Creating a completely ‘paperless’ NHS with fully interoperable IT is an issue keeping tech leaders awake at night.
Given that IT issues run deep within the healthcare system, it is a goal that could be out of reach for some hospitals.
This isn’t helped by the fact that, despite commitments to improving NHS IT, we currently have a string of ‘paperless’ targets that have been pushed down the road. Paperless 2018, 2020 and 2023 have come and (almost) gone.
The Department of Health and Social Care’s ability to overhaul NHS systems has wavered significantly since the heavily-criticised National Programme for IT was launched in the early noughties.
At the time, the government spent billions trying to deploy IT systems across NHS trusts. The programme was plagued with technical problems and had to be abandoned in 2011.
So, there was understandably a pretty underwhelming response when Health Secretary Sajid Javid announced another paperless NHS target last week – calling for 90% of trusts to have an EPR in place by the end of 2023.
But it could be different this time.
While this may seem like an ambitious target, we must remember that the NHS is already in a strong position here. Most hospital trusts – 80% – have an EPR in place, so now the focus will be on bringing the remaining 20% up to standard.
This could be supported by the new approach from the NHS Transformation Directorate – which calls for ICSs to draw up plans for a converged or single EPR.
These convergence plans have ruffled some feathers in the digital health world; some have said the process of aligning workflows might be too time consuming and expensive.
However, the new approach could help remove a significant bureaucratic hurdle.
Procuring an EPR is often a long and complicated process that can take years. The time could be shortened if a trust takes an EPR from a neighbouring provider. Not only that, but many EPRs in place are market-leading. Although a long way from perfect, the quality of the NHS’ EPR footprint compares well internationally.
The new approach seems pragmatic and is backed by a large amount of government funding. This could provide the final push needed to digitise the remaining 20% of trusts.
However, the purchase of an EPR is just one part of the process. The success of an EPR depends on its implementation.
Organisational, human and technological factors all need to be addressed. Trusts will need assurance that they will receive the right support to make sure new systems are implemented robustly.
Clinical leadership and staff training are essential elements for successful deployment. User needs also should be understood, and NHS has carried out an extensive EPR usability survey that can inform implementation.
The remaining trusts have never been in a better position to on board an EPR, providing the right support is in place.
And whether or not the target is reached this time round, the progress made will be another huge step forward for NHS IT. This could finally spell the end of paper-based patient files, while saving hundreds of hours of staff time.