Very interesting. Quite a few big hospitals in the UK are now using Epic and like it. But not everybody is enthusiastic - I've heard complaints that it is hugely expensive and not very flexible when you want to extract data for research purposes.
Hi Rory, one of the killer features of the app should be the repeat prescription - the alternative is clunky and involves phone calls, paper based information flows, and sucks time from a lot of people. I read that half the UK's population are on repeat prescriptions. Why people aren't urged to simply order their repeat meds on the app? I've been told to call the surgery, inform the pharmacy, etc. at different locations and different points of time but I've never been encouraged to use the app. I just checked and my prescription details are actually on the app! Why the reticence? Thoughts?
Hi Rory, it's not just the NHS app that's adrift but a whole raft of applications and systems being specified and implemented based on purely local requirements where suppliers are only too happy to oblige. It is changing slowly with major investments requiring detailed business cases prior to DoHSC approval but even the procurement process itself is time-consuming, expensive and clunky.
On a positive note, things are beginning to shift towards a more unified approach to specifications for IT requirements. The mammoth in the room however is the plethora of small legacy systems & applications which preclude all integration efforts, many because they're incapable and live on through various home-grown patchworks and 'mandraulic' workarounds.
One shining light through the murk is Robotic Process Automation (RPA) which, although it is a workaround in itself, is demonstrating the benefits of integration and in turn, helps add factual, tangible benefits to business cases in support of new systems which support wider integration standards throughout the NHS; the key is national standards being mandated for all new systems and applications. More on RPA here.
Likewise the NHS app albeit a fairly clunky app currently, is proving to be an embryonic standard to which new applications should adhere in terms of user credentials at a minimum. For example, an app such as Patients Know Best (PKB) which has replaced Patientview for renal patients, can use a patient's NHS app logon details. However, much of this standardisation work appears to be coming from ground level developments and only spreading slowly by osmosis.
The NHS app has the potential for far wider application, but the longer it takes to implement national standards, the harder it becomes to unwind the continuing and highly wasteful development of local workaround information sharing applications which is only happening due to the lack of direction from the NHS nationally and DoHSC.
I’ve mentioned before how things have progressed in the digital medical data area in the greater Boston area. Well in the beginning we also had many different systems in the various hospitals and doctor organizations but almost all are using “Epic.” Now each still has its own unique Epic system but as a patient with doctors across three different unaffiliated systems, I can link all three. I can see and reply to emails from a single login. I can also review all labs and make apts from that single logon. All I have to do is “link all my accounts” just once. I can also grant one time access to a provider outside. I’d suggest you Google Epic and with your reach and connections maybe nudge NHS in the correct direction to either use Epic or use it as an example
Having been involved, years ago I should, in Housjng Benefit systems trying to get a seem less reporting system for a very small element across all software systems I saw how complex it was, not the technology, but the politics of software providers and also their clients. It is very difficult to get all factions to play nicely, we did but it was hard and with very specific requirements for one very specific purpose.
I find the NHS app very clunky to use. At the moment, I prefer using the EMIS/Patient Access route to seeing test results etc, but admittedly, this only works for GP information, not arising from hospital appointments. I find it frustrating too, that different GP practices allow use for different things. I moved to my current home in Essex last year and now can see appointment times, order repeat prescriptions and see test results and my medical history. I can't make appointments or have an online conversation with healthcare staff, as I could at my previous practice in Somerset.
A common data standard, and an obligation to share if the patient asks, would go a long way towards fixing this. Much easier than trying to choose & impose a single common system. Trivially, like the standard for calendar entries that enables a Mac user to invite an Outlook user. More substantive: the Open Banking standard.
The reason to move to a ‘digital solution’ should only take place if it replicates and most importantly builds on the current solution providing more capabilities.
There are hospitals where many different computer systems are used and don’t talk to each other, within the same building. A complete overhaul and a fully integrated National system is required.
Would the funding be improved if government got a grip of tax avoidance schemes by highly paid UK residents (some of whom appear in government)? A bill to make some way to adjust this was talked out by a 'prominent' parliamentarian.
There was never a point that you needed a Covid passport to check into a pub or restaurant. It seems memories are already becoming rusty of what happened during Covid.
The only thing you needed a Covid passport for was to go abroad.
I cannot use the NHS app, as all my privacy settings are set 'not to share', as the NHS STILL hasn't sorted out consent issues regarding the sharing of data
Hi Jerry,
Very interesting. Quite a few big hospitals in the UK are now using Epic and like it. But not everybody is enthusiastic - I've heard complaints that it is hugely expensive and not very flexible when you want to extract data for research purposes.
"One patient one record" will never happen. Too many services are still relying on paper based records
Hi Rory, one of the killer features of the app should be the repeat prescription - the alternative is clunky and involves phone calls, paper based information flows, and sucks time from a lot of people. I read that half the UK's population are on repeat prescriptions. Why people aren't urged to simply order their repeat meds on the app? I've been told to call the surgery, inform the pharmacy, etc. at different locations and different points of time but I've never been encouraged to use the app. I just checked and my prescription details are actually on the app! Why the reticence? Thoughts?
Hi Rory, it's not just the NHS app that's adrift but a whole raft of applications and systems being specified and implemented based on purely local requirements where suppliers are only too happy to oblige. It is changing slowly with major investments requiring detailed business cases prior to DoHSC approval but even the procurement process itself is time-consuming, expensive and clunky.
On a positive note, things are beginning to shift towards a more unified approach to specifications for IT requirements. The mammoth in the room however is the plethora of small legacy systems & applications which preclude all integration efforts, many because they're incapable and live on through various home-grown patchworks and 'mandraulic' workarounds.
One shining light through the murk is Robotic Process Automation (RPA) which, although it is a workaround in itself, is demonstrating the benefits of integration and in turn, helps add factual, tangible benefits to business cases in support of new systems which support wider integration standards throughout the NHS; the key is national standards being mandated for all new systems and applications. More on RPA here.
https://transform.england.nhs.uk/media/documents/RPA-Guidance-May-22.pdf
Likewise the NHS app albeit a fairly clunky app currently, is proving to be an embryonic standard to which new applications should adhere in terms of user credentials at a minimum. For example, an app such as Patients Know Best (PKB) which has replaced Patientview for renal patients, can use a patient's NHS app logon details. However, much of this standardisation work appears to be coming from ground level developments and only spreading slowly by osmosis.
The NHS app has the potential for far wider application, but the longer it takes to implement national standards, the harder it becomes to unwind the continuing and highly wasteful development of local workaround information sharing applications which is only happening due to the lack of direction from the NHS nationally and DoHSC.
FYI https://digital.nhs.uk/services/nhs-app/future-developments
Hi Rory;
I’ve mentioned before how things have progressed in the digital medical data area in the greater Boston area. Well in the beginning we also had many different systems in the various hospitals and doctor organizations but almost all are using “Epic.” Now each still has its own unique Epic system but as a patient with doctors across three different unaffiliated systems, I can link all three. I can see and reply to emails from a single login. I can also review all labs and make apts from that single logon. All I have to do is “link all my accounts” just once. I can also grant one time access to a provider outside. I’d suggest you Google Epic and with your reach and connections maybe nudge NHS in the correct direction to either use Epic or use it as an example
Jerry… from Wellesley MA USA
Having been involved, years ago I should, in Housjng Benefit systems trying to get a seem less reporting system for a very small element across all software systems I saw how complex it was, not the technology, but the politics of software providers and also their clients. It is very difficult to get all factions to play nicely, we did but it was hard and with very specific requirements for one very specific purpose.
I find the NHS app very clunky to use. At the moment, I prefer using the EMIS/Patient Access route to seeing test results etc, but admittedly, this only works for GP information, not arising from hospital appointments. I find it frustrating too, that different GP practices allow use for different things. I moved to my current home in Essex last year and now can see appointment times, order repeat prescriptions and see test results and my medical history. I can't make appointments or have an online conversation with healthcare staff, as I could at my previous practice in Somerset.
A common data standard, and an obligation to share if the patient asks, would go a long way towards fixing this. Much easier than trying to choose & impose a single common system. Trivially, like the standard for calendar entries that enables a Mac user to invite an Outlook user. More substantive: the Open Banking standard.
The reason to move to a ‘digital solution’ should only take place if it replicates and most importantly builds on the current solution providing more capabilities.
There are hospitals where many different computer systems are used and don’t talk to each other, within the same building. A complete overhaul and a fully integrated National system is required.
Would the funding be improved if government got a grip of tax avoidance schemes by highly paid UK residents (some of whom appear in government)? A bill to make some way to adjust this was talked out by a 'prominent' parliamentarian.
There was never a point that you needed a Covid passport to check into a pub or restaurant. It seems memories are already becoming rusty of what happened during Covid.
The only thing you needed a Covid passport for was to go abroad.
I cannot use the NHS app, as all my privacy settings are set 'not to share', as the NHS STILL hasn't sorted out consent issues regarding the sharing of data