- Smart Healthcare, Wednesday 1 July 2009 09.00 BST
Day 220: The Lord be praised; it is now a whole month since I have been near "Fastrack Hospital", either as an inmate or outpatient. Perhaps, I have seen the end of the condition of which I have been suffering for seven long months. Maybe, it is time to tempt fate by summing up a patient's view of the whole experience. And to take a view on whether the billions of pounds for the National Plan for IT spent over seven years has improved my patient care one iota.
Before doing so, I must issue a health warning on what I am about to say. I deal only with "connecting for health" matters. I do not address clinical or nursing matters – unless these are part of a system. I am elderly, over-educated, articulate, IT-aware and stroppy. This puts me into a category of about 1% of the UK's patient population. So you can ignore what I say if you like. But I ask you not to stop reading, as my category is likely to grow exponentially in the next few years - particularly the stroppiness.
Fastrack is not a hospital which has had the trauma of implementing Lorenzo or Millennium, the two software packages on which most of the NPfIT money has been spent. It has a modest hospital computer system, with which all the clinical staff seem content. This is a change from most other hospitals I have attended over the last few years, where consultants have wound themselves up with hate-attacks against the IT department or Richard Granger.
Although my last column was critical of a particular aspect of Fastrack's computer system, I have been impressed by the way outlying departments like physiotherapy knew, through the computer system, within 24 hours what treatments I had received from other departments. To me, this is what a speedily-updated clinical computer system is for: communication. In 1990s standards, it is a good hospital computer system.
I do grumble that the way in which data is entered into the computer system is still manual, with all the potential for transcription errors still there. My GPs' surgery inputs directly. Why can't hospital doctors and nurses do the same? The conventional answer is that the GP sits at a desk, whereas a hospital doctor is on the moves around the wards.
OK, so give the doctors and nurses mobile devices, to record the data as it comes from the patient. To me this is a no-brainer. I appreciate that to the clinicians, this is a massive culture-shift, not a low-hanging fruit. As a stroppy patient, I say, OK, so what, that's your problem, not mine. I am the patient, and I believe that your mental block is jeopardising your care for me. The technology is there, so, do something about it.
Another of my gripes is that the NHS is an email-free zone, as far as patients are concerned. The examples I have quoted in these columns of distress caused to my ill friends by the slow delivery of snail-mail must be echoed around the country. Even MPs, whose public perception as luddites is even worse than doctors, carry out 60% of their correspondence with constituents by email. Why can't the medical profession jump from the 19th to the 21st century by doing the same? Again, email is technically a low-hanging fruit, but a massive culture shift for the medical profession.
My last complaint is that Fastrack found it difficult to get details in a hurry from another local hospital about an echocardiogram I had had a year ago. Getting any information from other hospitals is like drawing teeth. On my last visit to Fastrack, the chap opposite in my ward had just come from six weeks in a local general hospital, where he had had massive surgery to his spine. It seemed to me that his first few days in Fastrack were spent in having X-rays and scans to see what the other hospital had done. They even had to find out what metal had been used to mend the spine. They had to do this, because the record of treatment at the other hospital must have been inadequate.
This puts all the arguments about care records into perspective. To me a central national summary care record database would be nice, but what is infinitely more desirable is the detailed past record of treatment available on another hospital at the click of a mouse. This is not a low-hanging fruit, and will need a lot of work. I am puzzled that none of the planners have seen this as a vital project, when I, a simple elderly patient, cannot understand how doctors can function sensibly without it.
But, that's the thing about being a patient. From where I am lying, the priorities for smart healthcare look very different from where doctors, IT departments and administrators are sitting or standing.
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