The centre-left Labour party took to power in Britain, promising reform to the National Health Service (NHS). New Prime Minister, Keir Starmer, voiced ‘an NHS fit for the future’. His manifesto? To cut waiting times, invest in new equipment and services, recruit extra staff and decentralise healthcare provision. Bold ambitions that come at a substantial financial cost.
The headlines state funding will be found through a crackdown on tax evasion. The reality will be a combination of reallocating, saving and doing things better. To make the sum of all the pieces bigger than it was before, healthcare providers will have to work smarter and leverage their assets, processes, and people more effectively.
How? In a large part, through harnessing and enhancing digital technology.
Pragmatic Modernisation
Modernisation is critical for success for any healthcare system, no matter the location, who’s funding it, the current oversight model, or the policies that may be propelling sweeping change. But modernisation doesn’t necessarily mean fast-forwarding to sci-fi type setups.
In fact, before we jump to robotic nurses and AI-based consultations, we must recognise that almost every healthcare system around the world is still leaning on paper-based administration, or very aged technology like pagers or fax machines. (This includes large swaths of the NHS.) Why in this digital era? Quite simply because ‘if it ain’t broke why fix it’. I recently heard of a hospital in the UK that prints five million pages per month! The equivalent to 7,000 trees per year. Not a great record for a health service focused on becoming net zero by 2040.
So, whilst what is being done now does work, it could work so much more fluidly.
Take all the patient reports that are printed off and viewed at bedside by clinicians. Imagine instead our nurse or doctor simply carries a mobile device with all the information just a few screen taps away. Not a dirty smartphone that’s no doubt been dropped on the toilet floor at some point and is now home to a vast colony of pioneering germs looking to breed and multiply at the nearest opportunity. But instead, a clean fresh clinical device made of disinfectant proof plastics that can be wiped down between each and every patient.
Our worker can use their device as a mobile computer when on the move and then insert it into a cradle that converts that device into a desktop PC at a nearby computer-on-wheels (COW) or workstation on wheels (WOW) cart. They’ll have access to the patient’s medical record no matter where they’re working. Chunky documents like MRI scans can be illustrated on the big screen at the COW/WOW, letting a consultant advise on treatment. Procedures, medicines and vital signs to date can be checked electronically. Patient’s health, safety, and privacy can be properly protected with no risk of leaving scraps of paper with private patient information jotted down. There’s no need to sacrifice healthy trees for the sake of human healthcare. And if questions need to be asked, the device can be used for secure communication (within the hospital only). No wasted paper. No wasted steps. No reliance on ancient pager tech. Of course, that’s not the end of the story, though.
Patient safety
Curiously, ‘Labour’s’ top patient safety priority in the UK is to improve women’s experiences in ‘labour’. This is via recruitment of additional midwives. But new nurses come at a cost, and that money needs to be found somewhere. If it can be found by doing things better, then everyone benefits.
Asset management is a great place to start as this is a mighty cost for hospitals. In 2022 alone, $19.9bn was spent on hospital goods in the UK. Efficiency through better management of stock – i.e., carrying what is needed and not letting things expire, has the capacity to free up huge amounts of funding. In a recent webinar, we heard how Hull University’s hospital asset tracking solution saved £400,000 in one small area quite simply by enabling it to only hold the number of heart valves it needed in a year rather than having a full shelf. (Jump to the 20:55 mark in the video below.)
If every one of the UK’s 2,000 hospitals made a saving of this size, it’d collectively free up £0.8bn. That number would exponentially grow if every hospital in every region of the world followed suit.
Just look at the gains made by Clinica las Americas in Bolivia:
Or even Banner Health in the U.S.:
These stories are all evidence of both the savings and efficiency gains possible when we consider new ways of working.
Another deliverable in the UK is to digitise the Red Book record of children’s health. This paper booklet is issued after the birth of a baby and carries lots of information about vaccinations, size and health worker visits. Yet how many exhausted new mums forget to bring it with them to the doctors. (Me for one!) It seems crazy in this day and age that we rely on something so easy to misplace to monitor the progress of the most precious gift of all. With 5G-enabled healthcare grade tablets out in the community, clinicians could bring up the details and graphs of mum and baby records with ease. And added benefits of a tablet versus a book include an emergency response button to call in support should it ever be needed quickly. One nurse called this capability out specifically in this opinion piece:
Safety at the Touch of a Button: A Key to Retaining Staff in Hospitals, Clinics and Ambulatory Surgical Centers
Healthcare closer to home
Visits to newborn babies at home leads us to the next deliverable in the new UK Government mandate: bringing healthcare away from expensive, difficult to access (for many a sick patient) hospitals into local communities. It is sad to read that one in seven hospital patients don’t need to be at the hospital – yet they are. And having volunteered at a dementia ward, I can add my own experience to concur with this. Many of the patients I chatted with did not have any physical ailments, or they were recovering from a non-life-threatening injury such as a small fall. Marj had just popped down on the bus to see her sister. A week later she was still there saying the same thing, and I realised there was no sister, it was her memory that had glitched. Yet there was insufficient support to nurse her at home and no space in a local nursing home.
Shifting resources to primary care and community services means more patients with long-term illnesses such as mental health issues, age-related illness or disabilities, plus patients recovering from injuries or procedures will be treated at home. But, to make the move away from the wards, clinicians and patients will need resources to support a major change in working practices.
Visualise a future where technology packs provided to patients capture vital signs through wearables. Health surveys submitted via tablets or mobile devices provide data to guide remote consultation. Clinicians arrive at a patient’s home armed with knowledge to make informed decisions about follow up treatment. Care is more efficient and smarter too.
Joined Up Working
Plans in the UK are in place to take the pressure off general practice (GP) surgeries by improving access to services and treatment through new routes. These include giving prescribing rights to pharmacists. Other professionals, such as opticians, will be enabled to make direct referrals for specialist services or tests. Self-referral routes will be expanded too where appropriate. The spreading of the load will make healthcare much easier to access. However, this needs to be a universal initiative adopted by other healthcare systems around the world as well if we are to improve patient care access and quality of care for everyone in and out of hospital settings.
Pivotal for successful connected healthcare is access to a correct patient medical record anytime, anywhere. A simple search online yields a plethora of examples of medical records holding mistakes – some that can prove fatal. This is where initiatives such as Scan4Safety matter so much. Scan4Safety is focused on end-to-end scanning of barcodes. This enhances patient safety through accurate point-of-care scanning making sure data (e.g. what medication the patient has taken) is added correctly to documents (e.g. the medical record). This means any medication, treatment or surgical procedure are matched to the patient by scanning a barcode as opposed to manual entry, which significantly reduces the risks of errors.
Logic can be added to workflows, too, so an error alert fires up should a never event be about to occur, e.g. a surgeon poised to put a left hip replacement into a right socket. Pharmacists allocate the correct medicines, blood test results are matched to the correct patients, the benefits go on. The process contributes significantly to inventory management, too, by illuminating supply chains. Once you know what you have, where it is plus-product data (like when it expires), suddenly you have the intelligence you need to make clever savings – like Hull did with its heart valves.
In Other Words
Here in the UK, the newspaper front pages are talking about 40,000 more appointments a week, cancer scanners doubled, a new Dentistry Rescue Plan, 8,500 extra mental health staff, the return of the family doctor as the NHS is reformed. All great news for a nation tired of waiting weeks for appointments, watching ambulances parked up at admissions and hearing the gloomy news of yet more staff strikes.
(Considering these aren’t problems exclusively faced by Brits, I suspect you’d be happy to see similar improvements made in your community’s healthcare system, no matter where you’re sitting in the world.)
But for these dreams to be realised, funding is critical. It would certainly be a big win if we could finally tackle tax evasion. Yet, if that was so easy, why would the previous governments not have stamped it down by now?
My view of a successful future-resilient healthcare system – whether it’s the NHS or your local healthcare system – is one funded in part by being more efficient.
Using the technology readily available in supermarkets, restaurants, and big e-commerce warehouses to understand where and how everything is being used, so that savings can be ploughed back into patient care via recruitment of more staff would be a simple and logical starting point. Plus using mobile technology to take the hospital into the community seems like a reasonable next step. So much treatment is based on monitoring and evaluating patients’ vital signs and their own feelings. This would be much less expensive out in the community, and much less stressful for recipients. And it would free hospital beds for those who really need them.
A more effective, better staffed health service with pinch points like doctors’ appointments alleviated by spreading the load across different professionals and over wider locations. Less stress, smoother operations. Happier patients and staff.
Let’s get to work making it happen. (The Hull team did and look at how much better off they are for it.)
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When an ambulance is dispatched to a call, the assumption is that it will be fully stocked with the right equipment and medicines for EMTs to stabilize patients or perform life-saving measures in the field. But with the increased number of calls for service, it’s becoming more difficult for EMTs to maintain proper stock in their ambulances – and that has patient care implications. Why is such a fundamental task so hard to manage? That’s one of the questions we asked two public safety experts. The other question? Is there anything that can be done to reduce the wait times for ambulance services where the calls for service are exceeding EMTs’ capacity? These experts have some thoughts.
To answer these questions and more please click on the link below to download whitepaper on Zebra Technologies solutions.
