What does the paperless 2018 vision do for reputation of health informatics?

I read with interest a quote from the chief information officer of Bedford Hospital in Computer Weekly this week on whether the NHS can hit the paperless target: “I think going paperless by 2018 is a good aspiration, but totally paperless is just too big an ask,” he said. The quote, which was taken from an interview last year, seems to be reflective of the scepticism the health secretary Jeremy Hunt is facing in meeting his ambition to see digital information fully available across NHS and social care services.

At a time when the need for technology in healthcare is arguably at its highest, since the pressure on NHS is greater than ever before, how does the 2018 target impact the perception of IT supporting our clinicians? What will be the sentiments of patients, health professionals and the wider public if the target is not reached?

Healthcare IT has had a rough ride in terms of trying to deliver the clinical and operational benefits that are possible. Understandably, there are cultural, financial, and technological barriers to adopting technology in any healthcare setting. Frontline staff will know first-hand the difficulties of trying to use new systems; they often work in demanding environments where there is little time for IT training and are used to operating within an existing process that they are comfortable with, which can result in resistance to change.

Furthermore, hospitals that greet visiting friends and families of patients with signs that say: ‘You may experience some delays due to IT training today’ only adds to the perception that IT can be at times more of a hindrance than a help to the health service. Lagging behind other industries in terms of technology, patients continue to be frustrated that information is often unable to be passed quickly and securely through multiple care providers when required.

When you add the personal experiences of clinicians and patients in engaging with technology to the widespread media coverage of failed IT projects such as the National Programme for IT and the controversy surrounding care.data, then public perception remains cynical. Former Department of Health clinical audit advisor, Sean Brennan suggests in his book ‘The NHS IT Project’, that the perception extends to areas of the NHS as well, and that failed IT projects “have led to a nervousness among NHS chief executives when any suggestion about clinical IT rears its ugly head”.

Whilst the media, especially mainstream, is quick to cover the failures of healthcare IT, the exposure for the numerous successful projects that have been delivered over the decades remains in the shadows. Therefore it is difficult for the general public to be able to grasp the complexities of delivering a major IT project. However, the paperless vision has put IT firmly back on the mainstream agenda. Hunt recently talked up the importance of IT, saying that safety and technology are key to surviving the NHS’ squeeze.

Innovations in modern medicine, including the use of genomics to deliver personalised care, are likely to grab the headlines in the mainstream media, for example, over a patient administration system deployment at a major trust, as this poses more of an interest to the general public. But as we near the paperless target, the spotlight will be firmly on the state of healthcare IT and whether it is delivering efficiencies and innovations in coordinating patient care across multiple settings.

Whether or not the paperless vision is met, there is a renewed focus on the benefits IT can deliver. This means that a better understanding of how central IT is to healthcare, can only improve the reputation among the UK’s many stakeholders. As part of the announcement for the vision, Hunt added: “Only with world class information systems will the NHS deliver world-class care.” That is the reputation healthcare IT strives for.

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