Why NHS hospitals don’t utilise modern telecommunication technologies. A response to Prof Jonathan Kay, CCIO, NHS Commissioning Board

Professor Jonathan Kay, CCIO for the NHS Commissioning Boards asks on this NHS Hackday Google Group thread:  why so few NHS hospitals utilise modern telecommunication technologies such as the mobile phone, SMS to improve communications within and between medical teams.

Below are my observations:-

  • Communication and care coordination within the hospital is not on the radar on most hospital’s IM&T strategy: PAS, PACS, Electronic Prescribing, Clinical Correspondence (incl. discharge summaries), Clinical Notation (incl. Bedside observations) are.
  • Internal referrals and internal communication is often a problem for junior doctors and nurses on the frontline, who often do not have a seat at the table when it comes to influencing organisational strategy. We are the silent and transitionary workforce (junior docs).
  • Revolutionising communication requires investment on new platforms such as smartphones and other mobiles devices and staff skilled to manage their deployment on a large scale. (I’m not referring to Blackberrys that are relatively simple).
  • Due to points above there aren’t many people selling solutions. Those that exist require both a hardware and software investment. And often, the hardware is tied to the software instead of treating the hardware as a platform, a general purpose computer, that enables all sorts of other possibilities. Examples of this includes things like Wardware, VitalPAC, and various handover software.

I’m waiting for a forward thinking organisation to tackle the issues of intra-hospital communication head-on to solve the bleep bleep (pagers), patient list and guidelines at point-of-care problem that have been discussed in great detail on the NHS Hackday Google Group and on a series of podcast that a few of us junior doctors record: http://thedigitaldoc.co.uk/podcasts

In conclusion, the people that decides how the money is spent is blind to the problem -> resources are not allocated -> No one  steps forward to offer solutions.


5 thoughts on “Why NHS hospitals don’t utilise modern telecommunication technologies. A response to Prof Jonathan Kay, CCIO, NHS Commissioning Board

  1. Agree entirely. My recollection of being a junior doc in medicine was wasting hours on the end I the phone trying to get hold of an ‘ologist’. Ridiculously that still carries on. I now run an acute oncology service and set up a web form (I wrote the code – IT were not interested) on the intranet. Anyone can access it and best of all it pushes an nhs.net straight to my mobile phone. The result – instantaneous response time to referrals and no fannying around waiting for switch to tell you who is on for specialty X and then waiting for them to pick up their bleep. The tragedy is this is not rocket science but ’90s technology….

    • Thanks for your comment Richard. It is sad that it still carries on. My concern is that with the multiple ‘distractions’ of paperless referrals, patient access to records, social media we risk forgetting the very important aspect of intra-hospital hospital communication and care coordination. I hope that Professor Kay can highlight this issue at the highest level whilst we work from the frontline upwards.

      • I agree this needs publicising at high level but the people who have the clearest idea for change are those embedded in the system: the junior docs and nurses. How do we empower them to broker change?

        How about advocating hospital hack days or embedding AGILE developers in IT teams? Get a team of interested docs nurses in a room with some developers for a couple of days and see what falls out.

        I was a little harsh in my criticism of the Trust IT dept in my previous comment. They lacked resource to do what I had asked and probably would have had to provide a project manager and go out to procurement. The solution was painfully simple. Another problem we have is flagging of patients as they come through A&E. There are a variety of off the shelf solutions out there but I am lucky to be working with a very keen developer who is putting together a bespoke solution which would operate across 7 different Trusts. Its amazing what happens when we get the people who know what they want together with the people who know how to deliver it. Management sit back and facilitate….

  2. This is the old problem of alienation. In any sane system, the people who want something to help them be more efficient and effective go out and buy it and make it work. This is of course how and why GPs got computers.

    But in hospitals demarkation rules. A long long time ago, a plot was hatched whereby the Finance Directors got together with the people who looked after the payroll systems to seize control of all hospital ICT (information and communication technologies). They succeeded and have not let go since. So anyone who wants to do anything useful using modern technology has to deal with the ICT Commissariat. This is just a remnant of the mindless command and control approach which bred Mid Staffs and NPfIT.

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