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Electric Patient Records, where are we and how did we get here?

Electric Patient Records (EPR) aren’t new technology, the healthcare industry has long been aware of the benefits and availability of EPR. Initiatives were launched over a decade ago to start the introduction of EPR into the UK healthcare landscape.

So where are we now? 

Let’s go back to 2007, a decade ago. The Government launched the National Programme for IT in a bid to start rolling the digital snowball that would revolutionise the NHS and leave us with an efficient, paperless environment. Healthcare professionals could in theory, get a centralised view of patient data, both current and historic, instantly.

This was set to be a huge step forward in utilising digital technology as it was intended; to make life easier. It meant less misdiagnosed patients, accurate medication in a timely manner and a better overall user experience. So, what went wrong?

After a £12bn investment from the NPfIT, a target of 155 EPR systems established was set for the end of 2007. The number achieved was just 16. Those who did receive new systems experienced crashes, complete malfunctioning or an inability to connect EPR with other systems, so where did they turn? Back to paper.

So, we were left with a huge step backwards. Not only did it cause damage to the organisations involved but it strengthened the view of ‘why fix what isn’t broken’ amongst many healthcare professionals. Paper isn’t efficient and does leave room for mistakes but it will never crash or malfunction. It got worse; in 2010, the Coalition Government decided to scrap all the EPR work they started and put individual NHS organisation in charge of their own EPR initiatives.

Electronic health records

Focusing on more recent times, it’s not all doom and gloom. Here in the UK we were one of the fastest adopters of EPR. UK GP practices are the leaders in the digital healthcare boom, 95% of practices have some form of electronic records and are utilising digital technology successfully. The same can’t be said for hospitals just yet; In 2015, it was reported that just 50% of UK hospitals were using electronic records, this stat probably comes from small-scale operations.

The USA has seen better growth, despite a disappointing 16% adoption across hospitals in 2010 they quickly progressed to 76%. This was helped by a Government drive to change regulation in a way that would encourage digital adoption. We must bear in mind the UK NHS is probably feeling a little abandoned by the UK Government.Without the incentive, we won’t see a rush towards digital anytime soon.

Let’s not forget the recent cyber-attack on this year. The Telegraph described the NHS as ‘crippled’ by the ‘biggest ransomware’ offence in history. Naturally, this has left both NHS and public opinion towards a completely digital approach a little dented. It won’t be easy to restore public or professional opinion, uncertainty will linger for a long time to come.

Reports from the US have shown that for the UK to be successful moving forward engagement and training of staff need to be fundamental in digital deployment. Strong leaderships is also a crucial part of the transition. Leadership this is being introduced in the form of chief clinical information officers (CCIOs). CCIOs, wherever they are in the NHS need to have strong competencies in data analytics, management and health informatics. A much better level of autonomy must be established to encourage growth. High-level decisions need to be made accurately and quickly to avoid missed opportunities.

It is often overlooked in the development of any new process in healthcare is that digital platforms much be user centric. Once in place, the success of EPR will be dependent on how well front-line staff use it, or indeed if they are able to use it effectively. CCIOs need to work with the front line to create a system that works from the off, instead of patching up incoherent systems further down the line.

Overall, we’re on the right path but moving slowly. Everything started well but due to some sizeable setbacks, digital healthcare isn’t where it should be. The 2018 and 2020 predictions are looking unrealistic, but this doesn’t mean we can’t have made significant improvement by then.

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