It’s been a rocky year for technology and the NHS, succumbing to a marketing blow for its Care.data project and pushing back its e-Referral Service. But new technology frameworks and hard measures to make NHS divisions become more digital may lead to a more successful 2015.
One of the top healthcare IT stories of this year was the Care.data debate.
The controversies surrounding the plans to expand the collection of patient care data from hospitals to include general practices came to a head in February. Failure to explain the benefits to the general public forced the NHS to put the plans on hold for six months.
Critics argued the NHS had failed to educate the public about the scheme, leading to security fears over personal data, as well as an outcry that the scheme should be opt-in, rather than opt-out.
The arguments for and against Care.data are clear, with the benefits being the better understanding of health needs, how the data can be used to improve quality of care and also by researchers to identify patterns in diseases.
But critics of Care.data have expressed concerns about the protections around data and its ability to be used for purposes other than anonymised medical research, in particular for commercial purposes such as insurance.
Six months after the decision to put the controversial project on hold, NHS England announced it had finally entered the testing phase with four clinical commissioning groups (CCGs) in October.
The four CCGs plan to test a variety of communication methods to inform patients of the scheme, including further leaflets, addressed letters, as well as emails and texts from participating surgeries.
NHS England said it wants to explain the benefits and risks of sharing data, as well as making clear patients' right to opt out from the Care.data scheme.
NHS England committed to making patient-facing digital services a requirement by 2020. The Personalised Health and Care 2020 framework is a set of requirements, proposals and case studies intended to ensure the delivery of digital health and care information over the next six years.
The strategy provides information on how the NHS will deliver change and make the best use of data and technology.
The framework paper now makes this a requirement rather than an aspiration. It stated all patient and care records will be digital, real-time and interoperable by 2020, with clinicians in primary, urgent and emergency care accessing paperless records by 2018.
Computer Weekly spoke to Kelsey towards the end of the year to discuss the NHS’s 2020 framework.
He said the framework was finally drawing a line in the sand to stop the situation where the NHS is largely running on paper-based systems and using fax machines, and that all divisions of the NHS must have electronic patient records by 2020 or risk losing their licence.
“We are saying there is a hard stop, and if you don’t meet that standard then it’s unlikely you’ll be receiving NHS patients,” said Kelsey. “By 2020 we can look forward to a truly interoperable health and care service which will be capable of doing much more integrated and personalised things for patients.”
September was a big month for the the Health and Social Care Information Centre (HSCIC), which successfully upgraded the infrastructure behind the NHS Spine platform.
Thousands of care organisations, health professionals and patients in England rely on the NHS Spine, which is fondly known as the "electronic backbone of the NHS" and is considered part of the critical national infrastructure.
The system transfers 400 million electronic messages per month and has to be available 24/7, so the final steps in the two-year process to upgrade to Spine 2 had to be completed during an off-peak period to a very precise script.
What makes the upgrade even more significant is that it was the first major project to be conducted internally with a development partner, rather than outsourced to a large supplier.
In 2013, health secretary Jeremy Hunt gave the NHS the challenge of becoming paperless by 2018. Computer Weekly posed the question: Can the health service meet that deadline? Or will the NHS just end up with less paper than it did in 2013?
But pockets of paperless achievement are starting to appear. But Bedford Hospital CIO Mark Austin was doubtful. Meanwhile, Professor Mike Pearson at Aintree University Hospital said a paperless NHS is achievable only “with enough will and drive,” and that it is unlikely to happen.
“There will be odd examples of it achieved well, but the NHS doesn’t have the organisation to achieve that at the moment,” he said.
Computer Weekly spoke to the Department of Health's head of digital Stephen Hale in September of 2014, and he soon went on to become one of the Rising Stars of the year.
“I want to make digital less of a novelty,” he said. “Part of our job is to do us out of a job in a way. We make digital mainstream, so we stop noticing it as innovative.”
The Department of Health’s digital team, which was set up at end of 2013 and is now led by Hale, ensures the department uses digital to make better policy and that it is part of everything the department does.
Health secretary Jeremy Hunt promised all NHS patients in England will have online access to their medical records by April 2015.
“It means you will no longer have to pay to access your medical record. You’ll be able to see it and show it to anyone you choose. You’ll find it easier to do detailed research about your condition and easier to challenge decisions. Because the boss is not the doctor – it’s you,” he said.
Delivering online records would meet a commitment first made by Hunt in 2012 to make medical data available to GP patients by 2015.
The NHS has delayed the launch of the replacement for its Choose and Book hospital appointment system until spring 2015 to allow further time for testing.
The NHS e-Referral Service was due to go live in 2014. It is replacing the £356m Choose and Book system, despite this being regarded as one of the few successes of the failed £12.7bn National Programme for IT.
The e-Referrals system is being developed using agile methods and open technologies, in contrast to its predecessor. But in July 2014, it failed a service assessment by the Government Digital Service because it was not able to meet 11 of the 26 criteria for the "digital by default" service standard.
During the Oracle OpenWorld conference this year CIOs from Walgreens and Dunnhumby announced they were moving further into the health and wellbeing market using the cloud.
The CIOs from the two companies described how the cloud is becoming a driver in the healthcare.
Walgreens CIO Tim Theriault said the US is facing a healthcare crisis and it needs to reduce costs, improve outcomes and deliver better customer experience.
The retailer is moving further into healthcare, including immunisations for diseases such as flu, which could be a good business opportunity as 65% of Americans live within three miles of a Walgreens store.
Meanwhile, Yael Cosset, CIO at Dunnhumby – the company which provides customer insight data to retailers and brands – said it is investing a lot of energy into "new data”, a term he used to describe data created from wearable devices.
Cosset said Dunnhumby is likely to spend more time and effort in this market, developing a lot more services around health and wellness.