The Government’s announcement in February of £4bn-worth of funding to create a truly paperless NHS by 2023 has brought this issue back to the forefront of everyone’s minds. A paper-free health service has been talked about for years, but this latest push and size of the budget for new technology shows how serious the Department of Health is about making it a reality.
Moreover, rapid technology advances are enabling healthcare to shift to a more data-driven approach that leads to early treatment. The systems used within healthcare need to be able to support this – part of which involves removing the inefficiencies surrounding paper documents from the NHS.
More than simply electronic patient records
Much of the media coverage has centred on the electronic patient record, as it’s the most visible part of a digital health service. But there is much more to a paperless NHS than this alone. The patient record is a coming together of information from a variety of sources, such as GPs’ notes, test results, referral letters, data analysis and integrated care data.
To create paperless patient records, each area that feeds into it also needs to be fully digitised and, more importantly, able to share information securely with the other areas.
Plan now for 2023
This may seem like a tall order, when you’ve already got systems in place that weren’t necessarily designed to integrate, some of which may only have been procured recently.
However, if you start planning now, you can work towards your paperless vision in manageable steps, making the most of what you currently have and procuring new systems as part of a carefully thought-through plan as old ones reach the end of their lives.
Remember: with the five-year lifespan of most IT systems, everything you procure from now on will need to play a part in your paperless vision. A plan is more than a nice-to-have; it’s crucial to your ability to meet the Government’s paperless goals and the needs of new and future healthcare practices.
How to plan your paperless pathway
Planning your pathway to paperless needn’t be a long-term exercise. Given the appropriate attention, it can be achieved in weeks.
Because the outcomes of the planning will affect every future buying decision you make, we strongly recommend you pause all current procurement while you draw up your plan. This will help you avoid procuring something now that won’t interface with the rest of your estate in a few years’ time.
High-level capabilities: what do you need?
The first step in your planning should be to consult people across your organisation to define the business-level needs you have if you’re to deliver paperless. From here, you can define the high-level capabilities. This is about the ‘what’ and the ‘why’, not the ‘how’, so don’t worry about the technology at this stage.
Start with your management team – the CEO, CIO and chief clinicians. Then meet with other stakeholders, including your clinical staff and IT department. If you have it available, it’s also worth reviewing any relevant patient feedback you have about your services.
Lastly, think beyond your own organisation: could you work with other NHS Trusts to share the costs and benefits of the capabilities you require? Talk to them, to find out what they’re doing in this space and where you could save money by collaborating. After all, they’ll be facing similar challenges to you.
Time for technology
With the high-level capabilities agreed on, you can start to explore the technology you’ll need to deliver them. What types of applications will you require? Are there cloud-based ‘Software as a Service’ (SaaS) options available or coming soon, or will you need to procure something and operate yourself in the traditional way?
Think about the servers and storage infrastructure you’ll need to operate these applications. If you’re going to use cloud, what shape does this need to take? Do you simply need the bare infrastructure, or a fuller platform? If cloud isn’t suitable, consider the respective merits of using a specialist co-location data centre versus your own, in-house data room; colocation is typically cheaper, more secure and lessens the burden on your IT department.
Your target enterprise architecture
With all of this information, you’ll be able to map out your target enterprise architecture, with all the applications and supporting infrastructure you’ll need to deliver fully integrated paperless services by 2023.
Your next task is to review your existing architecture and set out a timeline of when things will reach end-of-life. It’s likely that some elements can contribute towards your vision in the meantime, so look to make as much use of them as you can to get the best possible returns on past investments.
Five-year procurement plan
Once you know what will need replacing when (and with what), you’ll quickly be able to put in place a five-year procurement plan to replace end-of-life systems with new ones that deliver the capabilities you’ll require for your paperless organisation.
You’ll probably find that many systems you currently run from your in-house data room will move to the cloud on a pay-as-you-use basis. This will lead to a significant change in the way you budget for services, because you’ll no longer face big capital expenditure (and the governance that goes with it) every few years. Instead, you’ll transition to a smoother operational expenditure model, which will make it easier to plan ahead and budget accurately.
Remember the people
A paperless NHS isn’t just about technology. Delivering it will rely on people right across every Trust. Clinical and other staff, for example, will make much more use of technology, including tablets and other mobile devices. This will mean your IT department needs to support whole new areas that technology currently doesn’t touch.
This will put much greater strain on your IT team and budgets. To mitigate this, think about ways you can reduce the burden on IT to free your teams up to be able to support front-line staff. Outsourcing the administrative functions of your IT, including the infrastructure, is one option that can significantly reduce costs and effort.
It’s time to act now
2023 may seem like a long way off, but if you’re to play your part in meeting the Government’s targets of a fully digitised, paperless NHS by then, the typical five-year lifespan of IT systems dictates you start planning for and building towards it now.
As we mentioned, planning your journey doesn’t need to take long and will give you a framework to guide every procurement decision you make over the next five years. It will help ensure everything works together to deliver your paperless vision. It will enable you to squeeze more value from everything you buy, meaning you can stretch your budgets further by doing more with less.
Most importantly, though, it will mean you spend less time thinking about and wrestling with technology and more time delivering world-class healthcare services that save and improve lives.