In an article published in The BMJJoe Zhang of Imperial College London and colleagues point to a recent 10-day computer system outage at one of the UK’s largest National Health Service (NHS) hospital trusts and warn that rising digital transformation “means that such outages are no longer mere inconveniences but fundamentally affect our ability to deliver safe and effective care.”
They argue that unlike the purchase of electronic health records, for example, investment in IT infrastructure (which includes computers, servers and networks) is rarely prioritized and easily seen as a cost to be reduced rather than an investment that increases productivity.
Still, the consequences are significant, they write. A recent survey of NHS clinicians commissioned by NHS England shows that user experiences with electronic health records are generally poor, due to slow and unreliable computing.
The British Medical Association (BMA) estimates that a significant proportion (27%) of NHS clinicians waste more than four hours a week due to inefficient IT systems. The BMA report also found gaps in investment and lack of clinician engagement in supply.
Outdated infrastructure is a data security risk, the researchers add. It’s unclear how many providers comply with national guidelines by maintaining multiple data backups, including offsite.
There is also a growing disconnect between government messaging promoting a digital future for healthcare (including artificial intelligence) and the lived experience of clinical staff dealing with ongoing IT issues on a daily basis.
“This digital future will not materialize without careful attention to crumbling IT infrastructure and poor user experiences,” the researchers write.
There is no one-size-fits-all solution, but the NHS can learn from approaches taken elsewhere, they say. In the United States, for example, the effect of health informatics on end users is an active area of research, particularly on how the functionality of informatics systems affects the burnout and efficiency of clinicians. , while federal oversight of health IT infrastructure can identify problems and coordinate a response. .
To facilitate a transformation of IT infrastructure in the NHS, “we need to include systematic and transparent measurement of IT capabilities and functionality at the level of clinicians – the people who actually use the systems”, they explain, “as well as at the level of those who buy the systems.
Armed with this understanding, quality improvement cycles must become routine in IT governance as they are in clinical care, and government must provide the necessary investment to identify and correct poor performance, and also require responsibility, with minimum standards for computer function and stability, they add.
“We should not tolerate IT infrastructure problems as usual,” they conclude. “Misfunctioning IT systems are a clear and current threat to patient safety that also limits the potential for future transformative investments in healthcare. Urgent improvement is an NHS priority.”
Failing IT infrastructure compromises healthcare security in the NHS, The BMJ (2022). DOI: 10.1136/bmj-2022-073166
Provided by British Medical Journal
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