Revolutionizing Health Services

Adoption of technology in the health sector is slow and disparate. The National Health Service is responsible for adopting technology but it has proven to be very slow (Healthcare Industries Task Force, 2004). The world is experiencing a data revolution whereby data information is becoming more useful. Opening it or making it accessible to a wide pool of people can result in an even more important outcome. Verhulst et. al., (2014) provide an evidence that suggest an increase in the healthy behaviour and an improvement of decision making process in patients that are able to access their personal medical records. Healthcare systems become cost effective when providers can access comparative performance indicators in the different hospitals and for the physicians. Data on prescription and performances of different hospitals will empower the public to make better choices and be accountable. It is for this case that Britain has established initiatives that will technologically revolutionalise the health services (NHS) and in turn translate into a positive outcome for the inhabitants of South East England.

1.1.1 Research Question

Will e-health record technology revolutionize the health services (NHS) for the inhabitants of South East England?

1.1.2 Aim

The project will investigate the government initiatives in regards to health care systems in the United Kingdom. It will also show how the National Health System has improved and give reasons why there are demands for a change.

 

1.1.3 Rationale

The fundamental reasons for this study is to ensure that a lot of people embrace e-health, register with e-health record systems, and make the NHS quickly develop technology in the health sector.

1.1.4 Purpose of the Research

The research towards revolutionising the health sector would educate the public about the benefits of e-health records, its efficiency and advantages. This research would like to build the people’s trust to the e-health initiatives and guarantee them security of their medical information. The paper would also reveal examples of e-health platforms in other nations and areas within the UK. The research would empower the public into making the best choices regarding their health.

1.2 Methodology

The methodology will involve carrying out a survey on the successful e-health records in the UK. This will focus on eRedbook  and analyse the issues of privacy, protection policies and membership. The study will involve the use of questionnaires and telephone conversations with the participants. The questions will mainly focus on: whether the participants have seen the implementation of eRedbook, their registration and membership on eRedbook, the user perceptions, security and privacy issues and whether the participants have embraced eRedbook.

One important area of the health sector that the government has identified for technological development is in the recording of health information. Health records have traditionally been put in patient books, health cards, discharge plan sheets and computer applications within the hospitals. The UK health secretary launched a “paperless NHS” project in January 2013 that ensured healthcare records were shared between social and health care services. The project was predicted to save £5bn in a year. It was aimed to make sure that hospitals and GPs were able to access and update GP records by the year 2014 while patients were able to access their records online. All parts of the NHS and social care were targeted to be connected by the year 2018 (eHealth Stakeholder Group, 2013). This led to the formation of an Electronic Health Records (EHR) computer-based application that mainly focused on the patients’ information.

1.3.0 Electronic Health Records

EHR is a term utilized by NHS England to describe the “concept of longitudinal record of patient’s health and health care, from cradle to grave” (IM&T Programme Board). It collects and stores information about a patient which can be made widely available across relevant institutions, within a community or a specific department. The name is referred by many terms in regard to how it was first called. They include the Automated Health Records (AHR), Electronic Medical Record (EMR), Computer-based Patient Record (CPR) and the Electronic Health Record (EHR) which is used by many countries (World Health Organization, 2006).

1.3.1 Electronic Health Records in Other Countries

Implementation of the EHR has been achieved in some countries. Two hospitals, one with a capacity of 960 beds while the other with a capacity of 270 beds, have gone paperless. A teaching hospital used a form of electronic health record called Health Information Management Administration System (HIMAS) that used an IBM mainframe computer. The version was upgraded to INFORMED systems which cover patient admission, medical records tracing system, appointment scheduling, transfer, pharmacy ordering, laboratory ordering and reporting etc (World Health Organization, 2006).

Korea had 11 hospitals that used EMR system to record patient information. Australian tried to implement HealthConnect system which will collect, store and exchange information of patients through a secured network. Belgium created Behealth at the end of 2004 which coordinated and organized information among stakeholders in health care. Czech Republic used IZIP system which stored about 200 million records by the end of April 2012 from 100 million in December 2011. France has implemented the Dossier medical personnel (DMP) while many others have used the normal EHR system. England has been using the Summary Care Records (SCRs) in order to improve the quality and safety of patient care (eHealth Stakeholder Group, 2013).  As of May 3, 2013, it had 27 million records across England.

1.3.2 EHR Policies

Introduction of EHR are guided by policies established to ensure that the system becomes reliable and more effective. The information flow into EHR system follows the same procedures as the manual system with the difference being that data is entered at the nurses’ or doctor’s station ward by an electronic device. Downtime policy is responsible for backing up the system. A policy to determine when and why documents should be printed is also very important. For how long a data should be retained in the database falls under the retention policy and it either increases space or determine the amount of data that can be entered. They are usually not retained for more than thirty years. Individuals have a duty of care for the records that are subjected to the Public Records Act 1958 (Department of Health, 2009). Language and format should be simple so that the patient can understand and analyze his health progress or communicate with the medical professionals.

Before introduction of the EHR, patients’ records need to be in one medical record. Records of each patient should be uniquely stored using codes for easy accessibility and storage. Patient Master Index (PMI) has to be maintained and later be computerized or introduced if it had not been present.

 

1.3.3 Privacy and Protection in the EHR System

With collection and sharing of information under the EHR system, the carers and health care institutions gain access to some information about patients for the purpose of continuity of care (Policy Engagement Network for the International Development Research Centre, 2010). Privacy is therefore dependant on the trust between the patients and the carers who make oaths not to disclose any information. In other cases, the patients are given more control over the information entered in EHR. They have a right to access their health records as stipulated in the Data Protection Act (DPA) 1998 (Royal College of General practitioners, 2010). Accessibility into the health information would require consent from the patient. Larger hospitals do not fully guarantee privacy in health records which may be due to low incentives that they get out of it (Miron-Shatz & Elwyn, 2011). A claim from the Consumers’ e-Health Alliance (2011) found that consumers (or patients) are able to manage their own medical information better that how healthcare providers can.

1.4.0 eRedbook: An E-Health Record for Children

Liverpool Community Health NHS Trust has implemented eRedbook as an e-health record for children. The electronic platform uses internet-enabled devices such as laptops, smart phones and other mobile devices to retrieve information about the health status of patients. Parents, GPs, health visitors and health professionals are able to work together to ensure that babies and young children’s health are improved. The Trust has registered over 450 local families to the eRedbook. eRedbook keeps information of a child’s health and development. It has details of the tests and immunizations that have been done on the baby patients. Sitekit in conjunction with Harlow printing have developed the online version of Redbook and it hopes to have digital health records of children throughout their lives (Todd, 2013). The database is hosted by Microsoft’s HealthVault.

The paper version has been in use for 20 years. It used to be given to the parents at a child’s birth. The online version is used by the health professionals together with the parents to manage the health of the baby. The electronic health record for children links the initiation of the eRedbook to the NHS number. It contains the birth details and examination from maternity services, Bloodspot, NIPE and Hearing Screening data from the national screening programme, immunisations, health reviews, aggregated appointment and parent initiated demographic updates. These data are highly secured because the database is being hosted by Microsoft HealthVault which is centred in England. It is globally renowned to provide a privacy policy.

The Royal College of Paediatrics and Child Health, the NHS and other companies were involved in developing eRedbook hence it has been hugely endorsed. Sometimes referred to as a ‘personal child health record’ or PCHR, it has allowed parents and children to co-manage their health with the health providers. RiO2RiO is another electronic health record that has been very successful in North East London because it has made it possible to get instant and wide information on the children immunizations, bloodspots, and health checks. Accuracy has been improved as a result of immediate addition of information at a click of a button.

1.4.1 Similar E-Health Records for Children

Some countries have similar e-health records but there has been slow adoption of the technology. Canada has such kind of a child health record referred to as eCHN based in Ontario. The eCHN records has currently listed 2,587,922 children patients from 2,586, 414 in the previous week (www.echn.ca). Information about children health can be accessed through eCHN which is easily accessible and to check. Dr. Beth Gamulka has used the electronic health record to retrieve information about children before deciding on the type of diagnosis. eCHN has enabled her get relevant information and lead  her into making quick and  right decision pertaining the type of diagnostic procedures on the patients.

1.5 Significance of e-Health to the inhabitants of South East London

South East London has a population of 1.67 million but a high percentage is underprivileged making the region the fifth most disadvantaged in England (Lewishamccg, 2014). Digital exclusion affects the most underprivileged areas in England (Government Digital Service, 2014). A lot of people in England are embracing technology with more than fifty percent of people below 54 years having mobile phone internet connections. This means that South East of London is also recording high numbers of people with internet connections. With London having the largest number of youngest people (63%) than the rest of UK, ehealth initiatives will easily be implemented.

With ehealth technology, the poor will be able to afford medical services while at the same time save a lot of money. A 60 year old woman fell down the stairs and unfortunately broke her shoulder. The woman made eight visits to see a doctor in a fracture clinic. She had to write eight letters to the doctor and make eight GP appointments. Each appointment cost £25. After registering in an electronic health service, the woman got quick feedbacks from the letters she wrote to the doctor. if she would have registered earlier, the woman could have saved the NHS £ 200 from the eight visits (Mynors & Newsorn-Davis, 2012). In addition to being cheap, health enquiries, assistance, observations and information can either be added or accessed from home. Less serious cases can be handled from home and allow the hospitals concentrate on medical cases that need a lot of attention. The time and space that people will use to seek medical attention can be used to save a life.

1.7 Conclusion

The benefits of EHRs outweigh the negatives. They ensure that admission and monitoring of patients is very fast and efficient. As a centralized system, different health information can be entered by any one but after a consent from the patients anywhere and any time. It will also allow health professionals to go through historical health information of a patient and resume treatment procedures. It is cost effective to both patients and hospitals. They will also increase health behaviour and improve decision making process of patients who are able to access their personal medical records.

 

References

Consumers’ e-Health Alliance (2011). “Review of the PCEHR draft concept of operations.” Retrieved from http://www.yourhealth.gov.au/internet/yourhealth/blog.nsf/AFA3EEBA58421EC7CA2578DC0003F72C/$FILE/Consumers%20e- Health%20Alliance%20submission.pdf

Department of Health (2012). The Power of Information – Equality Analysis. Department of Health.  Retrieved from www.dh.gov.uk

Department of Health (2009) Records Management: NHS Code of Practice Part 2. 2nd Edition. London: Crown

ECHN (2010). “Celebrating members of Our Community.” ECHN. Retrieved February 11, 2015 from www.echn,ca/about-celebrating-drgamulka.php

Fisher, B., Bhavani, V. & Winfield, M. (2009). “How patients use access to their full health records: a qualitative study of patients in general practice.” J R Soc Med. Vol.  102, Issue 12. pp.  539-44.

Government Digital Service (2014). “Government Digital Inclusion Strategy.” Available at https://www.gov.uk/government/publications/government-digital-inclusion-strategy/government-digital-inclusion-strategy

Healthcare Industries Task Force (2004). Better Healthcare Through Partnership: A programme for action. London: Department of Health. Available at www.abhi.org.uk/multimedia/downloads/2007/HITF.pdf

IM&T Programme Board. Electronic Health Records issues for discussion leading to a policy framework. EHR Policy. Draft 0.3

Lewishamccg (2014). “Improving south east London health services together. NHS. available at http://www.lewishamccg.nhs.uk/get-involved/improving-south-east-Londons-health-services-together/Documents/Full%20DRAFT%20case%20for%20change%20for%20south%20east%20London%20commissioning%20strategy%20-%20Feb%202014.pdf

Miron-Shatz, T. & Elwyn, G. (2011). “To serve and protect? Electronic health records pose challenges for privacy, autonomy and person-centered medicine.” The International Journal of Person Centered Medicine. Vol. 1 Issue 2 pp 405-409

Mynors, G. & Newsorn-Davis, E. (2012). Guide to Health Records Access. Patient Information Forum.

(December 2010). Electronic Health Privacy and Security in Developing Countries and Humanitarian Operations. A report prepared by the Policy Engagement Network for the International Development Research Centre. The London School of Economics and Political Science.

(June 2013). Patient access to Electronic Health Records.  Report of the eHealth Stakeholder Group

The Royal College of General Practitioners (2010). Enabling Patients to Access Electronic Health Records:Guidance for Health Professionals. Version 1.0. 1 Bow Churchyard, London: The Royal College of General Practitioners 2010

Todd, R. (2013). “Liverpool pilots eRedbook.” ehiNEWS. Retrieved Frebruary 11, 2015 from http://www.ehi.co.uk/news/ehi/8680/liverpool-pilots-eredbook

Verhulst,S., Noveck, B., Caplan, R., Brown, K. & Paz, C. (2014). The Open Data Era in Health and Social Care: A blueprint for the National Health Service (NHS England) to develop a research and learning programme for the open data era in health and social care. The Governance Lab.

World Health Organisation (2006). Electronic Health Records: Manual for Developing Countries. Geneva 27, Switzerland: World Health Organisation