The push for a paperless NHS can be one of the most meaningful and high-impact policy drivers of the next few years, says Eileen Milner

Eileen Milner

In setting out his vision for promoting the creation and effective use of digital patient records across the country, the secretary of state has brought to the fore the issue of how we can best use the huge amounts of data in the NHS for the benefit of patients, clinicians and commissioners.

This represents an opportunity to drive forward new, more open, safer and more cost-effective models of healthcare in the UK.

Although much good work, and considerable investment, has been made to make improvements in the way the NHS captures and utilises information, much remains to be done. However, the challenges are as much to do with culture, behaviour and expectations as they are to do with the requirement for additional technology investment.

Due to its scale and complexity the NHS is overwhelmed with the richness of the data sources that it holds. However, the value of these data sets is inevitably diminished by the absence of clear links and routes to bring them together, analyse them and utilise their full value.

‘The opportunity to save space and money by converting existing paper records to digital should not be overlooked’

This rich tapestry exists − what is missing, as Jeremy Hunt suggests, is the form and pattern to allow people to make use and sense of what emerges. So for the NHS the real challenge is to bring together some aspects of the jigsaw formed of disparate pieces. If connected and analysed properly, these represent the route to revolutionising the way in which clinicians, patients and commissioners engage with issues of performance, safety, outcome and cost and make better decisions consistently.

We expect the need for informatics in the service to grow dramatically over the next three years. The combination of large volumes of standardised data and intelligent analysis and presentation can yield significant quality improvements for patients.

Better decisions for patients

In 2011, analysis of the data collected by the National Joint Registry identified that the DePuy ASR artificial hip replacement had failed in an estimated one third of patients who had been followed for the longest time.

The NJR not only identified the problem but was able to immediately contact patients who had been fitted with the device to reassure them and take action if required. The issue attracted worldwide interest, including among clinicians in the US where 40,000 patients had received the implant and no such registry exists.

While our view is that the major benefit from more recording digital information at the point of entry is through the use of informatics to allow better decisions to be made on behalf of patients, the opportunity to save space and money by converting existing paper records to digital should not be overlooked.

Doctor using wireless technology

Storing, managing and accessing paper records is costly. Using online storage is far more cost-effective than running and maintaining physical storage spaces, in the form of running a patient record library or paying companies to store the records for you.

In the UK, the Audit Commission estimated that clinicians spend 25 per cent of their time searching for, finding, recording and updating patient records.

High-impact policy

A paperless solution can help hospitals save time and money − it is estimated that a saving of 10 per cent of clinical time spent on administration would release £6bn per year, which could be reinvested in patient care.

As we have seen across public services, better use of digital information can have very positive outcomes for providers and patients.

While the NHS has many examples of successful data management and informatics use, the next stage of transformation for the service requires that information continues to be not only collected but must be intelligently analysed and targeted for effective use.

With this in mind, the paperless NHS has the opportunity to be one of the most meaningful and high-impact policy drivers of recent times.

Eileen Milner is executive director for business strategy at Northgate Public Services