A paperless NHS? Swapping best practice and ideas with the US Veteran Health Administration to make it happen

If the NHS is serious about going digital it should continue to build on an existing partnership with the VHA and continue to revolutionise healthcare, says the report "Making connections - A transatlantic exchange to support the adoption of digital health between the US VHA and England’s NHS" developed jointly by the VHA, 3Millionlives and published by 2020health.

On the 16th January 2013 Jeremy Hunt announced his ambition of achieving a ‘paperless’ NHS by 2018. For most in the health service, this seemed overly ambitious and NHS IT experts said that it would “be a struggle to achieve”, whilst the Labour Party criticised the Conservatives for prioritising technology over “the bread and butter services”. But Jeremy Hunt’s announcement was intended to reflect the government’s dedication to ensuring that technology becomes a core part of the future of the NHS. Hunt said that technology could help the NHS tackle its two main challenges, one being an ageing population.

In-depth research conducted to support "Making Connections" into the use of technology in the VHA shows this to be true. The VHA consistently provides a better quality of care than other health systems in the US, and at a lower cost, when before the VHA technological revolution the state of hospitals were ridiculed as ‘socialised medicine gone predictably amok’ (1).

Fundamentally though, what the 2020health report ‘Making Connections’ shows is that it is not just which services are implemented, but how these services are implemented which will ensure the successful use of digital health in the UK. Equally, the VHA can learn from this publication regarding the use of digital health in the NHS. In particular in the area of mobile health, where the NHS has incorporated patient feedback and choice into on-line and mobile directories of services, such as what’s available nearby and social media tools.

John Cruickshank, Consultant Director, 2020health and co-author of the report says “Whilst successful use of technology has been a key enabler to success in making digital health the first route for delivering a service, it is the underlying culture, leadership, processes and training that have been paramount to the VHA’s success.”

The 2020health report recommends that if the NHS is going to achieve a digital health-enabled service they need:

1. Senior leadership commitment to care ‘at a distance’
2. To find ways to ensure that digital health becomes a default delivery channel for service.
3. Embed the core competencies for digital health into the curricula of doctors, nurses and allied health professionals, and relevant local authority staff
4. To set up secure messaging and electronic Personal Healthcare Records (PHRs). These are essential tools in empowering patients and improving self-care

Julia Manning, Chief Executive, 2020health says “If the NHS is to meet public expectations for quality, access and efficiency, then it needs new, powerful capabilities to access information, knowledge and expertise on demand, as well as deliver advice and care in non-traditional settings, including the home and the workplace. We need to make sure that sentimentality for the NHS does not trump rationality. Policy makers, MPs and the public should be challenged and reassured by systems such as the Veteran’s Health Administration in the USA where transparency, technology and putting patient’s at the heart of practice was crucial to turning around a failing system.”

(1) Longman P, Best Care Anywhere – why VHA Healthcare is better than yours. 2010. Polipoint press, p.21

Note to Editors

1. For interviews, comment or further information please contact Julia Manning or John Cruickshank on 020 3170 7702.

2. As part of the NHS commitment placing telehealth at the heart of service transformation through the 3millionlives initiative, and more widely to adopt digital health for mainstream services, the two organisations have agreed to an Exchange Programme for three years starting from 2013.

3. The report was released 13th March 12.15pm at the NHS Expo. The report was sponsored by an unrestricted educational grant from 3 Million Lives, the VHA and BOSCH.