NHS: Paperless by next decade?

BCS Multimedia Editor Justin Richards takes a pragmatic look at the mechanisms underpinning Jeremy Hunt’s desire for a paperless NHS by the end of this decade.

In recent months Health Secretary Jeremy Hunt confirmed his aim to make the NHS go paperless by the end of 2017. However, haven’t we been here before? The National Programme for IT (NPfIT), launched in 2002 as an integrated electronic health records, appointments and prescriptions system, is widely considered to have been an expensive failure and ended up being shelved in 2011 due to escalating costs and delays.

One of the other big stumbling blocks that faced NPfIT was growing public concern over the handling of all this potentially sensitive data, which they understandably wanted to be managed in a safe and secure way.

Nowadays much of the health-related data is managed by external contractors based on anonymous industrial parks up and down the country and beyond.


The contractor point of view

Companies like Arkivum have provided data management services for the NHS for quite some time. As the CEO Guy Yaniv says: ‘We’ve worked in healthcare for many years and we have both clinical contracts with the NHS and also research contracts where the data we store is more research-based data for healthcare purposes. We specialise in working with healthcare institutions who generate a high amount of data and they need to preserve it for many years and the common ground is both clinical and research data.’

Reassuring, I’m sure, to the many naysayers of the digitisation of the NHS, is the fact that the management and storage of clinical data of all kinds has to meet with strict compliance regulations and those companies who are charged with its care have to take their responsibilities very seriously. As Guy states: ‘There is an ever growing need for compliance in the light of regulatory requirements around data compliance, especially for personal data. And we’re helping to facilitate that kind of regulatory issue by providing the encryption and safeguarding of data as needed.’

According to Yaniv: ‘The NHS has a clear programme of becoming more digital and paperless, and we’re part of that. At the end of the day our business focusses on the long-term archiving of that data. So we make sure that the data is safeguarded for many years to come, can be accessed in the right way, lives up to any security or compliance standards that the NHS has to meet, and alleviates any risk that you get with digital data.’

The encryption/availability enigma

Encryption is now very much ‘part and parcel’ of the management of sensitive data and clinical data is no exception. ‘One of the services we provide’, says Guy, ‘is that the encryption is actually owned by our clients so we are merely custodians of the data. It’s not our business as to what kind of data is being stored so our clients are able to access, to use their data, to decrypt the data using the keys that they’re using. We are not keeping hostage any sort of data.’

But with all these vast amounts of data, much of it large pathology files, one has to ask: how readily available is it to the medical staff who want to use it?

Guy Yaniv says: ‘Almost instantaneously. With the technology we have we learn from our clients what kind of data needs to be accessed more frequently; there are many tiers of being able to access data. So, in essence, when we are making data accessible, it’s by understanding what kind of data our clients would need, whether they are a junior doctor, nurse or researcher, so we can make decisions accordingly on how to store it and how accessible we should make the data.’

Conflicting timelines

So it seems that the digital revolution is well under way, often running along nicely under our very noses, but somewhat out of the limelight. However, even though Jeremy Hunt wants the NHS to be paperless by early 2018, following a review it was found that half of hospitals would not practically be able have proper digital records until at least 2023. Hence, regardless of the government’s intention to fund the project, to the tune of £ 4.2 billion over the next five years, a truly paperless, fully digitised NHS could still be several years away.

June 2019

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