#14. W/c 2nd December '24
Alastair Allen
Partner, Head of Healthcare Technology at EY | Board Member at openEHR UK | Health and Social Care Council Member at TechUK
In this week's newsletter, there's a call for Epic to integrate with the NHS App, a study from BMC highlights patient and caregiver concerns about NHS EPR interoperability, and the Health Foundation highlights that most individuals are willing to share health data for developing AI in the NHS.? Meanwhile, the workforce challenge deepens, with a warning from a KLAS about the costly implications of clinician turnover, and top nurses emphasise that NHS reforms are futile without resolving recruitment challenges.? Finally, what does the future of digital health look like in Ireland following Donnelly's defeat?
‘Don’t buy Epic’ unless it integrates with NHS App
A senior government adviser has cautioned that the NHS should not engage further with the EPR supplier, Epic unless its future technology versions are compatible with the NHS App. The advice underscores the importance of seamless integration with the NHS App. It reflects a broader strategy within the NHS to ensure that digital solutions are cohesive and contribute to more integrated and streamlined experiences.
Patient and caregiver perceptions of interoperability in the NHS and its impact on care quality
A focus group study explored patient and caregiver views on the interoperability of EPRs within the NHS and its impact on the quality of care. The research highlighted that lack of interoperability often leads to negative health outcomes such as inaccurate medical records and impaired clinical decision-making. Participants noted that poor interoperability necessitates patients resort to workarounds like carrying paper records and repeating medical histories, which causes inconvenience and safety risks.
Many participants were unaware of EPR interoperability but understood its significance once explained. They expressed a need for better systems that allow seamless health data access and sharing, thus improving patient experiences and care coordination. Participants proposed solutions like creating a unified, centralised system with strengthened data security, integrating inputs from allied health professionals, and promoting patient involvement in managing their records to ensure accuracy and completeness.
This study's findings aim to inform better policy and practice, advocating for patient-inclusive approaches to improve EPR systems' design in future digital healthcare strategies. Recommendations for future research include exploring interoperability impacts on specific patient groups and enhancing data security measures to safeguard patient information as interoperability increases.
Most people are open to sharing health data to develop AI in the NHS
On a related note, one perceived challenge of wider information sharing is often trust and consent from people and patients. A recent survey by the Health Foundation indicates that 75% of the UK public is willing to share personal health data to aid the development of AI systems within the NHS. In mid-2024, the survey canvassed over 7,000 individuals aged 16 and above. Participants showed the most willingness to share data related to eye health (59%), medications (58%), and chronic illnesses (57%), while they were less inclined to share smartphone-tracked data (47%) and sexual health information (44%).
Dr Malte Gerhold from the Health Foundation emphasised that public support is crucial for the successful digital transformation of the NHS. He pointed out that AI, when implemented effectively, can assist NHS staff by handling clinical and administrative tasks, but it relies on high-quality data.
The survey also highlighted variations in data-sharing willingness across different socioeconomic groups. Individuals from lower socioeconomic groups (D and E), including those who are semi-skilled, unskilled, or unemployed, showed less support for data sharing compared to higher socioeconomic groups. Dr Gerhold noted the importance of engaging diverse social groups in the design and implementation of health technologies to prevent deepening inequalities.
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KLAS Report: The High Cost of Clinician Turnover in 2024
This new KLAS Arch Collaborative report on clinician turnover highlights a growing crisis in the healthcare sector, driven by burnout and dissatisfaction with EPRs. Almost half of surveyed nurses and physicians indicated a likelihood of leaving their current roles within two years, with actual turnover figures showing 21% of nurses and 13% of physicians departing their organisations.? These are significant, and worrying numbers.
Clinician turnover is costly, averaging $56,300 for replacing a nurse and between $500,000 to $1,000,000 for a physician. Key drivers include high levels of burnout from stress and workload, frustration with EPR systems due to usability issues and insufficient training, and a perception that organisational priorities are misaligned with patient care.
Read more: https://hitconsultant.net/2024/12/06/klas-report-the-high-cost-of-clinician-turnover-in-2024/
Reforms of NHS don’t stand a chance unless recruitment is fixed, say top nurses
On a related note, top nurses have issued a stark warning that the UK government’s proposed NHS reforms will not succeed unless the ongoing recruitment and retention challenges in the nursing profession are tackled. Despite a record high of 841,367 registered nurses and midwives as of September, the workforce remains "increasingly inexperienced" and reliant on international recruits. Recent data from the Nursing and Midwifery Council (NMC) indicated a declining trend in both UK-educated and internationally educated nurse joiners, coupled with a rise in those leaving the profession.
Prof Nicola Ranger from the Royal College of Nursing described the situation as "bad news for patients," pointing out that a substantial rise in early career departures exacerbates existing staff shortages. There are concerns about the drop in UK student nurse numbers and the slowing of international recruitment, which has traditionally helped fill staffing gaps. This creates a precarious situation for patient safety amidst soaring demand for healthcare services.
Dr Billy Palmer of the Nuffield Trust highlighted that the UK’s nursing workforce issues reflect deeper problems within the domestic education system, with specific areas like learning disability nursing facing critical shortages. Improvements in these foundational aspects are deemed crucial for the NHS reforms to make any meaningful progress.
Donnelly defeat: what now for digital health in Ireland?
In Ireland, Stephen Donnelly's defeat in the Irish general election has raised questions about the future of digital health initiatives in Ireland. As Minister for Health, Donnelly was pivotal in driving the digitalisation of health services, publishing the national digital health strategy and introducing the Health Information Bill. He believed that digital health solutions were essential for the reform of the healthcare sector, aiming to transition from hospital to community care and from sickness to prevention.
Despite his electoral loss, the commitment to digital health remains within the Department of Health, with Secretary General Robert Watt and HSE CEO Bernard Gloster being strong proponents of eHealth. They view digital health as crucial for improving productivity and cost-efficiency in the health system.
Read more: https://www.pulseit.news/irish-digital-health/donnelly-defeat-what-now-for-digital-health/
Director at BearingPoint
2 个月On a previous project for the NHS for patient activation, the feedback we encountered was something like "I thought my records were available across the NHS!". The NHS may be one brand, but the healthcare data is fragmented. We must fix this, the technology exists.
Honorary Professor in Engineering & Applied Science at Aston University
2 个月Thanks for sharing Alastair. Interesting article on patient and caregivers views on EHR interoperability.