English physicians recognise benefits of healthcare IT, but more work needed
The English health system is in flux, and its success in using healthcare IT to link hospitals and physicians will partly depend upon how the system responds to significant structural upheaval and stringent efficiency measures.
While healthcare experts in England expect a localised and diverse healthcare information technology infrastructure to emerge, some argue that local systems should be designed to integrate across the country in the longer term. Others believe that exchanging only key summary information nationally, with more extensive local and regional sharing, is a more realistic and pragmatic vision.
Unless the general direction becomes clearer, there are concerns that individual projects, even if they are successful on their own terms, will end up isolated from the overall goals of connected health in England. The key to the future development is leadership and collaboration at all levels of the health system—national, regional and local—to drive development and ensure that the pieces link together.
Shedding light on physician perceptions
While the majority of doctors are convinced that healthcare IT brings benefits. Research among more than 3,700 doctors in eight countries reveals ripe opportunities to accelerate broad healthcare IT initiatives, according to a new survey from Accenture. The survey illuminates prevailing perceptions (based on demographics and geography) among doctors today over the future of healthcare IT. While the survey illustrates similarities and differences in perceptions of healthcare IT, the findings clearly show that the broadest, fastest path to integrated, effective health practices requires outreach, education and changing mindsets.
Among Accenture’s survey findings, the majority of doctors in all of the countries surveyed believe that healthcare IT does provide some common top benefits, including better access to quality data for clinical research (70.9 percent reported positive benefits), improved coordination of care (69.1 percent) and a reduction in medical errors (66 percent). With an average score of 61 percent, English physicians are just above the global average of 59 percent in their perception of the benefits of healthcare IT across the 10 areas surveyed.
In England, physicians perceived other healthcare IT benefits to include: increased speed of access to health services to patients (55.3 percent), reduced number of unnecessary interventions and procedures (52 percent).
The Accenture survey asked physicians about the extent to which they used 12 different “functions” of EMR and HIE— such as electronic entry of patient notes, electronic referrals to or from other physicians, electronic ordering, electronic prescribing and communicating with other physicians or patients via secure email. The results showed that physicians who are routine users of a wider range of healthcare IT functions have a more positive attitude towards the benefits these technologies bring. The survey shows that, on average across all the countries, as physicians start to use more “functions” —the more positive they are about the benefits
Three stages of connected health
There are three distinct stages in the journey toward connected health: healthcare IT adoption, health information exchange (HIE) and insight-driven healthcare. England has made advances in each of the different stages simultaneously—and iteratively.
Healthcare IT adoption. The National Health Service (NHS) has seen significant improvements in its IT and communications infrastructure in recent years. A key development has been establishing broadband and secure email connectivity across the system, enabling a greater degree of communication and information sharing between clinicians.
HIE. Health information exchange solutions are progressing across some parts of the English health system, but slow progress in the national program and fragmentation between primary and secondary care settings are delaying the benefits of HIE.
Insight driven healthcare. Few experts believe that England’s practitioners are optimising the value of healthcare IT, but many see exciting possibilities. The NHS has done better than many similar health systems in collecting and making use of centralised data.
Despite the progress among specific care settings and regions, it is clear that the progress of connected health in England continues to face some significant cultural, technical and financial challenges. Accenture’s study points to four key barriers:
• Culture change and leadership at the front line—A lack of clinical enthusiasm, time pressures and financial incentives are all adverse factors, exacerbated by an environment in which clinicians and health managers are under increasing strain to deliver better quality and more efficient services.
• Public concerns over privacy and data security—Experts recognise privacy and security concerns as genuine, even if many believe they are inordinately influenced by misinformation or scaremongering. However, stakeholders have not yet done an adequate job of building public support for electronic patient records (EPR), focusing more on the final solution rather than addressing the problems EPR is meant to solve.
• Balancing national and local approaches—As the government moves from a “replace all” to a “connect all” mindset, a key challenge is ensuring that localised healthcare IT solutions are compatible with equivalent systems across England’s regions and with the national interoperability framework.
• The funding challenge and uncertainty of reform—England has spent a great deal of money attempting to roll out a nationwide connected health infrastructure, and most of the promised benefits to professionals—and patients—have yet to be realised. This will be further tested by an unprecedented squeeze on health expenditure over the coming years.
Overcoming these barriers will help to increase critical stakeholder buy-in across the system and boost awareness of the potential of connected health to improve quality, access and cost-control. The challenge ahead will be to turn this potential into a clear case for change across the National Health Service.