Innovation challenges in the NHS
I’ll never forget where I was when I witnessed the WannaCry ransomware attack unfold in front of my own eyes.
It was in 2017 and I was chatting to my boss in his office at Library House Surgery in Chorley when we both noticed his computer screen changed. It looked as though his screen had rebooted but a ransomware message appeared.
I immediately came up to our open plan office, where there were probably around 16 computers and as I walked in the room the screens changed one-by-one so that the WannaCry ransomware appeared. It happened to pretty much every PC in the practice and they were all rendered useless.
The ransomware demanded we pay a fee – I think it was about £500 per PC – and on paying the fee they would decrypt the information they’d encrypted. It was scary. I think a lot of people were looking to me as the IT and operations manager for what to do next but it’s just one example of the impact of technology – and everything that goes with it – in a busy GP surgery like ours. It really made us think about technology.
Library House Surgery in Chorley is typical of thousands of other GP practices. We have 16,500 patients and eight partner GPs. We’re one of six GP practices which form part of the Chorley Central Primary Care Network, which has a combined practice population of 55,000 patients. We have a population that is living longer, a lot of whom have some complex medical needs. We need to find ways of meeting the increase in demand and we are hoping technology will help us.
It was estimated that the WannaCry attack, which hit a third of hospital trusts and 8 per cent of GP practices, cost the NHS £92m but it acted as a line in the sand for us. What we realised was that while our PCs were affected across our whole local network, our clinical system wasn’t because it was effectively in the cloud. Our focus throughout was providing the best service to our patients but afterwards we reviewed our technology so that when our IT support team rebuilt the system up from scratch we used the cloud as much as possible. It gives us extra peace of mind for situations like another WannaCry attack and also allows potential for remote working. If people have got access to the internet and access to the cloud, they can work anywhere in the world.
There are so many examples of how we’ve used technology at Library House Surgery to try and improve patientcare and save our doctors and staff valuable time.
Technology has also transformed the way patients receive prescriptions. Known as the Electronic Prescription Service – or EPS for short – the service allows GPs to send prescriptions electronically from their computer to a patient’s chosen pharmacy. The old-style system meant patients would request their medications and a prescription would be processed and printed out and left in a box in our reception area. Patients would then come into our reception and collect their prescriptions. Our analysis showed that a paper prescription is ‘touched’ seven times before it actually got back to the patient. We found our waiting room was clogged up with patients simply collecting prescriptions to take over the road to the pharmacy.
The EPS reduces the number of times a prescription is ‘touched’ to three before the patient gets their medication.
However not all our patients are comfortable with technology. We found some patients were put off from using this service because it contained the word electronic. All we did when we were promoting this service was change the name from EPS to ‘Direct to Pharmacy Service’ and we saw an uptake in the number of people of using it.
One thing we did was engage with Preston-based Redmoor Health, which specialises in applying tech digital solutions on the frontline of health and social care. If the NHS is going to embrace technology fully then the staff need to know how to use it, which is where Redmoor come in.
The Redmoor Health team have a wealth of experience of working across health and social care and provide the valuable on the ground support for practices to enable them to use technology. They work with commissioners and IT suppliers and support practices teams with training, project management and data reporting so they can ensure any technology deployment supports rather than hinders the practice.
Another thing we’ve done at Library House Surgery is use social media, especially Facebook Live. Every year we hold a Patient Participation Group meeting and normally 10-15 people attend. This year we screened it on Facebook Live and an additional 58 people engaged with the meeting and a staggering 2,000 people watched the video after the event. People are happy to graze on social media. Although they might be too busy to attend a meeting they’re happy to view on Facebook Live while they’re in the kitchen making the tea.
We are looking at using video consultations where appropriate for consultations that don’t require physical examinations, providing more flexibility for GPs and more choice for patients.
For example a doctor with a young family dashing from completing the school run in Manchester to the surgery in Chorley will spend hours commuting when he or she could be holding a clinic of video consultations at home. Technology is about creating additional appointments.
We also piloted the myGP app by London-based health tech company iPlato, which allows patients to register remotely using their date of birth and mobile number. Patients are able to make and cancel appointments, use a secure and instant messaging service and book medication reminders. We found it particularly helpful when we sent SMS text invites to more than 4,000 patients, asking them to book a flu vaccination appointment. The number of patients now phoning the surgery to book an appointment is really dropping while patients booking online is really increasing. We’ve also noticed the number of DNAs (did not attends) has fallen.
Originally published here.
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