Further development of electronic patient records (EPRs) and virtual wards are going to be key elements of the transformation of England’s health service, according to one of its top officials.
Dr Tim Ferris, director of transformation at NHS England and Improvement, presented his thinking on the issues at the Digital Health Rewired conference in London yesterday.
He acknowledged the already important role of EPRs but said there are still gaps to fill on a national scale.
Referring to when he moved into the role last year, he said: “The most surprising thing is that I didn’t understand the level of digital maturity across the NHS. The current state is patchy with amazing examples of digital excellence and progress that is world beating in terms of the delivery of services and digital infrastructure.
“But there are also places that have very few systems, and I think 19% of acute trusts don’t have an EPR. That’s not OK in this day and age.”
Availability priority
He said the advantages to patients of electronic systems are now so well established that it is a priority to make sure they are available everywhere to ensure clinicians can see the same information.
“It is not a one size fits all, but converging is helpful for patients and for clinicians,” he said, adding that patients have the expectation that everyone treating them will see the information.
He highlighted the importance of that virtual wards as having the potential to play a major part in dealing with the capacity in the NHS, as they make it possible to monitor patients at home and provide communications them and clinicians in real time.
Where there are safety issues that have to be carefully attended, he said there is analysis showing that between 20-30% of hospitalisations are not because the patient is unsafe, but because it is the most convenient way to deliver a treatment.
“What if we didn’t need that but were monitoring you in a way to make us confident, and that if things go in the wrong direction we can quickly get you into a hospital, that would make beds available as we are taking care of the non-critical things in your home,” he said.
“Doing this right is a big deal. The delivery of any healthcare service must be done very carefully and this is a big change. But the greatness is that this country’s been experimenting with this for years already ….. This isn’t new, and the technology and processes are there, but we need more scale, and the secretary of state has announced putting in significantly more resources.”
Data architecture and interoperability
Ferris also highlighted the importance of data architecture and interoperability in the sector, saying the response to the Covid-19 pandemic have shown their value in enabling rapid improvements in care, but that the data has to be handled with care to ensure it is only shared under specific circumstances with the patient’s approval.
He said the circumstances of the pandemic provided a stimulus for innovation in the use of data and interoperability of systems, and that there now has to be an effort to find a way to sustain the momentum.
Ferris was speaking as a consolidation of the main transformation organisations for NHS England is in progress, with the digital policy unit NHSX having recently been absorbed into its transformation directorate and NHS Digital on course to follow.
