St Michael’s Hospital achieved a significant milestone in East Ireland’s journey towards digitally enabled healthcare by going live with an electronic patient management system in its Emergency Department (ED).
The new system will effectively make the ED paper-lite as the core clinical and administrative processes move from being paper-based to electronic.
And representatives from St Michael’s state that this was achieved with no disruption to patient care.
The new software, referred to as MAXIMS, introduces new work-flow processes that are intended to simplify and speed up core activities.
It is hoped that the paperless environment will contribute to better informed clinical decisions and enhanced outcomes for patients.
Following the successful activation of this system, the ED teams gain access to real-time oversight of a patient’s journey through the department.
Live tracking of a patient’s condition using alerts and warnings including life-threatening risk factors, means patients can be prioritised on their level of urgency, triage priority and length of stay.
It is also hoped that patient safety in the department will be greatly improved by using a single healthcare record for each patient, with the intention of seamlessly integrating this into the hospital’s other clinical systems.
Olive Vines, Emergency Department Nurse Manager, St Michael’s Hospital, is enthusiastic about the new system.
“Since the successful go-live, nursing and medical documentation have improved significantly, becoming clearer and more concise. Our workflow processes have become more efficient with the reduction of transcribing patient details into hand written referral and GP letters. Our need for storage of paper notes has also reduced and the introduction of an electronic version of the Manchester Triage system allows the ED to provide standardised patient priority allocation.”
Vines also suggested that the new system has aided collaborative working process at the hospital.
“Switching from a completely outdated, inadequate ED patient assessment and care documentation paper system to MAXIMS has been a dramatic change management project for the staff of St Michael’s ED. The transformation, however, has been a success because of the true partnership approach between us and IMS MAXIMS – from the outset and throughout we worked as one team.”
The next phase of the project will be to make the department completely paperless with the introduction of electronic order communication, assessments for specialist services such as the wound clinic, and e-prescribing.
It is hoped that this new system can be successfully migrated to other institutions and regions in Ireland in the coming months and years.
The Health Secretary Jeremy Hunt will announce plans tomorrow for a £4.2bn investment to create a ‘paperless NHS’.
With government departments generally embracing the digital revolution, it is hoped that the NHS can set high standards in this area.
Hunt will make a statement indicating that the investment in this department will enable the NHS to deliver superior and more convenient services.
It is also hoped that clinicians will be able to provide faster diagnoses, which will free them to spend more time caring for patients.
Full details of the funding are still being agreed between the Department of Health and NHS England.
But early indications are that £1.8 billion will be set aside in order to create a paper-free NHS, removing outdated technology such as fax machines from the health service loop.
In addition to this £1.8 billion investment, it is also anticipated that £1 billion will be set aside for cyber security and data consent.
This must be considered particularly important, as it has been made clear recently that IT vulnerability in the NHS is a concern.
£750 million will be invested in order to transform out-of-hospital care, medicines, and digitalise social, urgent and emergency care.
Finally, around £400 million will enable the NHS to construct a new website, develop apps and provide free Wi-Fi in all NHS buildings.
It has been confirmed that NHS.uk will be the domain name for the new website of the health service.
The government is also developing a new click and collect service for prescriptions.
Hunt offered the following comment on the multi-billion pound plan.
“The NHS has the opportunity to become a world leader in introducing new technology – which means better patient outcomes and a revolution in healthcare at home.
On the back of a strong economy, and because of our belief in the NHS and its values, we are investing more than £4 billion across the health system to ease pressure on the frontline and create stronger partnerships between doctor and patient.
Under the plans everyone will have access to their own electronic health record, which will be shared between professionals to prevent patients from having to repeat their medical history.
Patients will also be given the opportunity to upload and send real-time data to medical professionals on long-term conditions such as blood pressure.
By 2020, it is hoped that 25% of all patients with long term conditions such as hypertension, diabetes and cancer will be able to monitor their health remotely.”
However, despite the apparent advantages proclaimed by the government, Shadow health minister Justin Madders was sceptical of the value of this new scheme.
“Any investment in technology is welcome but it’s unclear how much, if any, of this money is actually new. Rather than re-hashing old announcements, Jeremy Hunt needs to be telling the public how he intends to sort out the crisis facing our NHS.”
Madders also delivered a damning verdict on the management of the NHS by the Conservative party.
“The Tories cannot hide from the fact that the NHS is going backwards on their watch. Hospital departments have become dangerously full, patients are waiting hours in A&E, and the health service is facing the worst financial crisis in a generation.”
Despite the political wranglings, it does seem that a digitalisation of NHS services is overdue.
According to a spending review carried out by the Department of Health, the NHS will need an increase of £5.6 billion in funding in order to deliver its technology plans.
Negotiations in the health sector are still unfolding ahead of the government’s 25th November spending review announcement.
This document is expected to set all government spending plans until the end of the decade, with current proposals for spending on IT in the NHS considered unknown.
Details of the funding issue in the NHS have been outlined by a paper produced by DH director of informatics delivery management Tim Donohoe.
This paper was discussed at the National Information Board’s October board meeting.
It is stated by the document that spending on technology in the NHS needs to increase between an estimated range of £3.3 billion to £5.6 billion.
The Treasury is challenged to invest more work on refining the costs for the sector, with investment in data and digital management considered to be particularly important in the overall spend.
It is important to emphasise that this is not a finalised document, with the paper declaring itself to be draft analysis subject to internal review and validation by NHS stakeholders.
And with numerous stakeholders potentially affected by this issue, there could yet be changes to the preliminary plans.
Nonetheless, the Department of Health has spent the last three months identifying appropriate technology programs and digging into their estimated costs and benefits.
This initiative has been conducted in collaboration with consultants Deloitte and McKinsey.
It was reported back in June that work carried out for NHS England by McKinsey had calculated that IT expenditure in the NHS could ultimately result in efficiency savings of £10 billion by the end of the decade.
NHS England has indicated that the report from which this figure is derived will be published by the end of this month.
The £10 billion figure will be particularly encouraging for the Conservative government and the hierarchy of the NHS, as the Tories have already challenged the health service to find efficiency savings in the region of £25 billion by 2020.
This new report on NHS IT expenditure sets out nine ‘domains” in which it needs to find funding, with a breakdown of requirements in these areas.
The biggest of these domains is paper-free health care and related transactions, with the research suggesting that projects in this field will require over £3 billion of investment.
With the government already committed to increasing NHS spending by £8 billion, it will be interesting to see how the spending review responds to this research.