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From the WannaCry cyber attack that caused chaos across the country, to England’s biggest trust hit by a week-long IT systems crash, and the revelation that the NHS accidentally “mislaid” patient documents, it has been a turbulent year for the NHS.
But it’s not all been doom and gloom. NHS Digital got a new boss – former Home Office chief digital and information officer Sarah Wilkinson – and NHS England updated its Five Year Forward View, filling it with exciting digital initiatives.
Trusts are beginning to look at the potential uses of artificial intelligence, and some are leading the way in virtual reality. Scotland launched its own GP information-sharing system, which went through much better than England’s Care.data disaster. All in all, it’s not been a bad year.
Here are Computer Weekly’s top 10 NHS IT stories of 2017.
In May, the NHS was struck by chaos when the WannaCry ransomware attack hit about 50 trusts in England and 13 NHS organisations in Scotland.
NHS Digital worked around the clock with stakeholders to get the situation under control, but the WannaCry attack, although not specifically targeted at the NHS, was a wake-up call for the health service and showed the need for both resilient infrastructure and proper cyber security education on a local level.
In fact, an NAO report later in the year called on the NHS to “get its act together”, saying the organisation could have prevented the attack if it had followed basic IT security best practice.
Royal Free Hospital NSH Foundation Trust and Google-owned artificial intelligence firm DeepMind’s datas-sharing deal was controversial from the start. The arrangement gave DeepMind access to the identifiable healthcare records of 1.6 million patients in order to test its Streams application. It relied on implied consent, leading to concerns and complaints from the public.
Both Fiona Caldicott, national data guardian for health and care, and the Information Commissioner’s Office (ICO) were unimpressed. In July, the ICO found that the deal failed to comply with the Data Protection Act and described the mechanisms to inform patients that their data would be used as “inadequate”.
Both the trust and DeepMind accepted the ICO’s findings.
Virtual reality (VR) has begun to gain a foothold in healthcare. Oxford Health NHS Foundation Trust is one of the trusts leading the way by using VR to treat persecutory delusions, while King’s College Hospital NHS Foundation Trust has created an app for children about to undergo their first MRI scan. When used with a headset, the app allows them to preview the whole experience through VR, from arriving at reception to the scan, noises included.
It might be a while before this becomes a regular feature in the NHS, but as more and more trusts look at its potential, uptake is likely to grow.
In March, NHS England updated its five year strategy, revealing that a number of health trusts had been chosen to become digital centres of excellence, including Oxford Health NHS Trust (mentioned above).
It also set out plans for how the NHS would incorporate the recommendations of last year’s Wachter review of NHS technology, as well as promising NHS 111 online services and an updated apps library.
In February, news came to light that the NHS had, over 15 years, accidentally mislaid 700,000 documents, including more than half a million confidential patient documents, by putting them into a warehouse rather than deliver them to their intended recipients.
Some of the documents had the potential risk of harm to patients by not being delivered, which prompted further investigation. However, a review of all the documents has so far found no evidence of clinical harm to patients as a result of the data going astray.
In October, a Public Accounts Committee hearing revealed that the number was even higher, with a further 162,000 documents being discovered, which must now go through the same review process.
Replacing former CEO Andy Williams, who left in March, Wilkinson is now in charge of delivering a paperless NHS, ensuring that programmes at both national and local level are focused on making effective use of technology, information and data.
In March, the Scottish NHS launched its own data-sharing system, allowing GPs to share anonymised patient information with researchers. Sounds familiar? That’s because it’s basically the Scottish version of NHS England’s Care.data programme, minus various issues that arose with that project.
Unlike the plans for Care.data, which aimed to extract data that would be held in a central database, in Scotland, data will only be collected for specific purposes, and once it has been used, it will be destroyed.
At the AI summit in London, experts said the NHS could definitely benefit from the use of artificial intelligence (AI). However, the organisation is far from ready. Despite the drive to introduce electronic patient records, there is a lot of paper flying about the health service, and when systems are in place, they often don’t talk to each other – not the ideal environment to introduce AI.
This echoes evidence at a recent House of Lords AI committee, which found that the NHS data is simply not yet fit for AI.
Before it starts banging the drum for AI, the NHS must fully integrate health and social care records, but when it does, AI has the potential to transform the health service.
In April, Barts Health NHS Trust faced a week of IT issues – not ideal when you are the largest NHS trust in the country. The main issues involved access to imaging and radiology systems, leading the trust to cancel operations and outpatient appointments that relied on images.
The problem also affected the trust’s chemotherapy prescribing system, pathology, and its digital dictation system. The week-long IT issues came just months after the trust was hit by a cyber attack, and right before the national WannaCry attack. It has not been an easy year for the trust.
The system is already being piloted by some GP surgeries, with some using their own apps to do so. Hunt says this will be “the best possible 70th birthday present from the NHS to its patients”.