Recent studies have found that NHS administrative errors are a lot more frequent than previously thought and they are causing appalling levels of harm. These errors consist of anything from incorrect medication being prescribed to operating on the wrong person. It is shocking to think that errors like this, which are so easily avoidable are still happening on a daily basis.Read more
Recent news articles have been reporting on the GPs vote at the Conference of England Local Medical Committee (LMC). The main vote that has gained media attraction is Motion Numer 9, which is the removal of contractual obligations for home visits, which was voted in favour by 54%.Read more
For many years the NHS has been used a pawn in political games and the upcoming election is no exception. With Labour’s discovery of the ‘NHS for sale’ dossier, there has been a huge debate around the NHS being vulnerable to privatisation and secret deals with Trump to sell off parts of the NHS.
Welcome to the sixteenth issue of Inside Medicalchain, our monthly newsletter to keep our community up to date.
If you missed the fifteenth issue, you can catch up by clicking here.
Product DevelopmentRead more
E-Prescribing for NHS Trusts
The UK’s Department for Health and Social Care has announced this week, that it will be providing £78 million to establish electronic prescribing and medicines administration (ePMA) systems in NHS Trust sites. There will be an initial share distributed to 13 selected NHS trusts, with a total of £16 million funding for 2018/2019 between them.
The reason for this decision is to move away from handwritten prescriptions which cause many issues within the system. Health Minister Stephen Hammond said, “As part of the long-term plan for the NHS, we not only want to harness technology to make it one of the most advanced healthcare systems in the world but crucially to improve patient care… The funding provided for these trusts will help to drive these changes to the patient experience, but will also aid our hard-working and dedicated staff… The introduction of electronic prescribing is not only known to reduce medication errors but also frees up time for staff by moving away from archaic systems.”
The benefits of ePMA systems include:
- The reduction in potentially deadly medication errors by up to 50% when compared with the old paper systems.
- The creation of a more complete electronic health record.
- Dispensers can reduce use of paper, have improved stock control, and provide a more efficient service to patients.
- Patients can collect repeat prescriptions from a pharmacy without visiting their GP, and won’t have a paper prescription to lose. In turn, freeing up GP time.
This is a great move to advance the UK’s health system for the benefit of service providers and patients alike.
A research body conducted by university academics from Manchester, Sheffield and York, identified more than 230 million medication errors a year that took place in the NHS. The report also stated that an estimated 712 deaths result from avoidable adverse drug reactions (ADRs). Furthermore, these ADRs could be a contributory factor to between 1,700 and 22,303 deaths a year.
Fiona Campbell, Research Fellow from the University of Sheffield’s School of Health and Related Research, said: “Measuring harm to patients from medication errors is difficult for several reasons, one being that harm can sometimes occur when medicines are used correctly, but now that we have more understanding of the number of errors that occur we have an opportunity to do more to improve NHS systems.”
A personal case in point occurred recently. On a weekend away within the UK, I became aware that I’d forgotten to bring my inhaler with me. Usually, the asthma is not a problem, but there was a lot of heavy walking and a log fire involved which seemed to exacerbate the issue.
Upon attending a local pharmacy I came to an abrupt roadblock as the pharmacist refused to sell me an inhaler over the counter, instead insisting I give her a paper copy of my prescription.
If I didn’t have my inhaler I certainly wasn’t going to have my prescription with me, so I asked if she could make a discretionary judgment as I had no means of providing the prescription and I mentioned the NHS website, which says:
“If you urgently need medication, contact your prescriber immediately to arrange a prescription. If this isn’t possible, you may be able to get medicine from a pharmacist in an emergency, subject to certain conditions.”
This is when she also quoted the NHS website and relayed to me:
“You must have been prescribed the medicine before by a doctor, dentist, nurse independent prescriber, optometrist independent prescriber or other healthcare professional, who is registered in the UK.”
Here was the alleged issue – I had no evidence that I had been prescribed Salbutamol previously, other than knowing what it is and wheezing at her over the counter.
The next step was to call up my home GP and ask them to send evidence of my repeat prescription to the pharmacy. The GP uses a system called EMIS, the Pharmacy I attended used a rival software, TPP. Therefore both could not communicate with each other to verify my need for this inhaler whilst I became more breathless and wheezy as time went on.
The solution to the issue? (although it is perfectly legal for the Pharmacist to make a judgment call on a solitary inhaler to a wheezing patient, they are registered health professionals for a reason you know):
- I needed to register with the local medical practice
- Meaning I needed to consent to the medical practice obtaining all my previous medical records
- To then book an appointment to see the doctor
- To then wait another 2 hours to get to see the doctor- taking up her lunch time
- To obtain a prescription I already have on repeat
- To go back to the pharmacist that turned me away to get an inhaler
The entire process took over 3 hours all the while physically no better off, which proves the point even though anecdotally. The current system is archaic and not in harmony with the times we live. Almost everything is digital – even the local old man I bought wood to build a fence from accepts online purchases and Google Pay.
The utilisation of electronic prescribing will streamline the present health system and save the NHS financially, by limiting cases of litigation as a result of ADRs and wasted appointments at GP practices (inhaler). Patients will benefit by being able to avoid unnecessary trips to their GP and in having quick access to their medication upon a visit to any cooperative pharmacy.
By Medicalchain’s Tim Robinson
Many will be familiar with the impromptu visit to the local hospital. That anxious rush to arrive at the reception desk to register your arrival with the admin staff on hand, to then need to sit and wait with the other attendees until you are eventually called in for assessment, then after no short while finally on for treatment, transfer or discharge. Or perhaps you have entered the system more subtly, via a referral from your GP to an outpatient appointment.
Either way, this is the most many of us will ever experience of this healthcare juggernaut. To filter through the various departments when the need arises. You will have noticed however the timescales involved between appointments, that oftentimes they seem to take longer than we’d like. This is something we might not appreciate.
A fitting analogy to help us see the overall picture is traffic flow. Each leg of a route can be thought of as an individual ‘process’ in the overall journey. As variations in speed at different legs of a journey can equate to delays, each ‘process’ affects the efficiency of the entire journey as a whole.
Just as the flow of traffic is improved by controlling the variation in the speed of cars and the havoc stop-starting causes in the endless lines of caterpillar-esque traffic, the flow of patients can also be improved by understanding the causes of variations of processes within the healthcare system.
Whole healthcare systems have been analysed: from GP practices, to ambulance services, secondary care, tertiary care, and including social services. This work has shown that improving patient flow across health and social care systems is beneficial to patients and staff alike in many ways, such as:
• improving the clinical outcome and experience of patient’s journey.
• eliminating waits and delays.
• saving time and effort by avoiding duplication of work.
• saving money from the cost of overtime, waiting list initiatives, locum and agency fees.
• improving the trust of the healthcare organisation.
The need to apply Quality Improvement shouldn’t be viewed as a box ticking exercise either, but rather, as healthcare organisations dedicated to the welfare of the general population and the NHS, they have a responsibility to identify and review these processes with statistical accuracy so improvements can be implemented and audited. That should mean taking into account all the costs related to any process, including the loss of income to a patient attending an appointment and the impact of transport on public health. The inefficiencies of our health system impact on the general health of our society as a whole.
In order to deliver high-quality healthcare, establishments must start to think in terms of value and sustainability; this means the need to identify a balance between cost and outcomes (value) and long-term impacts (sustainability). There is no ‘one-size fits all’ solution to the inefficiencies we encounter in the current healthcare system, but there are innovative solutions to address many of these sticking points; healthcare organisations need to acknowledge these deficiencies honestly and utilise new technologies to advance care for all.
A case in point is whether there is a legitimate need to physically attend a consultation. If there is not, are we not then forcing a one-size fits all solution to a legacy issue without taking advantage of the modern day tools at our disposal?- As Apple’s trademarked slogan goes, “there’s an app for that”.
Outpatient appointments and the sheer number of users flowing through a system may be the bread and butter of many establishments, but the reality is that cost is borne out in more than how taxpayer contributions are expended.
By Medicalchain’s Tim Robinson.
With the concept and proposed benefits of a paperless society first being introduced back in 1978, it seems absurd that we continue to rely on physical means of written communication when it comes to issues as serious as appointments and updates on critical screening services.
This is even more serious when it becomes evident that letters containing invitations to cervical cancer tests that should have gone to 40,000 women in England between January and June, had not even been sent. Yet this is just months after it emerged that 174,000 women had not been invited for breast cancer screening.
The contractor responsible for these errors, Capita, has previously been under the radar for failing to meet standards in managing the movements of patient records. The British Medical Association stated that problems included delays in records being transferred, even when urgently needed for patient care.
Dr Chaand Nagpaul, BMA GP committee chair, said: “Local GPs are reporting to the BMA that they are facing unacceptable delays in patient record transfers and mistakes in maintaining supplies of crucial medical equipment, like syringes and even prescription paper… These mistakes are directly impacting on the ability of many GPs to provide safe, effective care to their patients… They are in some cases being left without the essential information they need to know about a new patient and the tools to treat them.”
There has been some movement in the right direction by the NHS, in establishing the Global Digital Exemplar (GDE) programme. This is a knowledge sharing platform developed by NHS England. The programme is set up so that “digitally advanced” NHS trusts share their knowledge and experience with other NHS trusts. Specifically, the knowledge gained whilst implementing their IT systems, and especially their experience from introducing electronic health record (EHR) systems.
Therein lies the solution, patients need to be empowered to take charge of their own health and wellbeing, through applications like MyClinic.com which give them up-to-date 24-7 access to their health records, they can receive updates for appointments and screening reminders. Adopting this technology more widely would remove huge administrative costs from the NHS, and avoid the frequent problem of paper-based reminders and records getting lost or never being sent.
Medicalchain is proud to support Self Care Week 2018, which runs this year from the 12th to the 18th of November. Self Care Week is an initiative which aims to engage and empower people to better look after their own health. Last year it reached ~20,000,000 people with its message, mirroring Medicalchain’s ethos, “own your health”.
With a focus on health innovation to help patients help themselves Dr Knut Schroeder, a GP, Self Care Forum Board member and founder of free self care app resource producer Expert Self Care, said: “Health apps are easily accessible for anyone with a smartphone. Containing information, advice and tips on topics ranging from first aid and healthy living to pregnancy and mental health; health apps can be great for learning more about health issues and enabling people to self care.”
Dr Abdullah Albeyatti, Co-Founder and CEO of Medicalchain said: “Medicalchain is focused on addressing the issue of a fragmented healthcare system by empowering patients to be at the centre of their care. Through innovative use of the latest advancements in technology, we are able to resolve much of the issues we see in the health system today and we can provide all this through an app on a smartphone, making access and usability of a patient’s personal Health Record easier than ever”.
MyClinic.com is a tool anyone with Web access can use, either through their personal computer, laptop, or smartphone. MyClinic.com empowers patients by giving them choice and understanding of complex health issues and the treatment options available. It allows families to be more involved in their loved ones care and therefore support better self care, regardless of the distance between them. Secure and safe access to health records also promotes better communications with multiple doctors at the same time to always strive for the best advice possible for each individual patient. This is in perfect harmony with the theme of Self Care Week 2018, being “choose self care for life”.
A collaboration of technology and healthcare specialists seeking to prove the value of blockchain in healthcare.
United Kingdom, London: Today, Medicalchain announced that it signed a joint working agreement with the internationally renowned Mayo Clinic. The two organisations will work together to explore the potential benefits of blockchain technology in healthcare, with a vision to develop a variety of services in the future.
The US based Mayo Clinic has unparalleled expertise and was ranked the top hospital nationally by the U.S. News & World Report rankings of top hospitals.
Mayo Clinic is top ranked in a wide range of specialities, including diabetes and endocrinology, gastroenterology, geriatrics, gynecology, nephrology, neurology and neurosurgery, pulmonology and urology.
“We are thrilled to be working with Mayo Clinic. Mayo Clinic will provide their world-class healthcare and health IT expertise, while Medicalchain will provide our knowledge of blockchain and crypto. Together we will work on several use cases using blockchain based electronic health records. There’s a lot of opportunity out there, and we feel this working agreement will be of benefit to all healthcare stakeholders.”
Dr Abdullah Albeyatti, CEO of Medicalchain.
Blockchain technology is a revolutionary innovation that first gained traction within financial services for its ability to speed up transactions, reduce costs, and provide a shared immutable ledger. The same principles are widely applicable to healthcare and show promise in addressing some of the systemic problems our systems face today, such as data security, fragmentation, high costs, and lack of patient centricity. The joint working agreement between Mayo Clinic and Medicalchain is a step forward in realising this vision.
For more information, join the Medicalchain community on Telegram.
Contact: Natalie Furness