I've been dealing with the NHS quite a lot recently, fate would have it that a couple of family members have had some serious health challenges that require intervention. I must say that the people in the hospitals and surgeries are are pretty much universally polite, competent and seem genuinely keen to help. The "system" on the other hand often seems slow (I realise that's a relative measure) and also quite impenetrable in places. Having said that, I don't envy the challenges they face, it's clearly a gargantuan task to coordinate and manage health care for so many people on such a large scale, I can only imagine what carnage used to occur when the service didn't exist and people had to rely on hard currency to get help. So, don't read me wrong, I'm a fan, it's a good idea, fair and the right thing to do at the societal level, but I feel could be improved a fair bit.
I had to visit the hospital on Sunday evening, I took my Wife's mother there on the advice of a doctor, it wasn't an emergency but I'd say it was urgent. The doctor phoned ahead and gave me a note, I was hoping that someone would be expecting us. Having located the particular department that I'd been directed to (which was deep in the bowels of the facility and really hard to find) the reception was deserted and the corridors all around completely dark, no problem I thought, just go back to the main entrance (where there were people milling around) and ask. I did that, and a helpful porter directed me to the A&E department, this wasn't really what I wanted, after 30 minutes of queuing the A&E receptionist directed me back to where I was at the start, apparently I did find the right place but clearly needed to be more adventurous in finding someone. I did all that and managed to find a helpful nurse and she took the paperwork and advised me to grab a wheelchair and go get my mother-in-law (still waiting in the car-park), at this point I'd made the return trip to this far-off department three times, it was starting to feel like a gym workout!
The next hurdle was the the admissions process, unfortunately the NI number on the form completed by the doctor was incorrect, and they couldn't find her on the computer system (even though she's been before) - tracking her down in the database took about 2 hours! This didn't delay treatment of course but it did mean that she couldn't be allocated a bed and pre-existing records couldn't be seen by the attending doctor. Eventually things got straightened out (via much phoning around) and the process started to function smoothly, many tests were done, lab results arrived within an hour and more comfortable accommodation was secured, the machine clearly took a while to wind-up to speed but once there it worked very well, we got home about 3 am, it was a long night.
Whilst hanging around in the waiting room I got to thinking about how the process might be improved, being in the technology/software industry myself my mind was obviously drawn to how computer systems might assist.
First there's the problem of having a "joined-up" process, the doctor who initially visited could/should have had access to the historical records, he had a tablet computer but only seemed to be using it to take notes. I'm not sure why, in this age of cloud hosted applications, it wouldn't be possible to have all NHS personnel accessing the same system? The second problem was one of identification, not being able to "find" someone in your database seems like a fairly basic issue to me these days, perhaps something that would help would be for someone to develop a client-app running on mobile phones (which most people seem to have) that identifies you to the NHS. This could then be used (somewhat like checking-in to airports) to scan your Id (and visit purpose) when arriving at hospitals, and could also be used to direct you to where you need to go! Alerting staff to incoming patients/visitors might also help them in terms of having the right kit identified and acquired in advance or at least thought about. Using devices like phones or tablets as a means of identification via a custom app would also potentially save a lot of "typing" (much of which seems to be duplicated on every visit) - I've lost count of the number of times we've been asked for basic information like name, address, phone-numbers etc. It seems as though a mountain of paper is still created every time there is any interaction when a quick swipe of a QR code or similar might eradicate all that completely and improve accuracy.
The other area that a mobile/web app might help is in the dissemination of information, once someone is in hospital the relatives and friends want to know what the status is, currently this has to be done by phone which can be a very disruptive process. It might be better (in some cases) for status notifications to be sent by text and/or via a custom app to registered groups of people (i.e. interested parties) allowing hard pushed front-line staff more time with patients and less time on paperwork and answering the phone?
Of course there are data-protection issues with all of these ideas but nothing that I haven't seen solved before with a decent authentication system and some proper logging and auditing processes. Seems doable to me. There's just the small issue of what it would cost, I'd wager a lot less than paying people to do it but then again the Government hasn't got a great track-record in procuring software systems, especially at this kind of scale! We live in hope.
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