Nine out of ten times when we start to get to know new clients in the NHS IT space our initial questions are threefold – tell us about your solutions, tell us where your proof points are and ultimately describe what benefits you are helping those organisations to achieve.
The first two responses usually come easily, a well planned elevator pitch providing a comprehensive overview of the solution set accompanied by a list of reputable NHS trusts who have all successfully installed the system.
The third response is often less convincing ‘it saves the NHS money… it meets the Nicholson Challenge… it meets the QIPP agenda…it improves patient safety…it encourages clinical or patient engagement’…the list goes on.
Often we go onto ask whether any benefits realisation work has been done to quantify the effectiveness of the system in addressing the issues it was designed to overcome and virtually every time the answer is ‘no.’ Now this blog is not a rant at suppliers, often it’s not their fault and it isn’t through lack of trying that they do not have this information. It’s just something that appears to get overlooked or considered as an after thought as the NHS and many of its professionals are just too busy to dedicate time to measuring benefits.
This week, I was probably one of the very few who was actually quite relieved to see the news item in eHeath Insider “ROI demands delay tech fund.” The story explains the alleged reason for the delay to the awards of the government’s recently announced £260m ‘Safer Hospital, Safer Wards Technology Fund’, and said that it was due to “stringent Treasury demands on the return on investment trusts must deliver.”
While of course, I am not relieved to hear of the delay, which is undoubtedly frustrating for IT directors across the NHS who were rushed into submitting their requests for the Technology Fund and will now have even less time to spend the money once allocated. What I am relieved to hear is that pressure is being put on the NHS to really look at how IT is helping them to deliver return on investment, something that in many areas it has failed to achieve.
Don’t take my word for it, a clear example of this can be seen by doing a quick search on Google – try ‘does NHS IT save lives’ or ‘does technology save the NHS money’? There is quite simply no answer, barely any evidence base and therefore very little proof that technology can achieve such changes. Could this lack of evidence even go some way to explaining the reluctance of many frontline staff to engage in IT and its patchy roll-out as a whole across the NHS. Perhaps the lack of referenceable benefits is even more shocking given that England is known for perhaps the boldest attempt of all time to digitise its national health service by embarking on the ‘world’s biggest civil information technology programme’, otherwise known as NPfIT.
From discussions with finance directors, IT professionals and end users, it’s clear that it is no easy task to attribute improvements to patient safety, freeing up administrative time and having better information at the point of care directly to technology, and it is even more difficult to quantify in monetary terms. But this signal from the government that ROI is imperative could be the push that the NHS needs to make it happen and consider whether technology, for example, is saving time on ward rounds or in clinics, preventing law suits, reducing travel time for staff and patients, reducing reliance on paper and other resourcing costs.
And it can be done; there are pockets of success stories across the country where, when the organisations are pushed to look at their workflow or routine, real quantifiable benefits are quickly found. As an example, a clinician at Royal Liverpool Broadgreen University Hospitals NHS Foundation Trust told me that by using a clinical portal, in a three and a half hour clinic he is able to save 30 minutes of time that can now be used to see more patients. Meanwhile Hull and East Yorkshire Hospital NHS trust reported that an eWhiteboard is cutting hand over time from approximately 22 minutes approximately three minutes for each patient.
My advice to both the NHS and suppliers is to work together. As commercial businesses, technology suppliers are likely to have the expertise and potentially the capacity to help measure the benefits and will often want to do so to prove that their systems are effective. But don’t wait until the system is implemented, track your process before and after so comparisons can be made. The likelihood is that with the right metrics in place and a successful implementation it might just be a good story all round.