Q&A: How easy it is for the NHS to go completely paperless?

The goal of having a 'paperless office' is one that many organisations aspire to, with the financial and productivity benefits well documented for companies of all sizes.

The NHS is no exception, although comes with added complications. We recently spoke to Eva Weber, senior product marketing manager at ABBYY, about the challenges facing the NHS is going paperless.

  1. What kind of paper documents is the NHS using today?

Paper-based documents have traditionally been the life-blood of the NHS. Patient notes, registration documents, hospital discharge notes and prescriptions rely heavily on practitioners writing down developments in patient wellbeing, signing out patients and scribbling down prescription details to be passed onto pharmacies in order to communicate and record case notes and patient details.

While some trusts are innovating with the introduction of iPads, for the most part, paper still rules the roost, and is very much relied on across the NHS.

  1. What problems does it cause NHS trusts that are still predominantly using paper?

The problem with paperwork is that huge costs are tied to it. On top of this, these are costs that aren’t essential to the everyday running of, and development of the UK healthcare system. As information pours in, inbound mail and paperwork clutters surgeries and offices, and as such, the risk of misplacing important information increases. The cost of printing and filing these documents can become a huge drain on valuable NHS resources.

The time that medical staff spend on collating this information and filing has also dramatically increased. Managing the flow of paper and digital data, collating it, storing it, tracking it and sourcing it when it’s needed, is a role on its own. When collating this information, hurdles, such as messy handwriting, means that there is a reliance on individual interpretation that as a result, may be wrongly-read or misinterpreted – ending up with an entirely different outcome being taken as fact. The impact on patients can be significant. Yet, this shouldn’t be the case.

Making patient notes accessible - by centralising paper-based and digital documents into one digital data source - needs to be a key priority for the NHS to enable productivity and sustainability of time-stretched resources. Finding patient notes quickly, rather than rummaging through files and folders, can have huge cost-effective results.

  1. Has the drive towards a ‘paperless NHS’ made trusts more interested in adopting document management solutions?

As the NHS looks to adopt electronic health records, digital referrals and e-prescriptions more widely, there is still a backlog of information stored on paper that needs to be addressed. Before the NHS moves towards a ‘paperless future’, it needs to overcome its ‘analogue past’ and transform existing materials into a digital format.

However, digitising these documents is just the first step when it comes to transforming back-end functions. Effective document management should add value and save on stretched resources, making the documents easy to find, open and update as appropriate.

  1. Processes such as scanning are very resource-intensive, is there a better approach?

Scanning all existing paper documents on a case-by-case basis is a labour-intensive process. This is not only inefficient, but is also prone to error. In an industry where cost-savings make a huge difference, automating the digitisation processes will dramatically reduce the cost of scanning and improve the quality of critical services.

In order to make the best use of digitised documents, the text within them must become ‘readable’ so that it can be searched for. One way that this can be done from scanned documents is using optical character recognition (OCR) technology to translate image-based documents (such as image-based PDFs, TIFFs or JPEGs) into ‘readable’ text. When looking for specific patient notes or previous cases of a particular illness, being able to search for the relevant document by its title as well as by keywords will make life easier for those for whom time is precious.

Intelligent systems can divide high piles of loose pages into individual documents, extract meaningful information and assign indices to each document before attaching them to electronic medical records or storing them in the document management system.

  1. What benefits are there for trusts that embrace a ‘paperless’ system?

As well as the money saved by printing less, trusts will have more space dedicated to patients. While the initial digitisation project requires investment and time for medical staff to learn how to use the technology, in the short-term, the clarity of case notes will be increased, enabling a swift and accurate handover to take place between day and night shift practitioners. In the long-term, nurses and doctors will spend less time on administrative paperwork and can instead focus on the patient and improving value-add services. Centralised digital systems can also enable doctors to track patient developments more easily and quickly.

Data analysis needn’t be limited to a single or small group of patients. Collating vast volumes of patient history can enable trusts to study previous cases and current conditions and then learn about them in order to develop treatment on a national scale. As we’ve seen recently, from Google being given access to an estimated 1.6 million NHS patient records in order to identify and alert those at risk of developing acute kidney injury (AKI), technology is being used as an enabler for healthcare trusts to gain insight and transform the sector. Being able to learn from previous cases, will enable the NHS to position themselves at the forefront of innovation when it comes to the development of healthcare internationally.

  1. Realistically, how easy is it for the NHS to go completely paperless?

Healthcare trusts are starting to make progress when it comes to embracing a truly paperless NHS. However, there are still many challenges that need to be addressed. While the laws and regulations are being established, it’s clear that there is better understanding of the positive impact of paperless working now. Some practitioners are used to traditional working practices and are hesitant to try new technologies. Patients too have demonstrated their hesitancy towards online access to their information, with concerns centred around the security of their personal and private personal data.

One of the biggest challenges comes with signed documents. Pain treatment plans, vaccination agreements and surgery agreements still need to be physically signed by the patient. These documents must then be scanned and digitally stored.

While the healthcare sector still has ground to cover before achieving total digitisation, every step towards improving the patient care, increasing productivity, saving costs and having a positive effect on the environment is one worth taking.

Image source: Shutterstock/Carlos Amarillo