Top digital advisor says there must be “some slack cut” for chief executives implementing electronic patient record systems

Robert Wachter highlights example of Cambridge University Hospitals Foundation Trust

’Failing to digitise needs to become a bad thing for a chief executive’.

A senior government technology advisor has said regulators must “cut some slack” to provider chief executives who are adopting digital systems if the government’s aim of a “paperless” NHS is to be achieved.

Professor Robert Wachter made the remarks during a Kings Fund conference on digital health and care yesterday.

He singled out the experience of Cambridge University Hospitals Foundation Trust, whose chief executive Keith McNeil resigned following a the publication of a damning Care Quality Commission inspection report in September 2015. In the report the CQC had made explicit reference to the trust’s troubled implementation of the Epic electronic patient record system.

Monitor also linked the trust’s deficit last year to the introduction of Epic.

Prof Wachter said: “The experience of Addenbrookes [which is run by Cambridge University Hospitals] is very important. If you have a bumpy initial digitalisation – and that is going to get you fired - I think that is a problem. I can tell you that in the US we spend a lot more money on digitalisation than you do or can… and all their implementations were bumpy because digitalisation is really hard to do. There has to be some slack cut for the chief executive in the early stages.

“One of the things that I’ve heard many times in the UK is that if you list the things that can get the chief executive of a trust fired, failing to digitise is not on the list.

“That dynamic has got to change if we are going to get trusts to digitise. If the system has decided and I believe it has, that ultimately, we’ll get a better, safer, less expensive system if we are all digital… then chief executives who take up the challenge, and go digital, need to be applauded and promoted.

“Failing to digitise needs to become a bad thing for a chief executive.”

Prof Wachter said adopting electronic record systems would lead to immediate safety gains by making it easier to move information around, and in making records accurate, and also make organisations more efficient.

But, he added, the “ultimate gain – the ability of the computer to help clinicians follow evidence based practice” – may take years, as systems such as Cerner or Epic do not have “decision support” tools for doctors built into them, and adding them can take years.

Using electronic systems to aid clinical decision making will led to “massive gains” in productivity and lower costs over several years, Prof Wachter said. “Unless you think your trust is not going to be in business in three or four years from now you’d better get started now.”

Prof Wachter is currently drawing up a set of recommendations for the Department of Health on the key challenges, priorities and opportunities facing the NHS in terms of planning, implementing and adopting digital technology.

His recommendations to the health secretary and the National Information Board are due to be published September 2016.