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Policy-makers and employers are predicting big savings with new technology to bring ‘efficiency’ and better patient care to UK health services. But will this be another false IT dawn?
Picture the scene. A person deemed at risk of heart attack awakes at their home. The information is relayed to a nearby healthcare facility, where the individual is added to a watch list. As their vital signs decline, an emergency team is being prepped to whisk them to hospital.
There, computer-aided surgeons and can offer a cocktail of therapies and medicines tailor-made for the individual based on a detailed database of their specific needs.
This depiction is currently, as HCSA members will recognise, far closer to science fiction fantasy than it is medical reality. But for how much longer?
The march of digital miniaturisation, wearable and mobile technology and the “web of things”, where each technological device in our homes is interconnected via the worldwide net, means such innovations will become increasingly embedded into the world of medical science.
One study last year by PriceWaterhouseCoopers – albeit on behalf of the not disinterested global mobile phone operators’ organisation GSMA – suggested that developed nations’ health systems could net a $400 billion (£260bn) saving by 2017 simply through more intelligent use of mobile devices such as tablets and phones.
With that scale of saving apparently at stake, in the context of a wider £22bn NHS “efficiency” drive, an aging population, and the push for seven-day services, it is little wonder that UK policy-makers appear to have pinned their hopes partly on new technology.
Recent months have seen a renewed publicity push in this area, for many years dominated within the NHS by the failure of major IT projects aimed at the Holy Grail of a “paperless” system – most notably the disastrous, defunct £12bn National Programme for IT, branded one of the “worst fiascos ever” by members of the Commons Public Accounts Committee.
NHS England chief executive Sir Simon Steven’s NHS Five-Year Forward View stated that the aim is now “to raise our game.”
“Technology is transforming our ability to predict, diagnose and treat disease,” it noted, adding that a particular focus would be placed on hospital systems, where the NHS has historically “oscillated” between “highly centralised national procurements and implementations” and “the opposite extreme of ‘letting a thousand flowers bloom’.”
The result “has been systems that don’t talk to each other, and a failure to harness the shared benefits that come from interoperable systems.”
This analysis has prompted a significant shift of approach, one where national schemes focus mainly on successful interconnectivity between systems commissioned locally in line with common data and functionality standards.
Responsibility for co-ordinating NHS technological developments has been passed to the National Information Board, whose working group meets six times a year and includes key NHS organisations, local government, regulators and the Department of Health.
The Five Year Forward View gave a tantalising glimpse of the possibilities that harnessing and pairing different technologies may bring, envisioning the equipping of “house-bound elderly patients who suffer from congestive heart failure with new biosensor technology that can be remotely monitored” and “can enable community nursing teams to improve outcomes and reduce hospitalisations.”
Secretary of State Jeremy Hunt added to this vision, declaring that he wanted “patients not just to be able to read their medical record on their smartphone but to add to it, whether by recording their own comments or by plugging in their own wearable devices to it.”
But navigating to this brave new world will not be plain sailing. Last month it was revealed that health workers had been using their personal smartphones and other devices to share information on patients, underlining concerns over the security of sensitive data. So too did reports that third-party mobile phone apps officially approved for public use by NHS Choices contained “security holes” that allowed personal data to be siphoned off.
Days earlier Cambridge University Hospital Foundation Trust had been pilloried by regulator Monitor over a £200 million IT project attributed as a key cause for a financial plunge – a reminder that the idea that new tech will be a miracle cure for NHS finances should be treated with a (un)healthy pinch of salt.
In the HCSA’s own stress survey last month frustration with the IT systems used by our members in hospitals was highlighted as a key cause of workplace stress.
Yet nevertheless the technology rollout locally and regionally is carrying on apace – a seemingly unstoppable steamroller, accompanied by targeted funding via the Integrated Digital Care Technology Fund.
So whatever the barriers, new technology is set to change drastically and permanently the way in which we and our health system work.
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© Hospital Consultants and Specialists Association 2013
The Hospital Consultants & Specialists Association is a professional association and trade union affiliated to the Trades Union Congress.