The National Health Service (NHS) is investing in the latest life-saving technology, but its back-end systems are struggling to survive. It still uses more than 8,000 fax machines, and Windows XP, which Microsoft stopped patching in 2014, is found on many desktops. The health service’s modernisation is long overdue — but at last it’s underway.
Matt Hancock, secretary of state for health and social care, has a plan to “ensure that every part of the NHS can use the best technology to improve patient safety, reduce delays and speed up appointments.” He’s also banned the NHS from buying any new fax machines.
Hancock pictures a revolution built on mobile data, which puts patients back at the heart of the NHS. He wants internal innovation, shorter procurement contracts and interoperable systems. Contrast these elements with the proprietary electronic health systems in use today, and the discrete platforms clinicians must switch between, with all the potential for error that they introduce — which could cost lives, not just money.
A technological revolution in healthcare
“Integration isn’t just about merging services,” says Amy Galea, deputy director of system transformation at NHS England. “It’s about understanding what different cohorts of people within a population need, and then thinking about that pathway from beginning to end.”
Doing so, and making a data platform agnostic and malleable, will require a top-down reworking of existing systems. Out will go mainframe computers in favour of cloud, artificial intelligence (AI) and analytics, which could help offset the required investment through short-term cost savings.
Express Scripts, which processes 1.4 billion U.S. prescriptions per year already uses big data to “detect patterns that might alert doctors to potential adverse drug interactions and other prescription issues,” reports MIT Technology Review. Those patterns can identify — 12 months in advance and with 98 per cent accuracy — which patients may fail to take their medicine. With similar metrics, the NHS could prescribe more accurately — or more conservatively — while monitoring compliance.
The proven potential of big data
Germany’s National Centre for Tumour Diseases uses records from tumour registries to identify groups of similar patients, analyse their treatment and help doctors make better decisions in the future, managing patients’ expectations as they embark on a particular pathway.
U.S. oncologists do the same, using a million patient records analysed by CancerLinQ, while Gustave Roussy, Europe’s leading cancer centre, researches new cures using the clinical and genomic data of 300,000 individuals.
The NHS could — and should — do the same. The cost savings the NHS could achieve, along with the potential for monetising its research-driven intellectual property, have the potential to keep it funded for generations. It could be, quite literally, just what the doctor ordered.
But the NHS will get there only if it achieves patient buy-in. Taxpayers need assurance that their data will be at least as secure as it has been to date, particularly as trusts continue to contract with third parties to deliver at lower cost. Modernisation at the expense of confidentiality, whatever efficiencies it could deliver, would certainly be a pill too bitter to swallow.