Time for change – over the years the patient journey has altered, now we all have to adapt our approach to healthcare
Advances in medical science over the past 40 years have delivered a wealth of new investigations and treatments for disease, some as old as humanity while others have become more common due to choices in our lifestyle.
Success is evident by the increase in our population’s life expectancy but is accompanied by long-term illnesses – for old age does not come alone.
Our health care systems have evolved to accommodate the new technologies but not in step with the social care systems needed by the people who now require help as they become frail.
This can cause delays in getting people home from a hospital stay and is part of the problems we see across healthcare today.
People become patients when they enter “the system” and then need to learn how to navigate their way through appointments, tests, medications and treatments; they are often left bewildered by the lack of understandable information for their problems, what they can expect and when, often leading to worry and fear.
On the care giving side, healthcare professionals want to deliver the highest quality of care but often find that difficult. Clinicians now deal with more patients, with more illnesses and complex needs than ever before and the demand is increasing.
Patients often need the skills from many clinical disciplines and sometimes in different parts of the country.
For patients, carers and clinicians there is one common need – access to relevant, timely and understandable information.
Clinical information historically was contained in written paper records, but over time much of that information moved into digital systems.
The reasons for this transition are different in different settings. General practice systems were widely adopted following government incentives, whereas hospital systems evolved from the needs of laboratories, x-ray departments and patient administration.
The history of these systems is important since our current digital tools are built on these foundations. They were designed for specific tasks and not originally designed to communicate with one another, a need that has arisen over time.
While not an issue 40 years ago this has become an obstacle to the exchange of information between clinical teams in the community, hospitals, and specialist units.
Not only can this cause delays for a patient’s treatment and inefficiencies, but it can also become unsafe when a clinician does not have all the information when they are treating their patient due to information stored in separate silos of data.
These silos of information or data are being overcome firstly through the widening adoption of digital records instead of paper and secondly by the adoption of interoperability standards. These standards are the common language for electronic systems to communicate the complexities of a person’s medical history from one setting to another.
The adoption of a unifying approach to accessing, directing, and storing this information in a single space through national systems like the National Digital Platform is potentially revolutionary, by providing an easier mechanism for sharing this important data.
Furthermore, it opens the potential for modern digital technologies to support clinical decision making and to allow tailored treatments for patients through linking clinical information with a person’s genetics.
Perhaps most importantly is the potential to give people access to their own medical information and allow them to make better decisions for their own care.
These goals and the path to them are set out in the Scottish Government’s Digital Health and Care Strategy.
But the third vital factor to improving the sharing of information and the experience of patients and clinicians are patients and clinicians themselves.
If we do not prepare the workforce for the changes that digitisation and access to data can enable, we will not see the full potential of shared clinical information.
If we do not prepare our population to make sense of their medical information, then we are not truly empowering them to make decisions for their own care with the possible repercussions for our already stretched clinicians who will be left to answer patient questions on meaning or accuracy.
Only by working with the health and care workforce can we design future systems supported by accurate and up-to-date information across care settings that will make it easier for them to look after patients rather than forensically searching through silos of data.
Only by giving our population access to their health data and the resources to understand it will we help them navigate the system and perhaps one day reduce their need to use it.
Dr Sam Patel is a speaker at the Health & Care Transformation conference in Glasgow on 30 March