Posts Tagged ‘NHS IT’

EPR system goes live at Cambridge NHS Trust

By Mike Broad - 28th October 2014 1:28 pm

A new electronic patient record system that will support two hospitals to go paperless has gone live.

The new system across Cambridge University Hospitals FT is intended to improve the quality of care for patients by ensuring that doctors and nurses can access relevant patient information wherever they are on handheld devices.

The £200m system at Addenbrooke’s and Rosie hospitals in Cambridge, based on bespoke software, prevents clinicians having to wait for medical notes.

Renal consultant and Chief Information Officer Dr Afzal Chaudhry said: “We’re delighted that this revolutionary new system has now gone live. It is the biggest single investment the trust has ever made in the quality of patient care, and will make a real difference for everyone who comes into the trust.”

The trust is the first in the UK to use Epic’s eHospital system, which is used widely in the US.

The software currently contains more than 2.1m patient records from the last five years and it can be used on 7,000 computers and devices at the hospitals.

Nurses can quickly access and update patient records using 500 iPod Touch devices and using its barcode scanner, run tests such as measuring blood pressure.

The software can also be accessed on staff smartphones.

Chaudry said patients will get their medication quicker, nurses can spend more time with their patients and people who are treated in the trust will get home sooner.

He added: “This doesn’t mean the trust will be going ‘paperless’ immediately, it will take about a year to transfer medical records over. The most important priority is that we continue to deliver high quality care for our patients. For example, a midwife delivering a baby may decide it is more appropriate at a particular time to write on paper then transfer the data electronically later.”

In total 7,000 devices, including some of the previous computer hardware, will be running the electronic patient record software.

All data will be encrypted and no information will be stored on the devices. Data is backed up on two separate HP server centres in different geographic areas. There are multiple links to the data centres to ensure the system can operate continuously.

The trust has conducted over 200,000 hours of staff training a head of this week’s launch.

“Waiting list data must become more robust”

By Rt Hon Margaret Hodge MP - 29th April 2014 10:09 am

The chair of the Committee of Public Accounts comments on its new report on waiting lists which suggests the data behind them needs to be better managed and independently audited:

“Public confidence in the success hospital trusts have had in meeting the 18 week waiting time target is inevitably undermined by errors in trusts’ recording of waiting time information. Trusts are struggling with a hotchpotch of IT and paper-based systems that are not easily pulled together, which makes it difficult for trusts to track and collate the information needed to manage and record patients’ waiting times.

“The National Audit Office reviewed cases at seven trusts, and found that waiting times for nearly a third of cases were not supported by documented evidence, and that a further 26% had at least one error. Waiting list data needs to be independently audited.

“The NHS England guidance on the management of waiting times is complex, allowing trusts some flexibility in how they manage patients’ waiting times. There are, however, unintended consequences, such as variations between trusts in the number of cancellations they allow patients to make before referring them back to their GP, thereby restarting the waiting time ‘clock’. These differences reduce the comparability of trusts’ waiting times.

“If patients cannot be confident of accurate comparable data on the performance of hospitals they cannot exercise choice. Both GPs and their patients need reliable and comparable information about the waiting time performance of individual trusts so that they can make an informed choice about where to be treated.

“Furthermore, patients do not fully understand their rights and responsibilities. It should be a lot easier for patients to interact with hospitals and understand when they will see a consultant, but individual hospital policies on access to treatment are often out of date and not publicly available.

“The online Choose and Book appointment system has been underused by both patients and healthcare professionals. We are sceptical about the NHS’s ability to ensure that the replacement system, e-Referrals, will be used any more fully.”

Read the full story.

Profession sets NHS information challenge

- 7th November 2013 10:59 am

The NHS must radically overhaul the way it collects and shares data if patients are to be treated safely and effectively, says a report.

The report by the Academy of Medical Royal Colleges, called i-care: Information, Communication and Technology in the NHS, sets out seven key challenges for achieving the technology revolution within the NHS.

The seven key recommendations state that:

- Patient record must be both the cornerstone of integrated patient care, and the main source of data to inform the service.

- Patient record systems must be focused on the individual, not on the disease, intervention, service or the organisation in which the patient is seen, in order to provide an integrated picture of their problems and the care they receive.

- Clinical data quality and ease of data capture must be of paramount importance.

- The structure and content of records must be standardised across the NHS.

- Patients should be given appropriate, standardised access to their records.

- The NHS must learn from the information it collects in the course of everyday care.

- Professionals and patients need access to reliable information, from both the individual record and the knowledge base of healthcare.

The report has been developed in answer to the health secretary’s ambition to make the NHS ‘paperless’ by 2018.

While noting examples of good practice in hospitals, clinics and doctor’s surgeries, the report also reveals a healthcare system in which information is dispersed across sites in incompatible formats which are too often focussed on the illness rather than the patient.

In some cases, even electronic data transfer remains stuck in the 1990s, with some GPs unable to receive an email which is larger than 5mb. The result, all too often is poorer and less effective patient care and greater costs to the NHS as information is sent by post, courier or sometimes even via the patients themselves.

Professor John Williams, director of the Royal College of Physicians Health Informatics Unit, said: “Information is absolutely critical to the NHS. When you visit your GP, when you attend hospital, when you undergo surgery; all of it relies on high quality information. Today’s NHS information systems are way off the mark. This document sets out how we can realise the technology revolution.

“The Francis Report and Berwick Review both identified that the NHS has lost its way, and must be reoriented to deliver patient-focused, compassionate, safe care. Central to achieving this is the availability of real-time accurate information that focuses on the patient.”

The report builds on a statement produced four years ago by the Royal College of Physicians and adopted by the Academy of Medical Royal Colleges which set out the ‘case and vision for patient focused records’. As the culture of openness and choice develops within the NHS the report says patients and their carers must also have greater online access to their own records, enabling them to be kept up to date and involved with decisions about the care they are receiving.

Professor Terence Stephenson, chairman of the Academy of Medical Royal Colleges, said: “If the NHS is to continually improve patient care and safety it is essential that we bring our IT and communication systems into the 21st Century. Computer technology plays a huge part in medicine and is key way in which we can strengthen the patient experience. Poor systems could disempower staff leaving them fighting to deliver care effectively.

‘The Academy is committed to working with Department of Health, GMC and NHS England to produce and maintain informatics standards. But, it’s clear for the findings that doctors, clinicians, nurses need to raise their game too, and we are dedicated to ensuring that the necessary skills are acquired so that the Academy’s vision can be realised.”

Read the full report.

One billion pound fund for NHS IT projects

By Mike Broad - 5th September 2013 9:33 am

The government and NHS is to invest £1 billion in IT technology to improve clinical efficiency and safety.

It will fund systems which allow hospitals, GP surgeries and out-of-hours doctors to share access to patients’ electronic records and move towards a paperless NHS by 2018.

It is hoped the funding will form part of the government’s long term solution to pressures on A&E by freeing up health professionals to care for patients and cut down on paperwork and bureaucracy.

The £260m Safer Hospitals Safer Wards Technology Fund was announced by Hunt earlier this year.

The DH is adding £240m to this existing fund and extending the deadline by a year, making the total figure for investment £500m by 2016.

All successful applications must be matched by local health and social care organisations, bringing the total to £1 billion.

The original Technology Fund was launched by the DH to provide a boost for e-prescribing and the use of electronic patient records in hospitals.

Health Secretary Jeremy Hunt tried to counter cynicism over the previous government’s failed IT projects. “We can’t let their failure hold patients back from seeing the benefits of the technology revolution that is transforming daily lives. It is deeply frustrating to hear stories of elderly dementia patients turning up at A&E with no one able to access their medical history, and for their sakes as well as all NHS users we need to put this right,” he said.

He continued: “Rather than impose a clunky one size fits all approach from Whitehall, this fund will empower local clinicians and health services to come together and find innovative solutions for their patients. Technology is key to helping our A&E staff meet the massive demand they face as the population increases and ages.”

It is intended facilitate online GP appointments and repeat prescriptions by March 2015, as well as give everyone who wants it online access to their GP record.

David Dalton, chief executive of Salford Royal NHS Foundation Trust, said: “This new funding is great news for the NHS. I’m really pleased that the government is supporting local IT solutions to local problems - this is so much better than the previous one-size-fits-all approach. Investing in electronic patient records has the power to transform patient care.”

Details  on how to apply to the fund will be published later in the year.

Chief executive of the NHS Confederation Mike Farrar said: “NHS staff at all levels have told us it is crucial we think carefully about every piece of information we collect and why. We need to stop collecting information we no longer need, and make sure we extract the full value and potential from information we do collect and hold.

“Patients find it massively frustrating when they have to give their personal details or medical history multiple times over, sometimes three or four times in one hospital visit. Clinical and support staff find it just as frustrating having to ask them.

“If today’s funding is invested in the right tools and technology on wards, in clinics and in the community, clinical staff can spend less of their valuable time filling in forms and more of it giving patients the care and treatment they need.”

NHS: IT answers lie in Services Oriented Architecture

By Wayne Parslow, VP EMEA for Harris Healthcare - 21st July 2013 6:03 pm

Following the passage of the Health and Social Care Bill, the term ‘integration’ is now frequently described as ‘removing the invisible divide that has for many years sat between primary, secondary, community, mental health and social care.

Already we are looking at how integration has the potential to redesign care around the needs of patients rather than NHS structures to provide more joined-up, patient-centred and value-based care, which improves patient outcomes and provides the support needed for our changing and aging population.

There are already limited, but great examples of NHS commissioners and local authorities developing shared visions, plans and budgets and of different sectors collaborating with providers to design coherent, reliable and efficient care pathways.

But with such a vision in mind, healthcare professionals are looking for modern information systems that provide better access to all relevant patient information at the point of care, enabling the provision of the best possible care regardless of the setting and source of information.

There is a growing acceptance by those delivering care that if a new type of national health and social care service is to emerge, it can no longer do so on paper.

Information will need to be in more than one place at one time, for example, if a clinician needs to access it during an outpatient clinic it may well need to be accessible by a community nurse that evening to support that patient at home. However, after failing to implement a national electronic patient record system for more than a decade, there are questions around if and how reducing the reliance on paper or going ‘paper-lite’ can be achieved.

Past experience has shown that whether it is time constraints or a lack of willingness to adopt to new technology, many clinicians simply do not want to move away from their disparate clinical systems, in which a typical hospital there can be up to 200. More likely, their unique system meets their specialty’s unique needs in ways that are not met by a “one-size fits all” approach.

From the conversations that I have had – including those within acute, primary, community and social care – it is also apparent that few seem willing to give-up the “best of breed” philosophy that underpins their IT strategy. The scepticism around single supplier electronic patient records (EPR) certainly has some validity - by implementing a single EPR there is a risk that ‘digital islands’ may be created whereby all data is ‘held’ in one single inflexible system. Doing this may in fact recreate some of the same issues that existed when using paper.

A logical solution is to provide web-based applications that integrate all the various systems they currently use, to present the information to the care-giver on a single screen tailored to that individual’s specialty information needs, whether a PC, a tablet or a mobile phone.

There are many who believe that the NHS could learn from the US Department of Veteran’s Affairs (VA) who have long been evolving a Services Oriented Architecture (SOA) to provide integration and interoperability.

Unlike mass replication of data across multiple and separated repositories using HL7 messaging, SOA is an architectural style that links together different IT systems in different locations and enables clinicians, administrative staff and even patients role-based access in real time in a single view. This architecture enables IT environments of any type to respond easily to changing requirements, as well as providing flexibility, re-usability, interoperability and scalability.

A SOA is a collection of many pluggable services presented in a way that allows clinicians to quickly accomplish tasks with complete information about the patient and condition. It paves the way for interagency integration rather than just the distribution of shared data.

This technology tends to perform faster than traditional centralised data models because it is does not require data synchronisation and relies on the integrity of the data source at the point of care, meaning that if the information is there it can be shared.

It seems that there is very little use or even understanding of SOA within the NHS and that we appear to prefer to replicate information rather than draw it from systems at the point when it is required. However, some of the more ambitious and thought-leading trusts are gradually seeing its validity and are beginning to take it seriously as a way forward.

The idea is similar to iGoogle, the service draws information from everything that you want to see, whether it be the weather forecast or the news you like to read, and presents it to on a single webpage. For example, that weather report remains on the Met Office or BBC News homepage but is presented as a view for convenience to the end-user on a screen or application of their choice.

Integration can occur across multiple boundaries from primary and secondary care, health and social care, and even the whole wider health economy in what Scotland have termed ‘inter-agency’ care. Here, health boards are already working with local authorities to share information beyond their own boundaries with the potential for emergency services, police, prison and education authorities, to access relevant information as well as allowing patient’s to view relevant areas of their records through a patient portal.

We’re also seeing examples emerging in England. In Hertfordshire for example, Central Eastern Commissioning Support Unit is making information available from A&E and GPs to ensure vulnerable children are safeguarded.

Of course, it’s not always as simple as joining up the relevant IT systems and providing the right access to the right people. The cultural barriers of introducing IT to clinicians are now being overcome, but the right infrastructure needs to be in place to support integration. Without working and usable systems the buy-in from end-users, which is often difficult to get, can very quickly be lost.

On top of that different organisations, and the suppliers that hold the data relating to the patients, need to make it securely available to others. Currently there are huge variations across the UK in the willingness to share data, but those providers who are too reluctant to do so may fall behind in their ability to ensure the NHS can deliver seamless and coordinated care.

Equally, there is also a role for suppliers to support each other in enabling the NHS to make the process as simple as possible – not always easy when vendors often fear that this approach may open the door to greater competition.

Since the realisation that having a digital NHS has the potential to provide improved outcomes for more patients using the same amount of resource, NHS England has been eager to get the ball rolling. Health secretary Jeremy Hunt has said that patients would have access to their GP records electronically by 2015 and that the NHS should be ‘paperless’ by 2018. Extra pressure came when he announced that penalties could be incurred if NHS trusts had not put the wheels in motion to deliver an EPR in 2014.

More recently Dame Fiona Caldicott, who led the review on confidentiality in the NHS, suggested that there is “a lot of work to do in terms of IT in order to achieve integrated care.” She added that it should be considered whether penalties are applied to organisations to ensure that they meet a “duty to share” information where it is believed to be in the patient’s best interest that could well accelerate innovations around integration.

But are penalties and deadlines the right way to go? The answer is probably not, as they tend to manifest themselves as “carrot and stick” management – where management beats you with the carrot. While they will certainly help to remind the NHS of the desperate need to move its IT into this century, the real way to convince end users and their organisations of the benefits, both clinically and financially, of investing in technical integration, is to learn from technological best practice and examples of where integration is working well.

How IT systems can address Francis report findings

By Dr Paul Shannon, CSC’s UK medical director and a consultant anaesthetist at Doncaster and Bassetlaw Hospitals NHS Foundation Trust - 25th March 2013 1:23 pm

Many of the issues identified at the Mid Staffordshire NHS Foundation Trust could be seen at any hospital in the NHS. The overwhelming message of Francis was the need for ‘cultural change’ in the NHS.  However, this is a tall order since the NHS doesn’t so much have a culture, it is a culture and it’s the individuals within the organisation that make up that culture. In short, it’s ‘the way we do things around here’. But, the way we do things can be greatly influenced for the better by IT systems.

Somewhere along the line, according to Francis, the NHS seems to have lost its way. The causes are no doubt manifold, but I believe that new technology can be used to help re-establish these principles, and should certainly be part of the solution.

Francis report finding: ‘Secrecy’

IT systems can show you what’s going on. Some of the shocking and callous treatment that patients were subjected to at Mid Staffs would be impossible if only we could ‘see’ what was happening. A good example is the recording of clinical observations.

Most inpatients will have their vital signs recorded regularly. Parameters such as, blood pressure, heart rate, respiratory rate, oxygen saturation, temperature, pain scores, etc, are noted on charts so that a longitudinal picture can be seen, which indicates whether the patient is deteriorating, improving or staying the same. Early Warning Scores (EWS) exist that can detect when patients need more intervention.

‘A lack of openness to criticism’

At present, bedside observations are done manually and are most often paper-based. There is audit evidence that only about 70% of observations are actually done and/or recorded. When electronic systems are introduced recording increases to nearly 100%. Partly, this is due to the fact that it is obvious where the gaps are and, perhaps more importantly, who is responsible. Steps in tasks can be made compulsory, no ‘corner-cutting’ or skipping items. (Think of buying an airline ticket online; you must follow the prescribed sequence else you can’t complete the task). More sophisticated IT systems can proactively assimilate automatically information from disparate sources to predict which patients are most at risk.

Regulators, commissioners of healthcare and the public also need information to make meaningful comparisons between organisations. Sharing and comparing the outcomes of different hospitals can drive up standards.

‘Acceptance of poor standards’

With the best will in the world no doctor or nurse can know everything. Health IT can help direct care and ensure that the patient stays on the right track i.e. receives all the appropriate care that they should in a timely manner: right thing, right way, right time. For instance, when teams hand-over care using electronic systems, communication is improved. This helps to overcome the fragmentation of care delivery, where the left hand doesn’t know what the right hand has done. Similarly, electronic prescribing systems contain decision-support software that can automatically alert clinicians about potentially harmful drug-drug interactions.

‘Misplaced assumptions about the judgements and actions of others’

According to Francis, the quality of care should be described in standards. IT systems can be used to monitor how closely these standards are adhered to and to guide practitioners in what to do in given situations. At present, in the UK, very little use is made of such electronic, standard-based applications. Where they can replace tedious, repetitive, high-speed and complex tasks currently performed manually, they can improve safety. Electronic systems are logical and operate to high standards.

‘Clinical intelligence’

IT systems collect huge amounts of data. If all the data currently held on paper were available for easy analysis, we would be able to produce reports in ‘near real-time’.  In other industries, great use is made of such data and is called ‘business intelligence’. To make this concept culturally acceptable to the NHS, I would suggest calling it ‘clinical intelligence’.

There are three main applications:

- Direct patient care: what’s happening to this particular patient? The EWS above is a good example

- How well is this doctor/team/hospital performing? There is huge variation in the performance of different individuals and teams, yet rarely is this made known.

- Wide-scale issues: with good population data, we can track large-scale changes, such as the obesity ‘epidemic’, ‘flu outbreaks, and the uptake of public health measures.


Electronic systems permit the automatic capture of data. This can be structured, semi-structured and unstructured. Coding systems, such as SNOMED CT and ICD10, aim to overcome ambiguity in language by providing terms that have defined meaning.  If information is captured it can be investigated, analysed and presented in meaningful ways providing the possibility for remembering and learning from mistakes as well as providing a real-time picture of how things are (current status, dashboards), and how things are likely to be in the future (prediction).

‘A failure to put the patient first in everything that is done’

Having the necessary information about a patient is essential to good clinical care.  Having that information at your fingertips, when you need it, helps avoid pitfalls and promotes personalised decisions. The patient feels valued, listened to and at the centre of your attention.

In my experience, patients love to read their medical notes! It helps with shared decision-making and simple errors can often be detected. But, in reality, it rarely happens and the NHS makes it pretty difficult to do. It is technically quite easy to provide the same information to the patient that the clinician has, in a secure and safe way. For a number of reasons though, clinicians are often the biggest barrier preventing patient access to records.

Feedback from patients and carers is a great idea, but only means something when it impacts on individuals and teams in some way. For the first time, doctors have to collect patient feedback in order to revalidate their licence to practise. Moreover, financial penalties for 30-day readmission rates could reduce NHS hospital income by as much as 3%. Quality will count.


There will be much soul-searching and analysis following the Francis report. For me, the key is better information leading to better care. Francis states: ‘If the culture of those engaged in and with the NHS is to change, information must be made available about the performance and outcomes of the service provided to enable patients to make treatment choices and have a proper understanding of the outcomes for them.’

As we have seen, electronic systems can help reduce risk through a variety of mechanisms. I believe that the time is now ripe to exploit health IT fully in the NHS in order to reap the patient safety benefits. These systems, properly implemented, can provide the step-change in patient safety that everyone knows we need. The result will be ‘a rich and varied source of information on each patient to help patients avoid or manage chronic disease, deliver truly personalised health care and proactively monitor safety and quality of care.’

Ten tips on meeting the NHS digital challenge

By Dr Paul Shannon, consultant anaesthetist in the NHS and medical director at CSC - 11th March 2013 10:55 pm

Following heath secretary Jeremy Hunt’s recent challenge to the NHS to ‘go paperless’ by 2018, doctors and hospitals are going to need IT tools to coordinate care electronically.

Care coordination is essential to avoid duplicate treatment and to prevent medical errors. Whether it is a GP, hospital, other healthcare provider or local authority, they are all at different levels of implementing IT. In fact, many are still manually posting or transporting health records to other members of care teams, which can take days. Even if a patient moves from one doctor to another down the corridor in a medical building, the patient may have to carry records in a paper folder rather than their being accessed or transmitted digitally.

For healthcare providers to properly exchange information and coordinate care, it should be in “near-real time.”  A phone or fax machine may not be good enough but there are numerous ways that the NHS can rise to the health secretary’s challenge. Here are ten tips:

1. Make more use of existing, national tools that are already up and running:

a. NHSmail is a secure, encrypted email service that can be used instead of ‘inhouse’ email systems. It means that secure emails containing patient-identifiable data (PID) can be safely sent anywhere within the NHS. NHSmail 2 is coming soon, which will have even more functionality. There’s really no need to send letters and faxes to colleagues anymore!

b. Choose and Book (CAB). About 60% of all first outpatient referrals are now done through CAB. Make it 100% to get the most benefit. Consider the other functionality within the application such as the ‘Advice and Guidance’ section to avoid inappropriate referrals.

c. Summary Care Record. A surprising amount of useful clinical information can be found here. The more it’s used, the more useful it becomes.

2. Automate the discharge summary. It’s virtually impossible to attain the NHS standard of discharge summaries to GPs within 24 hours without using electronic systems. A good electronic patient record system should permit electronic discharge summaries to be sent to GP systems easily.

3. ePrescribing. This is a high-impact patient safety issue; no more problems with doctors’ notorious handwriting! ePrescribing can be ‘standalone’ or integrated into an EPR. It may be best to start with a gradual roll-out in enthusiastic areas, rather than a ‘big bang’ approach. Once the benefits are seen, clinicians will clamour for it in other areas.

4. View results electronically instead of printing out paper. Get into the habit of accessing pathology and radiology results without printing out paper and consider using a Single Sign On tool so that you don’t have to remember multiple passwords.

5. Exploit ‘departmental’ systems to the maximum. For example, if your trust has a theatre management system, see if you can use it to record the clinical record. A relatively easy start is the surgical operation note. But, make sure that any ‘bespoke’ systems can talk to others using Health Level 7  standards.

6. Don’t duplicate. Paper records are not more valid than electronic ones, so you don’t have to do both. If you’re told to write paper records and create electronic ones, someone’s missed the point. One consultant I heard of confiscated all the pens of her trainees when they came to her clinic!

7. Know your ‘business continuity’ policy. Inevitably there will be times when electronic systems are not available, so you need to have robust alternatives in place just in case.

8. Develop a ‘portal’ mentality. This means automatically pulling information from multiple sources into a single area. There are various ways of achieving this, but make sure the patient is the ‘context’, that is, you only view information about one patient at a time. This is an important patient safety factor in order to avoid confusion.

9. Find out about your trust’s IT strategy. Your IT department needs your input. Do you have a clinical lead for IT, or even a chief clinical information officer (CCIO)? Could you do it? You don’t need to be a ‘techy’ or have a Master’s in Informatics; this is about improving patient care, it’s not an IT project.

10. Enjoy the digital revolution! The NHS is ‘data rich but information poor’. In the era of ‘big data’, find out ways of exploiting data for patient benefit and/or professional development. For example, how do you compare against your colleagues, other trusts, international best practice? Annual appraisal and revalidation requires individual, practitioner-level information, and nobody wants to bottom of the league table!

Plan to put NHS patients’ medical details online

The Guardian - 16th January 2013 1:36 pm

Patients will be able to see their medical details online under plans for a “paperless NHS” in which digital records will be shared at the touch of a few buttons between all parts of the health and social care services.

Jeremy Hunt, the health secretary launches the project today alongside a report claiming it could save nearly £5bn a year, after the costs are taken into account. He said it should also improve patient care and save lives.

“More importantly [than money] it can save billions of hours of time so nurses can spend more time with patients if they are not behind the nurses station trying to fill out forms,” Hunt said. “And I think it can save thousands of lives.”

The multibillion-pound scheme will raise concerns about a repeat of the fiasco over the NHS database, set up by the previous, Labour government and scrapped by the coalition in 2011 after more than £6bn of public money had been spent.

Read more in The Guardian.

Increasing online access to care ramps up demand

Pulse - 23rd November 2012 8:26 pm

Government plans to increase online access to medical records and e-consultations will push up demands on clinicians and increase costs, a study suggests.

Users of online access had a significant increase in consultations, out of hours visits, trips to the emergency department and hospital admissions, analysis of data from an online access system used by US healthcare organisation Kaiser Permanente showed.

The researchers concluded that, contrary to current thinking, online services do not cut the need to see the doctor.

The study compiled data from almost 159,000 patients and compared health care use by those who used MyHealthManager with those who did not. It showed that patients who had electronic access to their medical records, test results and the ability to email their doctor had an average 0.7 extra clinic visits a year after they signed up.

Read more in Pulse.

Communications technology vital but has risks

By Mike Broad - 1st February 2012 10:52 pm

Communications technology has become vital to the way hospital doctors work but concerns remain over patient confidentiality, research reveals.

The online survey, by medical defence body the MDU, shows that 99% of the respondents use some form of modern communications technology in their day-to-day work.

The most popular use of technology was for emailing other members of staff with 92% of doctors stating that they do this, while 64% track test results electronically and 63% use the internet to research patient symptoms.

Sixty eight per cent of hospital doctors also revealed that they had recommended a telephone ‘app’ or website to a patient, an indication of the perceived benefit to patient care.

However, many of the doctors surveyed also expressed concerns about the impact that modern technology could have on patient confidentiality, with 41% stating that they were concerned about this aspect of patient care.

Dr Mike Devlin, head of advisory services at the MDU, welcomed hospital doctors’ embrace of communications technology and its benefits but warned that technology brings new risks and threats.

“It is important that any technology employed does not threaten a hospital doctor’s ethical and legal responsibilities,” he said. “A full assessment of confidentiality and security of data should be undertaken and appropriate policies and procedures put in place.  In addition, doctors should ensure that the use of technology complies fully with any policy that their NHS trust may have in place, many of which do not allow patient-identifiable information to be held on personal IT devices or equipment.”

Other findings from the survey include 44% of hospital doctors use a smart phone; 64% of consultants use a laptop; and, 8% of hospital doctors are using Twitter for work.

Read tips on managing the use of communication technologies.