Dr Shaun O’Hanlon, chief medical officer at healthcare software provider EMIS Group
The digital technology that exists today has the potential to transform the way patients receive healthcare, but it’s vital that NHS teams don’t put the cart before the horse by starting with solutions rather than understanding the challenges.
What are those challenges? To build a more joined-up, efficient and patient-centred service in which patients are asked questions just once as they travel through the health system, and those they interact with always know their medical history and why they are seeing them.
We also need to minimise the potential for errors to deliver better, safe clinical care and to encourage patients to see themselves as true partners in their care.
There is no doubt that we have the technology to allow us to achieve these goals. However, the task we face is not only about technology, it’s about getting buy-in from users and changing behaviours in the NHS.
Changing behaviour in the NHS
Existing ways of working are often difficult to modify and this can hamper effective implementation of new systems - even when they promise greater efficiency and a more streamlined workflow.
For example, when it comes to the way patient records are stored, shared and accessed, individual specialists across the NHS can have very different views of how their patients’ data is used.
It isn’t only the behaviour of healthcare professionals that needs to be considered, but that of patients. Video consultations have the potential to revolutionise the nature of contact between health professionals and patients, but it’s important not to underestimate how deeply ingrained traditional processes can be.
If the behaviour of the individuals in the process is not managed with appropriate guidance, leadership and training, it will be impossible to implement new technologies effectively, no matter how well designed the IT solution or service might be.
The critical point is that buy-in from the people that use and depend on the system is essential.
So how can we get their buy-in? The answer is that a holistic view is required which always stays focused on solving or alleviating real patient care challenges. Purchasing and attempting to implement any IT service or solution without proper consideration of the bigger picture in which it will sit is unlikely to lead to a successful outcome.
Effective implementation of new technology
The first step in any IT upgrade process should be a review of current practices and performance, and this should be done in partnership between users and an IT systems expert. This should be a regular and on-going exercise in order to ensure technological capabilities keep step with the evolving needs of both organisation and patients.
It’s important to move away from the mindset of purchasing standalone hardware or software products, towards implementing services and solutions that tackle specific challenges, taking into account the existing ecosystem of technology and people already in place. A good IT partner will be able to help with this, providing experience-based consultancy to ensure important barriers are not underestimated or overlooked.
I’m not going to pretend the process of change will be straightforward, or that there is any kind of one-size-fits-all answer. The challenge the NHS faces is to tackle very complex IT challenges on a tight budget.
However, it remains true that what budget there is needs to be focused in the right areas, and that means addressing the obstacles in the business processes themselves, rather than taking piecemeal sticking-plaster initiatives that attempt to make the best of sub-optimal working practices.
Where there is a budget for technological improvements, in almost every case a sizable proportion of it should be spent on change management.
Training and support for users right through the process and detailed monitoring and analysis to evaluate how effectively the service or solution has addressed whatever challenge it set out to tackle are both essential.
The technology available today gives us access to a set of tools that have the potential to revolutionise the way the NHS delivers patient care, making it more efficient, secure and patient focused. With the right approach to change management in the NHS, we can put these tools to work and create a better healthcare system for everyone.
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