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The new normal

In March 2020 we concluded an article with the comment that “The headlines at the moment may naturally focus on the ongoing coronavirus situation but the day-to-day work of health practitioners still remains.” At that time the UK was still in the containment phase with health practitioners have to manage their duties in the face of a rapidly changing situation.

Just over one month on and the UK is entering its fourth week of lockdown. News headlines are full of little else but the ongoing COVID-19 situation with a lack of PPE (personal protective equipment) taking the top spot. In response, across the country factories are rapidly retooling to produce much-needed equipment for the health service, in some cases consolidating months of research and design into a few days.

For the population as a whole the initial lockdown shock is gradually being replaced by a feeling of acceptance of the part we can all play in staying indoors and saving lives. And when we do have to venture out for food we are becoming used to waiting in line and keeping our distance in order to shop safely.

That we are adapting is hardly surprising. One of the reasons for the rise of mankind as a species is our ability to adapt, to overcome challenges and to make the most of any given situation. But we are also a social animal and that is why some aspects of the lockdown are particularly hard to come to terms with as we isolate from each other. That’s why it’s so important to keep up lines of communication as far as possible, whether it be by telephone, internet or other means.

When the restrictions are eased some aspects of life will revert to how they were before, albeit with a new appreciation of the ability to interact freely. Aside from this, there may also be some more permanent changes in daily lives; born out of the ways in which we are currently working through, and have learnt from, lockdown restrictions.

For example, in order to reduce interactions and protect lives the health service has seen a rise in telephone and video consultations and in the sharing of digital records. Prior to the coronavirus outbreak less than one percent of consultations were carried out via video link. Now, telephone and electronic consultations are generally seen as the first port of call for practitioner contact. Practices such as these may be workarounds now; but may also become the new normal as the benefits for patient care and the health service become apparent.

Traditionally in times of crisis technological development leaps forward. Some of the practices which are today becoming the new normal were available prior to this crisis but may not have been implemented to any great extent. COVID-19 has forced us to look again, to move towards online booking and consultations, to electronically store and share patient notes, and to manage virtual diaries. This is the new normal and if some of this benefits the delivery of patient care not just now but also in the future then the new normal might go on helping to save lives.   

Taking care of patient data

There’s no escaping the fact that we live in a data driven, online world. And why shouldn’t we? Properly managed, electronic storage of data can free up substantial amounts of time, leaving us free to concentrate on the more interpersonal and interesting aspects of our jobs and lives.

Just take the electronic filing of records for example. With x-rays, scans, clinical notes and histories all being available in a single patient record at the touch of a button; it’s far easier for health professionals to diagnose and understand the nature of a particular problem and move swiftly towards developing a treatment regime. It’s also far easier for data to be shared between health professionals, enabling complex cases to be managed in a more holistic way.

Add in the benefits of time saved in not having to print out records, manually file them and then post or courier information between health centres and it’s easy to see how health practices and their patients benefit from electronic data storage.

However there is one area of concern with electronic data storage and that is the question of security. Now it has to be said that many of the problems arising from electronic data storage are simply replications of problems that can arise in a paper driven world.   Yes it is possible to email a record to the wrong person but it is equally possible to put a patient record in the wrong envelope or for paper copies to be lost in the post.

And even with errors there are some aspects of data management in which electronic storage comes up trumps. Miss-file a paper record and you can spend hours searching for it, miss-file an electronic record and a reasonable data search facility can help you to retrieve the file relatively quickly.

Naturally our trust in the security of data isn’t helped when we see headlines which would indicate that the health sector is responsible for considerable numbers of security breaches. The Information Commissioner’s Office (ICO) summary of data protection reports and concerns for 2016/17 indicates that the health sector is responsible for 41% of self-reported incidents. To put this in context, next on the list is local government with 11%.

On first indication this would be a concern; however, the report highlights the fact that the health sector’s mandatory reporting policy naturally leads them to report more incidents than other sectors. Looking at the types of data breaches, whilst it is true that 11% relate to data being sent by email to an incorrect recipient, this has to be taken in context with the 15% of reports relating to data being posted or faxed to an incorrect recipient and the 14% of occasions when paperwork was lost or stolen.

It’s often said that security is a state of mind and what the ICO report highlights is the importance of treating patient data (whether in paper or electronic form) with the same level of care as you would give to the patient. When data is being transferred between health practitioners it only takes a few seconds to check and double check that the forwarding email address is correct and that the request comes from a genuine source. Similarly with security being forefront of people’s minds, passwords are less likely to be left lying around on desks or set to the standard default of password or 1234.

Electronic data isn’t simply some laboursaving device. Patient information is real and personal. Being human we’re all going to make mistakes from time to time but being security aware will help to minimise those mistakes and ensure that patient data is treated with the care that your patients deserve.

Telling your story once

The NHS in England has announced further initiatives in its drive towards streamlining patient records. The National Innovation Board established by the Department of Health has set out bold new plans to move information off the page and onto the web by 2020.

The plans include a commitment to give everyone access to digital GP records by 2015 with other patient records including those kept at hospitals and clinics being online by 2018. The ‘Red Book’ which records details of a child’s developmental progress and vaccinations is expected to be replaced by a digital version by 2016, thereby enabling parents to view their children’s records at the touch of a button.

Commenting on the announcement Secretary of State Jeremy Hunt said “I want the NHS to be a world class showcase of what innovation can achieve” whilst Tim Kelsey, NHS National Informatics Director, said “We must embrace modern technology to help us lead healthier lives, and if we want – to take more control when are ill.” To this end the NHS is also planning to ‘kite mark’ certain apps which will help patients to access services and take more control of their own health.

Digitising patient records not only helps patients to take control of their own health, it also has major implications for health practitioners. Firstly, health practitioners will be able to quickly access a full patient history without having to wait around whilst records are located and physically transferred between departments or treatment centres. To a health system which is currently geared towards paper records this will have benefits both for speed of access and speed of treatment.

Equally importantly, with records to hand patients won’t have to go through their story over and over again; perhaps missing out vital elements in the telling. As a result there should be a better understanding of patient history, thereby leading to an improvement in treatment regimes and in outcomes. This is particularly important when it comes to areas such as physiotherapy where early treatment can make a measurable difference in a swift return to mobility.

From a pure practitioner perspective the digitising of patient records also helps to reduce unnecessary administration time.  Time taken in filing records, in retrieving records and in waiting for records to be walked or posted from one treatment centre to another is time which could be better spent on actually treating patients.  ‘Waiting for the records’ is a mantra which bedevils healthcare across both the NHS and private practice and it can lead to delays in treatment which would be better avoided.  The ability to sit with a patient and to see their history at the touch of a button will make a measurable difference to long term health care.

The announcement of these initiatives comments that “technology will play a vital role in helping contribute to the £22 billion in efficiency savings needed to sustain the NHS.” Whilst there is no doubt that these savings are welcome, the deployment of technology is not just about cost savings. Rather it is about improving patient lives and that is an ambition which we can all applaud.

Learning to Walk

The tale of the man who is learning to walk again thanks to an implant of regenerative nasal cells has hit the headlines in a big way. Remarkable in itself, the successful treatment carried out by a team of British and Polish doctors holds out hope for the millions of people across the world who have been paralysed by a form of spinal injury.

Of course, as with any medical breakthrough the story comes with a caveat. The man’s injuries were caused by a clean stab wound, helping the possibility of regeneration and just as one swallow doesn’t a summer make, one success story doesn’t automatically lead to universal success.

But stories of this type do show the way in which pioneering work is continually going on under the radar, with dedicated teams working across the world to create lasting solutions for problems which affect millions of us. In fact, a Thomson Reuters white paper earlier this year predicted that 10 inventions which would change the world by 2025 included:

  • Greater understanding of the human genome leading to improved detection and prevention rates for degenerative diseases such as Alzheimer’s
  • Advances in RNA-guided genome engineering which would lead to the eradication of conditions such as Type 1 Diabetes
  • Advances in antibody production and targeting which will make cancer treatments more individual and less toxic
  • Improved management of disease thanks to DNA mapping at birth

Whilst important work of this nature continues, for the health profession generally there is a continuing drive to do more with less. Every breakthrough comes at a cost and with an aging population the strain on resources is ever upward. So when hip and knee joint degeneration means that the patient is unable to walk properly; the strain on the rest of the body can lead to multiple complications. For example a lack of exercise, and even something as simple as a regular walk can apply here,  can lead to cardiovascular disease, poor circulation, and increase the risk of developing type 2 diabetes.

An increasingly elderly population combined with the demand from the population at large to come up with solutions puts ongoing pressure on health services. Health practices including physiotherapists, osteopaths and podiatrists are not only looking for medical breakthroughs but are also taking advantage of the way in which technology can help to provide greater efficiency on a daily basis.  Areas such as the use of virtual assistants, electronic filing of records, on-line appointment and diary management and electronic payments are all under scrutiny in a drive to do more with less. And the more that the routine is automated, the greater the time available for research and patient care.

IT-related savings may not have the headline grabbing glamour of advancements in cancer care or mobility but nevertheless efficiency savings are the backbone of a drive to improve patient care. For not only do they save time and money, they also free up valuable clinical time, helping to increase the time which health professionals are actually spending with patients and that can only help everyone in the long run.

Holiday Blues

Once upon a time we just went on holiday and everything we did when we were away was part of the holiday experience. Nowadays it seems as though spontaneity is out the window as we have to have a clear idea before we go and our every intention is scrutinised in detail by those responsible for booking and insuring the trip.

Completing a holiday insurance form recently, a colleague was struck by the number of exclusions and ‘do you intend to..’ questions. They felt that having to think up and list activities in advance killed the joy and anticipation of being able to relax and just ‘go with the flow.’

Admittedly activities such as base jumping and volcano boarding are not in the usual run of chill-out holiday activities. But an activity such as ‘walking on a mountainside for more than an hour’ is hardly a dangerous pursuit, particularly if you are visiting areas of Switzerland or Austria where it is hard to avoid strolling on gentle slopes.

Of course, the insurance strictures do have a basis in fact as some activities are more likely to result in injury than others, particularly when combined with a relaxing glass of your favourite holiday tipple. In fact, statistics from the FCO last year revealed that of the 19,000 people who asked for help whilst abroad, just over 3,500 had been hospitalised. But whether or not hospital treatment is required there are still a fair number of people who do need further help when they return to this country. From broken limbs to strains and misaligned joints; the chances are that those working as chiropractors, physiotherapists and osteopaths are likely to be called upon this summer to treat those holiday injuries.

When the call comes, it is good to be able to respond at once; but this is not always possible, particularly if answering the call means pausing an existing treatment session. That’s where a virtual assistant service comes in handy. Calls can be switched seamlessly to the service with callers being greeted as if from the health practice itself.

Not only does this mean that your potential clients receive a swift and positive response right from the start, it also helps to ensure that your appointment book is kept as fully up-to-date as possible. And of course, if you don’t have to interrupt a treatment session in order to answer the phone, using a virtual assistant service also enables you to provide a first class service to those who attend treatment sessions.

Additional benefits of using a virtual assistant service include the ability to take card details at the time of booking, thus helping to smooth out cash flow and reducing on administration time. Pre-authorised card payment also enable health practices to take a no-show fee in accordance with their published criteria, should a patient fail to attend an appointment. Add in an appointment reminder service, and the chances of missed appointments are considerably reduced.

With appointment booking and card deposits taken care of the health practice can concentrate on what it does best, treating those in need.  If your clients are going away this summer, encourage them to think carefully about how they answer the holiday insurance questionnaire. But if the worst comes to pass at least, thanks to some virtual assistance, you may well have time to treat them on their return.

Keeping on track

Whether you are a physiotherapist or a hair specialist, an osteopath or a dentist; it’s a fair bet that you chose your profession because you wanted to help people. It is also a fair bet that the matter of paperwork and records wasn’t really a factor which came to the fore when you were deciding on your chosen profession.

But no-matter what the profession nowadays it seems as though movements are circumscribed by reams and reams of paperwork. And unless something is done to rein this in, the volume of paper can not only seriously interfere with patient treatment times, it can also detract from the provision of effective treatments.

In an era in which every patient and every treatment comes with a paperwork trail, it is little wonder that records can become lost or treatments delayed as records are transferred from one place to another.  Partly in an attempt to smooth out the pathway and partly to improve self-management of long term conditions the Richmond Community Neuro-Rehabilitation Team has trialled a patient-owned folder.  The folder not only contains important contact details, it also contains details of the patient’s condition and therapies which have been agreed upon.

Since the folder was trialled in 2012, the team has seen pick-up time for new patients improve by five days. In addition 92% of patients agreed that the folder helped their therapy as they were able to use it as a continuing reference point.  But even with initiatives such as the patient-owned folder there is still the hurdle of paperwork to overcome.

Moving away from a paper based system to electronic records can make a huge difference.  Paperwork safely stored in an electronic folder can be accessed at the touch of a button.  This not only saves the time taken in finding missing paperwork it also enables health professionals to quickly call up information when patients get in touch as well as facilitating the transfer of information between professionals. All of this not only helps to improve patient treatments, it also creates valuable additional time which can be spent on treating additional patients.

No more searching through filing cabinets, no more waiting for days for the post to arrive; electronic storage of patient records can make a huge difference to the daily practices of health professionals; bringing them back on track to the reason why they joined the profession in the first place – the treatment of patients.

Designing care pathways around patients’ needs

A report by The King’s Fund has recommended that local organisations be given the freedom to prioritise quality patient care under the supervision of NHS boards.  Entitled “Patient-centred leadership” the report acts as a follow-up to the Francis inquiry.

One of the central themes of the report relates to the need to move away from externally imposed targets and towards a culture which puts patient-care at the centre of the NHS.   Commenting on the report the NHS Confederation chief operating officer Matt Tee said: “It is very worrying that such a significant proportion of respondents to the King’s Fund survey think the NHS does not sufficiently prioritise quality of care.”

The president of the Royal College of Physicians, Sir Richard Thompson, backed the report but highlighted the way in which technology can play its part in aiding, or hampering, a physician’s attempt to provide quality care.  A report on the national health executive website quotes Sir Richard as saying that “Clinicians desperately want to provide high quality care, but problems with systems and resources can often make it difficult for doctors and nurses to treat their patients well.”

Certainly the old days of scribbling a note on a piece of paper and putting it in a patient’s file are gone.  But whether the introduction of technology has improved and streamlined care processes is a matter of debate by many health practitioners.  As with any new technology, some systems prove a boon in terms of time saving whilst others are so complex that the practitioner sometimes feels they are spending every moment in satisfying the ever gaping maw of IT and processes.

But there are some technologies which can make a real difference to maximising patient care times.  For example, systems which record and store patient files electronically can generate huge time savings.  Gone are the hours of filing and the wasted time whilst you search for a note which has been misplaced.  Instead, a touch of a button and the entire patient file is there before you, with notes, MRI images and other documents available to view instantly. Not only does an automated patient record help to manage multi-practitioner cases, it can prove to be a boon in smaller practices such as those provided by osteopaths or physiotherapists.

Undoubtedly our health practitioners have the will to provide top quality patient care at all times.  With automated patient records freeing up valuable time, perhaps technology can lead the way in this transformation.

Harnessing the power of technology

Speaking at the Healthcare Innovation Expo 2013*, the Health Secretary, Jeremy Hunt, outlined the way in which innovation is to be used to drive the NHS into a future where it is “freed from the shackles of top-down bureaucracy.”  Giving the online seat booking innovation which transformed the air industry as an example Mr Hunt bluntly stated that “while they innovated, we stagnated.”

In a speech which touched on the Francis Report, culture and values as well as regulation and systems Mr Hunt highlighted the care and compassion which is at the heart of our health services.  He also called for patients to be put in the health driving seat.

One of the key practices which the Health Secretary believes needs to be implemented to transform the health service is the move to electronic patient records.  Giving examples of ways in which patient care can be improved by the use of electronic records, Mr Hunt said that a paperless NHS will have “massive implications for improved patient safety, genuine patient empowerment and self-management as well as scientific research.”

Of course it is not just the NHS which will benefit from electronic records.  Health practitioners both within and outside the NHS can find that electronic records will make a sizeable difference to their working patterns.  For example, the Clinic Appointments patient records service is already helping practitioners to streamline their operations.

With patient notes, documentation and X-Rays all available at the touch of a button the health practitioner no longer has to spend time in filing or searching for records.  This means more time spent on patient care and less chance of errors creeping in if important documents are mis-filed.  Combined with the Clinic Appointments’ virtual receptionist and diary management services the secure patient records service helps every health practitioner from a sole practice to a multi-unit facility to provide a streamlined and efficient service.

Health services in the UK are going places and those who are at the forefront of innovation and streamlined technology will be best placed to make the most of the new vision.  Putting patients first, innovating, bringing fresh thinking to health care; all these are on the Government’s radar.  The Health Secretary closed his talk, as we do this article, with this quote from Bill Gates “Never before in history has innovation offered promise of so much to so many in so short a time.”


Going paperless

The Health Secretary, Jeremy Hunt, has set out plans for a paperless NHS by 2018.  In a speech to the Policy Exchange the Health Secretary said that a series of milestones would mark key stages towards the eventual goal.  These include hospitals being able to accept electronic records by 2014 with 2015 seeing electronic referrals in place.

In advance of the announcement a report by PwC suggested that over £4 billion could be saved within the NHS by better use of information and technology.  This includes automatic referrals, e-prescriptions and the smart use of technology increasing the time clinicians spend with patients thus leading to a reduction in waiting times.

This latest drive towards a paperless NHS has been broadly welcomed with the only scepticism coming from those who suffered from the failure of the previous attempt by Labour to bring in a centralised NHS system.  This latest initiative avoids the “monolithic system” pitfalls by enabling health providers such as GP Practices and hospitals to commission their own systems which will merely be required to share records with other systems.  This means that health providers can develop, store and manage records in a way which suits them, subject to central sharing protocols.

There is no doubt that digitising records can save time and money.  For example, the John Taylor Hospice near Birmingham has more than doubled the time clinicians can spend with patients simply by using laptops.  But the drive towards a paperless NHS can also benefit others within the health care sector.  Software such as that offered by the Clinic Appointments patient records service is already helping health practitioners to digitise their patient records.  This means that records can be accessed 24/7, there is no time wasted in finding or sorting records and with clinical notes, x-rays and invoices all centrally handled the health practitioner can spend more time on treating patients.

Combined with the telephone answering and diary management service this means that while an osteopath or physiotherapist is treating one patient the Clinic Appointments team can take calls, book appointments and the health practitioner can then call up the next patient’s details at a touch of a button.  With faster administration time and no more worries about losing patient records in fire or floods clinicians can concentrate on what they do best, treating their patients.

Prioritising Patient Records

On 21 May the Department of Health published its information strategy setting out a ten year plan for improving information management across health and social care.  Key targets include providing people with access to their own records online by 2015, promoting online appointment booking and the ability to share test results on line.

The information strategy, subtitled “The power of information” has a two fold aim.  Firstly it seeks to improve the patient-professional partnership by providing patients with access to their records and thereby improve informed choice decisions.  Secondly the strategy recognises that a system which efficiently collates patient records will save time and money as well as improving care.

The proposals have received broadly positive responses.  Although the BMA has raised a concern over security of records, particularly across shared systems, it has also gone on record to say that it supports “the sharing of relevant information between healthcare professionals.”  The Chief Executive of the NHS commissioning board, Sir David Nicholson, commented that the adoption of an information strategy is the first step “in a genuine cultural shift in the NHS that will enable the service to work at its most efficient and give patients real power and choice.”

Certainly the more work which can be done on computerising patient records the better.  Health professionals work in a time pressured environment and time spent looking for records is time which is not spent on patient treatment.    This is one of the reasons why Clinic Appointments instituted its Patient Records service.  This enables health care professionals to upload and view clinical notes, x-ray and scan records as well as client invoices.  The software is simple to use and the secure records can be accessed at any time 24/7.

Keeping patient records in one place means the end of searching for missing records; it means that patient histories can be viewed at a glance and eventually it will mean that information can be shared with others under the information strategy.  Linking the patient records service with diary management and virtual receptionist services frees up clinicians to do what they do best.   So, no more filing, no more searching and no more phone answering, just client treatments.

The Department of Health and the NHS Commissioning Board have until April 2013 to finalise the information standards and route map.  In the meantime the Clinic Appointments Patient Records Service is there for health professionals who are looking to cut down on administration time now.

Contact us today to discover how Clinic Appointments can help your clinic. Book your free demo call now to learn more.