NHS IT- where’s the evidence?

Over the past few weeks it’s felt like the NHS has faced unprecedented amounts of criticism. While visiting Scotland not long ago, I read the headlines as Scottish NHS Incident Reports were uncovered by the press with the key message being that one in ten people who go into hospital are harmed at the fault of the NHS. These figures not only conveyed the pain and anguish so many patients and families suffer but also a legal bill of more than £120 million a year in compensation and legal costs for the NHS and in turn the taxpayer.

This story was of course followed last week by the equally concerning BBC Panorama programme ‘How safe is your hospital’ which detailed how poor patient care is putting thousands of people at risk. It drew on some of the conclusions from Dr Foster’s report, which highlighted that while there have been improvements on last year’s statistics there are still ‘excessively high death rates’ in at least 12 NHS trusts.

Following these broadcasts, Twitter filled with numerous messages that healthcare professionals “should not be blamed,” that “demand was increasing” and “resources are sparse” and that eventually “something is going to have to give.” Healthcare IT experts tweeted their frustration that many of the tragic errors reported, such as incorrectly prescribed medication, may have been prevented had the trust been making the best use of technology.

After spending several years writing about healthcare IT, I would like to think I am familiar in understanding the benefits of technology in healthcare. So I started to question why so many trusts are yet to realise the benefits that healthcare technology can bring. Is it that they aren’t aware of what is available to them, do they simply not have the funds to invest, or do we still have a long way to go to get healthcare professionals across the board to accept that many NHS IT systems are PROVEN to reduce errors and in turn fatalities?

So I turn to the internet and wonder ‘if I was your average healthcare professional looking to know whether technology will really make a difference to my patients what would I Google…?’

Let’s start with the basic search – ‘IT reduces patient deaths’ I get nothing. Ok, let’s try ‘technology reduces patient deaths’, the first few items in the search come as news stories and just four out of the twenty have any link at all to technology and reduction in fatalities. Three of these four are actually the same story.

The scholarly articles offer a little more substance, the first finding that the “introduction of clinical decision support and better linkages in and among systems, resulting in process simplification—could result in substantial improvement in patient safety.” (Bates, 2001). The second concludes that “information technology interventions have great potential for reducing the frequency of errors [particularly in paediatrics]” (Kaushal, 2001). The third (more specific research into how IT for patient follow-up and chronic management of HIV and Tuberculosis in poor areas) by Fraser 2007 says “Effective information systems in developing countries are a recent innovation but will need to play an increasing role in supporting and monitoring HIV and MDR-TB projects as they scale up from thousands to hundreds of thousands of patients.” However it adds: “More quantitative evaluations need to be performed on the impact of electronic information systems on tracking patients.”

While I recognise that is a reasonably narrow search, the findings are exceptionally limited. Anyone looking to find this information would certainly have to delve a lot deeper and what they would almost certainly find in doing so is weak, outdated, broad and often US focused evidence that IT can reduce errors and in turn patient deaths.

So my question in raising this is, is it time for the Department of Health or even suppliers to put some real funding into research that demonstrates the benefits of healthcare IT to patient care and patient safety. Moreover, is it time to collate the evidence that is already out there in such a way that it is easy to find for the people who know least about it?

One of the key drivers in recent months to implementing IT systems has been around clinical engagement, and rightly so, but just think of the difference it might make if those end users were already convinced of the value of IT by relevant, hard evidence.