Cloud-based systems could transform NHS working practices and help it achieve QIPP initiative objectives, says Chris May.
The recent government review, which found the National Programme for IT “not fit” to provide the computer services it needs, underlines the urgent need for change.
But as the power to buy computer systems is handed down to local organisations, how can they ensure that they make procurement decisions that are fit for the new NHS landscape and deliver the cost savings and quality improvements required by the QIPP initiative?
Cloud computing is currently all the rage – at least outside the NHS. It is not a new concept and is already rapidly gaining traction in the private sector. The cloud allows users to access applications and data via a web browser with little or no software needing to be installed on local machines.
This is not the way the NHS has traditionally worked but the current overhaul of both services and associated IT has created a perfect storm of ideological changes for which a move to cloud technologies just might be the answer. Not only would cloud computing provide more options for a future health economy peppered with a mix of providers - but it is an approach to IT that could help the NHS make substantial cost savings.
Cloud based systems are already being used in some areas of the NHS. For the last ten years the National Cancer Action Team has used a cloud-based system to create a collaborative community linking every cancer service across the country. A similar system has recently been launched for end of life care.
More recently, patient records have started to move onto the cloud. The national Improving Access to Psychological Therapies (IAPT) programme has almost 100 per cent adoption of cloud-based patient management. Cloud technology is ideal for services which are community-based and where a range of organisations (NHS, local authorities, private and third sector providers) need to work together as an integrated whole.
However, the wider NHS has failed to grasp how cloud computing could be utilised to help make the revolutionary changes it seeks to achieve, particularly in relation to how and where care is delivered.
The NHS Confederation recently claimed that at least one in four patients would be better off being treated at home. The NHS, it claims, should focus on reducing hospital care, where appropriate, and shifting resources into community services.
This kind of care requires close co-operation between a variety of healthcare workers ranging from GPs to social workers and charities, and with the onset of the any qualified provider model the number of providers will soon increase. This kind of care cannot be delivered effectively without an IT infrastructure that enables staff to access and update patient records securely on the go.
Cloud computing enables authorised users to access and share patient records and other information remotely and securely from any location – which is key to underpinning more efficient ways of working and delivering the integrated care services that are at the heart of its reforms.
Already we are seeing emerging AQP services look directly to cloud providers for their IT. After all, if someone else is taking care of the applications, the hardware, the training and the user support, this frees up the AQP to focus on its core business: providing health services.
Not surprisingly, the biggest barrier to storing and accessing confidential data on-line is the perceived security risk.
When the aim is to share data to improve care coordination, there is inevitably a balance between accessibility and security, but the risks are primarily people-related, not technological. Cloud-based systems have been heavily adopted in other sectors over the last few years, and as such, the security measures that are available have become far more advanced.
The benefit of secure access to information via the internet is that it eliminates the need for transporting data on paper and portable devices, such as laptops and memory sticks: a practice that has severely damaged the NHS’s reputation in the past.
The benefits of cloud computing for integrated care are numerous but the good news is that this doesn’t need to come at a cost. Early indications are that trusts could save up to 80 per cent on system costs compared with traditional approaches. This is because associated costs for local hardware and maintenance are moved onto the cloud with the applications. Support too can be provided externally, all of which can benefit from significant economies of scale where IT provider hosts services for multiple companies
Implementations can be rolled out rapidly – within two weeks for some systems - with minimal disruption to the client. This is not possible with locally managed systems, which take much longer to install and commission. Furthermore, IT providers can make regular updates to cloud systems without inconveniencing users.
Cloud computing has immense potential for the NHS in these challenging times. It could help the organisation transform its working practices and enable it to achieve the cost and efficiency savings that are vital for its future.