World Hospitals and Health Services - International Hospital ...

SPECIAL FEATURE: INTERVIEW WITH RICHARD GRANGER
Records Service (NHS CRS). By 2007 all England’s 50
million plus patients will have an electronic NHS Care
Record.
Detailed information will be stored locally, where the
majority of care is provided. In addition, a summary of a
patient’s essential health information will be accessible
whenever and wherever a patient seeks NHS care in
England, whether that treatment is planned or unexpected.
This will improve the speed, effectiveness and safety of
diagnosis and treatment. Authorised clinicians will have
secure access to potentially lifesaving information, such as
patient allergies, current medication, outcomes from
operations and test results.
In time, patients themselves will have easy, but secure,
access to their record, via the secure HealthSpace website,
which will also provide tools and information to help people
look after their own health.
In the future, patients will be able to use HealthSpace to
express their treatment preferences, organ donation wishes
and needs, such as wheelchair access or translation services.
Patients will have to weigh up the benefits of information
sharing between health organisations against the risks. A
major public information campaign is planned to ensure that
they are able to make an informed decision about whether to
opt out of allowing their electronic record to be shared with
health professionals involved in their care. Once the new
systems are complete, patients will also be able to request
that certain parts of their record are only shared in particular
circumstances, such as an emergency.
Whilst there are issues and risks with the new technology
that must be identified and minimised, there are huge
potential benefits. Patients will be able to gain a speedier
diagnosis when a specialist opinion is required. New Picture
Archiving and Communications Systems mean x-rays and
scans will be stored digitally on computer so they can be
sent instantly from a hospital where they were taken to a
specialist who may be many miles away.
In the future, patients in hospital could also begin to see
clinicians using wireless technology to call up their health
record at the bedside. As the patient’s NHS Care Record will
be automatically updated, GPs will be aware of all the
relevant details when a patient makes a follow up visit to the
surgery.
Prescribing will be safer and more convenient for patients
by the end of 2007 when the Electronic Transmission of
Prescriptions (ETP) is fully implemented. It will not always
be necessary to visit a GP’s surgery to collect repeat
prescriptions, as they will be sent electronically to
community pharmacists.
Safety will also be improved as, in most cases, prescription
information will not be handwritten or typed more than
once. ETP will, in addition, ensure that information about
medicines that have been prescribed and dispensed are
automatically added to a person’s NHS Care Record. This
will lead to better patient care as authorised clinicians and
associated health care professionals will have more
information about the medicine someone is taking.
In rural areas, telemedicine could in future take away the
need for patients to travel miles to hospital for a
consultation. Instead they could visit their GP’s surgery and
have the consultation via a video link with a specialist. In
some places this already happens.
The new technology could also assist patients with
chronic diseases, such as diabetes, to play a more active role
in the management of their condition. They could in future,
for example, ask for online information about managing
diabetes and store care plans and online diabetes
management courses. They could use HealthSpace to log
their weight and blood sugar level readings and organise
email reminders to book appointments to check their
eyesight.
Everyone providing care will have the essential
information they need to make safe decisions. Treatment
and prescribing errors that can harm patients will be
reduced. And patients will also have easier access to their
medical information and be able to play a more proactive
part in their own health and care.
WHHS: How does the UK national plan differ from
attempts by other countries?
RG: England is leading the world in developing an electronic
care record for every single patient – nothing has ever been
attempted anywhere else in the world on this scale so we are
leading from the front.
The National Programme for IT also has a larger functional
scope than other national strategies, seeking to cover the
whole range of services across primary and secondary care.
There is a strong history of electronic patient record
development across Europe over the years – to which the
NHS has made significant contributions – but they are
usually more on an institutional or regional basis, rather than
national.
It is testament to the exiting progress we are making that
other European countries such as France and Sweden have
been taking a very close interest in what the National
Programme is doing.
WHHS: What lessons can other countries learn from
your experiences?
RG: We have been able to start from a very solid base of ICT
experience, expertise and knowledge built up over many
years. The National Programme did not start from scratch,
but drew heavily on previous IT strategies dating back to
1992.
What the National Programme has done is to accelerate
the process, to have a clear focus on what needs to be done
and how to achieve it quickly, efficiently and cost effectively.
Do not underestimate the amount of effort required, it is
a huge task and one which can only be driven through with
hard work, commitment, enthusiasm and a passion to
succeed.
We have already begun to see the fruition of our
endeavours with the successful launch of Choose and Book
and within a short space of time many more patients and
NHS staff will see the benefits of what we are aiming to
achieve. ❑
22 | World Hospitals and Health Services | Vol. 40 No. 3