effectively
  • Help achieve £100m+ of digitally enabled service benefits and financial savings
  • Deploy standardised patient pathways to help reduce unwarranted variation in clinical outcomes, and achieve Lord Carter’s Productivity Recommendations
  • Support Sustainability and Transformation Plans and Local Digital Roadmaps in delivering fully integrated care over a timeline that suits individual budgets and needs
  • Offer opportunities for shared digital investment to help manage the cost and risk of these important transformation programmes

Digital blueprinting is the next natural step to help revolutionise the NHS, and most importantly, ensure our digitally advanced hospitals provide us and our loved ones with the best possible care. But only together, with the collective ambition to make it possible by 2020, will we achieve truly transformational success in healthcare.

 
  • Blueprint, Digital transformation, Fast Follower, Global Digital Exemplar, HIMMS Level 7, IMS Blueprint, Local Digital Roadmaps, NHS, paperless, STPs, Taunton and Somerset NHS Foundation Trust, Wye Valley NHS Trust

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