BMJ 2015;350:h1142 doi: 10.1136/bmj.h1142 (Published 5 March 2015)
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Views & Reviews
VIEWS & REVIEWS IF I RULED THE NHS
Harness technology to produce real change Farzana Rahman locum consultant radiologist, University College London Hospital, and clinical adviser, Health and Social Care Information Centre I am amazed by technology on a daily basis. On my daily commute I use my phone to check emails while at the same time listening to a podcast and monitoring train updates. I also record the number of steps I’ve taken during the entire commute to assess my level of activity. I am not alone: on the rare occasions I look up from my phone everybody else appears to be doing the same thing.
and outpatient clinics, could log on to tablet computers to get up to the minute information for each of their patients. Updated information on patients’ location, blood results, wound hygiene, and nutritional status would mean ward rounds could be slicker, leaving more time for consultants to talk to and examine patients.
If I ruled the NHS I would make it a priority to use technology to help clinical staff improve the care they offer to patients. The days of painstakingly checking results for different patients from numerous different systems would be gone. I would set up a basic alert system that would transmit alerts to secure devices to inform the relevant team members that a patient had an abnormal blood result or that their computed tomography report was ready.
Such ideas may seem farfetched, but if we look at the strides made in other industries we can see that we are lagging behind in healthcare. So how to make this vision a reality? A first step is a unified, long term national strategy that involves clinical staff and encourages innovation. Data must be used and processed to help clinicians make decisions, not just to assess whether targets have been met. Encouraging collaboration with industry and thinking outside the box will help us to harness the potential of technology to produce real change.
Yet when I walk into a hospital the technological breakthroughs that are now part of our daily lives seem absent. Hospital computers are invariably slow, often with limited internet access and old versions of applications. NHS trusts’ intranet sites can be difficult to navigate, and the average hospital has at least three different systems storing patients’ information. Hospital data are collated locally and nationally, but we have to wait months, even years, before the data are published.
Every hospital system follows a simple algorithm that uses observations to help identify patients’ care needs. If observations were entered electronically this information could be processed automatically to give real time alerts to the relevant teams. Similar alerts with regard to nutritional status or infection risk could also be developed. Information would be easily available in a user friendly format to help clinicians make the best decisions for their patients. Consultants, between theatre cases
Dynamic, user friendly access to information would help managers as well as clinicians. It would allow better management of periodic bed crises, minimising disruption to patients. A dynamic map of the hospital would pinpoint which wards patients were on, nursing ratios on each ward, and each patient’s estimated time to discharge. Infection rates in different wards would be visually mapped to ensure that cases were contained as early as possible and vulnerable patients moved accordingly.
Competing interests: None declared. Provenance and peer review: Commissioned; not externally peer reviewed. Cite this as: BMJ 2015;350:h1142 © BMJ Publishing Group Ltd 2015 [email protected]
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