'When I go to my GP, I don't see any paper!'

Lexmark, patient care

(HealthTech Wire / Interview) – Kevin Starling, UK & Ireland Healthcare Director, Enterprise Software, Lexmark, talks about the paperless NHS initiative and how UK Trusts can ready themselves.

The Five Year Forward View made a commitment that, by 2020, there would be “fully interoperable electronic health records so that patient’s records are paperless”. How realistic was this ambition, for you?

Many Trusts have made considerable progress in their quest to become paperless – or at least paper-light. Awareness and enthusiasm remains high at all levels – the majority see the benefits of becoming paperless. However, there is still a long way to go. I believe the NHS will get to a point where many Trusts are paper-light by 2020, but relatively few will be completely paper-free.

What does a ‘paperless NHS’ look like, for you? What has to happen for this vision to become reality?

A paperless NHS allows a healthcare professional that requires legitimate access to a patient’s history to access that data instantly, where and when s/he needs it. As the information is digital, this information is always available and up-to-date enabling healthcare professionals to have a complete view – which improves patient care. It also means that patients are able to access their medical records and to add notes and comments to it.

GP practices are further ahead on this than many hospitals, in the UK – with many systems already digital. For instance, if I visit my GP, I can register my attendance, consult with the doctor and collect my prescription – all without seeing a piece of paper. If I visit my local hospital, however, I may be referred digitally, but once inside, I still see paper in many areas – even healthcare professionals reading information from a digital screen and writing what they see on a piece of paper.

Many Trusts are implementing EPR systems in order to facilitate a reduction in the amount of paper being produced, going forward. However, they are often unable to handle existing paper that is scanned, radiology imaging, digital photos, video footage and other electronic data like Word documents to Excel spreadsheets – i.e., what we might call ‘unstructured data’.

So what are the barriers to a truly paperless NHS?

Going paperless is a large and complex task which takes planning to be effective. Although ‘going paperless’ implies that getting rid of paper is one of the major tasks, it is only part of the issue, although paper is entrenched in many of the processes within a hospital. As well a reducing the paper being produced on a day to day basis and digitising some or all of its historical patient records Trusts will need to approach thorny issues like system interoperability, implementation, training on new workflows, data security, privacy and who has access as well as maintaining the clinician/patient relationship.

What can the healthcare industry – and, in particular, its CIOs and health IT leaders – do to facilitate a more paperless NHS?

The CIOs of the world must consider the bigger picture. Implementing an EPR gets part of the job done, in that it reduces paper being generated day-to-day and improves efficiencies (easier sharing, greater speed of access, data security…), but it doesn’t solve the problem of unstructured data that does not exist in the EPR. Trusts need to look for innovative solutions to enable the capturing of this type of data and to enable the seamless integration and display of that data, in-context, alongside the EPR, or any other best-of-breed solutions that they have. This removes silos of information and cuts costs.

What is Lexmark doing in this space that could help Trusts move forward on the route to becoming paperless?

We can help people capture data intelligently, manage the data and reduce silos, helping to bridge the gap between structured data (i.e., those held within Trust systems such as EPR) and unstructured data, which often aren’t. Our innovative solutions help prepare for an EPR, by enabling simple production and digitisation of medical records without the need to change clinician workflow.

We also offer tools to data mine and search that data for research purposes and can provide Trusts with the capacity to view that data in-context with the EPR. This means clinicians have complete access to the data they need when they need it – providing peace of mind and making the whole process more intuitive!

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