In the midst of England’s healthcare digital transformation, outpatient care takes centre stage with the government’s 2023 mandate. With significant investment and a focus on improving outpatient productivity, the introduction of new technologies aims to address the persistent challenges in accessing patient information and delivering optimal care. We hear from Alex Ryan, Director, EMEA Healthcare Business Development at Hyland, about the integration of content service platforms and enterprise imaging promises to streamline outpatient processes, enhancing the patient experience and relieving administrative burdens, ultimately advancing the goal of a more efficient and patient-centric healthcare system.
Healthcare in England is experiencing a significant year of digital transformation. Between the merger of NHS Digital, NHS England and Health Education England and the appointment of John Quinn as Chief Intelligence Officer to that new body, there’s a concerted effort to streamline and accelerate the technological advancement of UK healthcare.
The government’s 2023 mandate to NHS England has promised up to £14.1bn investment into health and social care over the next two years, largely delivered through the NHS’ network of integrated care systems (ICS). Its stated goal is: “supporting health and care systems to ‘level-up’ their digital maturity and ensure they have a core level of infrastructure, digitisation and skills by March 2025.”
Interestingly, that mandate specified improved outpatient care: the technologies that support patients who don’t need a bed within a hospital and/or who don’t need to stay overnight. It intends to “focus on increasing outpatient productivity and transforming outpatient pathways”, with a target that 95% of the patients requiring diagnostic tests be seen within six weeks by March 2025.
But with so many potential targets for healthcare investment, why is outpatient care such a focus? And what are the technologies that are being introduced in 2023 to digitally transform the outpatient experience?
Out of reach
While the layman might assume that patient information is available to every clinician, the inability to access unstructured clinical content and images at the point of care can be a persistent impediment to delivering the best possible outpatient care.
According to research from Frost and Sullivan, more than 75% of patient information is unstructured and not natively captured by – or stored in – an electronic health record (EHR). This makes access inconsistent; speciality imaging systems, mobile devices and physical storage media can all silo important files or context, for example, with no guarantee that systems can integrate with one another.
This can be further exacerbated by the way in which written documentation and similar content are stored. Paper files, faxed records and clinical documentation systems can be distributed between different hospitals or practices and are vulnerable to human error.
As a result, research conducted by the Healthcare Information & Management Society and Hyland Healthcare, has found that almost two-thirds (65%) of health systems lack medical images and other unstructured data patient information at the point of care. Sixty-one percent of clinical content captured on mobile devices isn’t integrated into the EHR; 15% of respondents working week was wasted searching for information unavailable in core systems.
This is where the importance of developing outpatient processes becomes clear. No matter how talented the physician is or how cooperative the patient, there is inherent risk when medical professionals make decisions without the context and information necessary to deliver the most appropriate care. In a field where the smallest detail can drastically change the course of treatment, this is intolerable.
These data points require structure, and by that, we mean infrastructure – an underlying platform that can integrate a myriad of file types and datapoints into a secure, navigable format.
Sort it out
In the absence of a centralised repository for all NHS data, which would be a monolithic task both logistically and financially, improving health system outpatient services depends upon content service platforms to act as a natural, important extension of the electronic patient record.
In combining content services with enterprise imaging, such systems can feed unstructured data into the workflow of care and administrative teams. That may be into the EHR, but also enterprise resource planning (ERP) solutions, human resource integration systems (HRIS) and other core technologies that drive standard processes.
The benefits of such a system span the entire inpatient and outpatient experience, as the process of collating becomes so much more coherent. Patients can complete registration forms and advance directives/statements electronically before their visit or upon arrival, accelerating the process and making data available for appropriate enterprise access to the patient’s care team.
The same applies to medical images generated during the encounter and consent forms required for future treatments, improving patient satisfaction by eliminating repetitive physical form-filling.
It also enhances the outpatient experience beyond the medical practice. Patients can upload documents and other resources remotely and access their medical images via a provider’s patient portal – while staff claw back valuable time that might have been spent burning medical images to a CD and mailing them to each patient.
At the back end, strain is relieved on administrative staff, too. Paperless form processing eliminates time spent scanning documents or rekeying information, while workflow automation speeds approvals.
Over and out
In an organisation as pressured and multifaceted as a healthcare system and its medical practices, introducing technology requires careful change management. Internal consultation is needed to establish a system’s remit across the organisation, supported by a team of ‘superuser’ advocates that can lead by example and help the period of transition.
The scale and scope of change required exposes how unadvanced outpatient care can be in a worst-case scenario. Without access to key information, the likelihood of delay and misdiagnoses rises – undermining the government’s long-term plan to level up digital healthcare services.
To deliver joined-up support that better meets the needs of the population, different parts of the NHS (including hospitals, primary care and community and mental health services) need to work in a much more joined-up way. ICSs are the latest in a long line of initiatives aiming to integrate care and a carefully curated content management system is the failsafe that prevents this.
Acting as the foundation upon which other data can rely, an appropriately selected and targeted system can speed up the outpatient process across the board while simultaneously improving the quality of service for both patients and staff.
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