Maurice Dixon:
Technology could most definitely make the NHS more efficient. Having spent many hours in an eye A&E department for a serious condition this weekend it is obvious how inefficient current NHS patient processing is. Having been sent by an optician who had studied a series of digital photos of the eye over. a few weeks, it was decided priority investigation and and treatment was needed for a potential blindness-inducing condition. Whilst the eye department processes and staff that eventually did the eye operation were very proficient, the A&E process and the 'arrival information, triage and detailed assessment, treatment, post-op processes and emergency review' yesterday and today completely ignored basic digital imagery technology that could make the whole process far more efficient and effective. The optician has a time lapse trail of the eye condition with numerous very high definition digital photos of the eye in question. The NHS would not accept these photos, even as background information. When at the A&E, that had been pre-warned of arrival, the initial reception admin process was quite efficient, and the initial triage quite efficient (within 15 mins?), thereafter the 'your wait is determined by priority not time of arrival', didn't function. After 3 hours of sitting in line with a potentially life changing condition, others who had been waiting many hours were seen by doctors and many discharged with eye drops (thus, perhaps not quite such a priority) - why couldn't these be processed by nurse practitioners? Once on the 'being seen to' list, everything was done manually, no digital photos taken of the eye and its deteriorating condition from initial triage to, detailed assessment (by at least 2 doctors), pre-op, during op, post op, to discharge and having to been reviewed again today. Each doctor made manual sketches on scraps of paper, hand written notes (some not as legible as perhaps necessary), and no digital photos were taken or reviewed for consistency of trail eye condition changes. each doctor had their 'snap shot' of the eye condition. Fortunately, the doctor that had to do an emergency review this morning, due to concerns about eye deterioration overnight, was the same one on duty yesterday who signed the discharge papers - that was the only continuity - a doctors memory of what the eye looked like yesterday and what it looked like today. The use of very effective high-res digital photos/videos from the optician to the hospital and through the whole process would have been far more efficient and provided a factual 'digital trend trail' of the pre-op eye condition, what was done during the operation, what was the status post op and at discharge and hopefully provide evidence of eye condition improvement over the next few months. If a high street optician chain can have a digital library of its clients eye condition over years, why can't the NHS specialist eye departments, and why can't they all use each others images if the patient consents? Why can't the optician now be provided with post-op and hopefully after treatment has been completed, so that at the next annual eye review/check, the condition can continued to be reviewed by professional opticians, but not take up valuable NHS resource and time?
This must be one of 100s of examples where properly applied use of technology could significantly improve the NHS. Technology could save the NHS if applied to improve processes, not just 'digitise' bad paperwork and manual processes, provide better access to patient information and records, and provide factual evidence trail of medical conditions across the value chain.
What a fantastic story!
This is far from the first time when the NHS has refused to accept medical information originating from a third party source (your optician). I am well aware of NHS psychologists and paediatric consultants refusing to accept reports from teachers or local authority educational psychologists and SEN officials for cases involving Asperger Syndrome or autistic spectrum disorders.
It is deeply questionable why the NHS is refusing (or possibly cannot legally accept) information from other medical practitioners, such as opticians, and then update records following treatment. Your story is an indication of how the NHS is lagging behind the private sector when it comes to storing and using medical records - a library of high-res photos vs handwritten notes - and the disconnectness it has with other medical practitioners.
Maurice Dixon:
Technology could most definitely make the NHS more efficient. Having spent many hours in an eye A&E department for a serious condition this weekend it is obvious how inefficient current NHS patient processing is. Having been sent by an optician who had studied a series of digital photos of the eye over. a few weeks, it was decided priority investigation and and treatment was needed for a potential blindness-inducing condition. Whilst the eye department processes and staff that eventually did the eye operation were very proficient, the A&E process and the 'arrival information, triage and detailed assessment, treatment, post-op processes and emergency review' yesterday and today completely ignored basic digital imagery technology that could make the whole process far more efficient and effective. The optician has a time lapse trail of the eye condition with numerous very high definition digital photos of the eye in question. The NHS would not accept these photos, even as background information. When at the A&E, that had been pre-warned of arrival, the initial reception admin process was quite efficient, and the initial triage quite efficient (within 15 mins?), thereafter the 'your wait is determined by priority not time of arrival', didn't function. After 3 hours of sitting in line with a potentially life changing condition, others who had been waiting many hours were seen by doctors and many discharged with eye drops (thus, perhaps not quite such a priority) - why couldn't these be processed by nurse practitioners? Once on the 'being seen to' list, everything was done manually, no digital photos taken of the eye and its deteriorating condition from initial triage to, detailed assessment (by at least 2 doctors), pre-op, during op, post op, to discharge and having to been reviewed again today. Each doctor made manual sketches on scraps of paper, hand written notes (some not as legible as perhaps necessary), and no digital photos were taken or reviewed for consistency of trail eye condition changes. each doctor had their 'snap shot' of the eye condition. Fortunately, the doctor that had to do an emergency review this morning, due to concerns about eye deterioration overnight, was the same one on duty yesterday who signed the discharge papers - that was the only continuity - a doctors memory of what the eye looked like yesterday and what it looked like today. The use of very effective high-res digital photos/videos from the optician to the hospital and through the whole process would have been far more efficient and provided a factual 'digital trend trail' of the pre-op eye condition, what was done during the operation, what was the status post op and at discharge and hopefully provide evidence of eye condition improvement over the next few months. If a high street optician chain can have a digital library of its clients eye condition over years, why can't the NHS specialist eye departments, and why can't they all use each others images if the patient consents? Why can't the optician now be provided with post-op and hopefully after treatment has been completed, so that at the next annual eye review/check, the condition can continued to be reviewed by professional opticians, but not take up valuable NHS resource and time?
This must be one of 100s of examples where properly applied use of technology could significantly improve the NHS. Technology could save the NHS if applied to improve processes, not just 'digitise' bad paperwork and manual processes, provide better access to patient information and records, and provide factual evidence trail of medical conditions across the value chain.
What a fantastic story!
This is far from the first time when the NHS has refused to accept medical information originating from a third party source (your optician). I am well aware of NHS psychologists and paediatric consultants refusing to accept reports from teachers or local authority educational psychologists and SEN officials for cases involving Asperger Syndrome or autistic spectrum disorders.
It is deeply questionable why the NHS is refusing (or possibly cannot legally accept) information from other medical practitioners, such as opticians, and then update records following treatment. Your story is an indication of how the NHS is lagging behind the private sector when it comes to storing and using medical records - a library of high-res photos vs handwritten notes - and the disconnectness it has with other medical practitioners.
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