Jeremy Hunt, England’s Health Secretary, once led the charges for creating a truly paperless system. Initially, the plan was to roll out their solution by 2018, but it’s been pushed back to 2020. What is the cause of the delay? And what is the prognosis for success? We’ll take a look at the way this situation has unfolded and investigate possible improvements.


The New Digital Services Are No Longer Voluntary

When Jeremy Hunt initially brought this issue the forefront, his intention was to make digital services voluntary. However, the Personalised Health and Care 2020which is their guide for implementation—no longer makes it voluntary: it is now a requirement. They had 6 years to get the ball rolling with the goal of finding ways to ensure the NHS is delivering change and best utilizing both data and technology.


False Starts and False Problems

When Jeremy Hunt first came out with a digital plan back in 2012, he promised not only that the NHS would go paperless by 2018, but that all patients would have access to online medical records by April of 2015. This was not the case.


What Patients Should Expect by 2020

The newest framework confirms that the requirement will be in place by 2020. The requirements include ensuring that patient and care records are completely digital, real-time, and interoperable. However, primary care physicians and clinicians in urgent and emergency care should be able to access paperless records by 2018.

By March of 2018, individual patients will be able to access their records online, but they won’t be able to write in and edit those records and comments until 2020. They’ll be able to view their records by visiting the NHS Choices online.


The Brains Behind the Personalised Health and Care 2020 Framework

So who came up with this plan in the first place? The National Information Board (NIB), which is made up of individuals from several organizations, including the Department of Health (DOH), Local Government Association, NHS England, and other organizations. Their purpose is to create the framework for actions that will support patients, citizens, and frontline staff. Their hope is to ensure everyone can take better advantage of the benefits of digital records.

According to the NIB, a roadmap will be published this year and will offer more detail on who exactly will be responsible for making these digital changes. They also plan to test the program with certain users, physicians, and technology suppliers before going national with it.


New Additions by the NIB

The NIB doesn’t want to stop there. They also want to create a national experiment that provides patients with uniquely personal mobile care. For example, they’ll encourage the parents of newborns to use a personal child heath record to document everything, including immunizations, in a digital format—instead of the physical book that’s currently being used.

They also want to introduce a kitemarking system. This accredits applications and services to show they’re safe to use. They hope that this system will provide the security and confidence users and physicians need to feel comfortable using the new system.


How Will Digital Records Improve the Patient Experience?

The framework makes numerous points about the value of creating digital documents in general and in the healthcare world specifically. The hope is that digital documents can help improve both prevention and self-care and that it will result in a cultural shift that puts the power into citizens to share information with their doctors.

For example, doctors point to the importance of routine sexual health screenings for those most at risk. The goal is to make it as simple as possible for them to get these screenings. Digital records make it as convenient and fast as possible for them to get the screenings they need. They won’t need appointments, they can check in with a touchscreen, and they can take the self-taken tests on their own. Staff can then send results out in a text message just hours later.


Improvements to the Current Framework

It’s true that significant changes need to be made in the healthcare system in England, and it’s true that going paperless is a part of that. However, going paperless is not without challenges. The NIH has many obstacles and they’re not necessarily meeting them as effectively as possible.

The reality is that they’re trying to build a framework from scratch when there’s no need to. Document management systems already exist. They’ve been tested for decades, users’ needs have been taken into consideration, and they’ve been updated and improved as needed. The NIH is planning to build this system from scratch. It’s inevitable that it will lack the resources it needs, and it’s likely it will take longer to build than expected. A wise member of the NIH would stand up and encourage them to work with a third-party that has already worked out the challenges in these systems.