Paper notes are persistently hindering the digital transformation of the National Health Service (NHS) in England, according to a recent survey conducted by The BMJ. The survey reveals that over 75% of the English trusts that responded still rely on paper patient notes and drug charts, despite efforts to transition to electronic records and prescribing.
The findings coincide with an expert panel’s conclusion that the UK government has failed to meet a crucial target of eliminating paper prescribing in hospitals and implementing digital or electronic prescribing across the entire NHS by 2024. This poses significant challenges to the NHS’s goal of achieving a core level of digitization by 2024 and accelerating the rollout of electronic patient record (EPR) systems and apps as outlined in the NHS Long Term Plan.
While the NHS has made progress in implementing EPR systems, with 88% of trusts in England currently having them in place, the prevalence of paper notes remains a major hurdle. Out of the 182 trusts that responded to the survey’s questions on patient notes, 4% reported using only paper notes, 25% were fully electronic, and the remaining 71% used a combination of both. Similarly, for drug charts, 27% of the responding 172 trusts rely solely on electronic systems, 64% use a mix of electronic and paper prescribing, and 9% use paper charts exclusively.
The quantity of paper generated by trusts is staggering, with some estimates reaching up to 25 million pages of A4-sized paper per year in certain hospitals. The continued reliance on paper in healthcare settings not only hinders efficiency but also compromises patient safety. Electronic prescribing has been shown to reduce medication errors by 30% compared to paper prescribing, according to government figures.
Moreover, in a survey conducted by Oxleas NHS Foundation Trust after the implementation of an electronic prescribing and medicines administration (EPMA) system, 96% of respondents acknowledged that the electronic system saved time, and 93% stated a preference for electronic prescribing over paper.
While electronic systems offer the potential for improved patient care through enhanced information sharing, challenges relating to data interoperability persist. Issues such as a lack of agreed technology standards, concerns regarding patient consent for data use, and inadequate digital skills hinder the seamless exchange of information between electronic systems. Unlocking the potential benefits of the vast amount of data available in the NHS relies on the development of interoperable systems that facilitate advancements like artificial intelligence.
Transitioning from paper to digital is crucial not only for better patient care but also to meet the NHS’s ambitious targets for digitization. As the survey highlights, progress has been made, but there is still a long way to go in reducing reliance on paper in healthcare settings and fully embracing the benefits of digital transformation. Continued efforts are needed to ensure a safer, more efficient, and patient-centered approach to healthcare delivery.
