Managing interoperability and communication in the NHS


So, we are led to believe that our systems within the NHS talk to each other and are doing so to alleviate the need to check in multiple places for patient information so that we have an informed approach when assessing our patients. Also that the healthcare professionals that use these systems are communicating with each other so that the delivery of care is effective.

I am using first hand personal experiences to try to make sense of how this actually works when trying to put into place a package of care with basic needs for a member of my family.

Interoperability is ‘the ability of computer systems or software to exchange and make use of information’.

With this in mind, if a district nurse comes to your home to assess a member of your family and states ‘everything is done on computer now so we don’t need to right notes and it talks to the other systems so everyone knows what’s happening’, you would feel as though there is a cohesive mechanism for delivery of care.

But I then have to call the district nurse on several occasions to come and see my dad as nobody had communicated to us since their first visit. This does not instil confidence in the service that is supposed to be looking after you and making sure that this is done safely and efficiently.

If we are going to use health IT to support services in the NHS then make sure the people that use it firstly, know how to use the application and what its purpose is for, secondly, know how to use the system to then pick up future visits/tasks that need to be actioned.

Another team member from the community team visited to complete a home assessment and identified a number of services/equipment that would be required for my dad to be cared for at home. When she left again said ‘I have put this into the system so it will be all sorted!’. My question is ‘when and by who?’ as we didn’t get anyone come to see my dad or any of the promised equipment over the next four weeks. So we were led to believe on several occasions that things are being managed when actually we are doing all the management and the people who should be are perceived to be doing nothing.

How do we tackle this problem? If healthcare IT providers are looking at their applications and promoting interoperability and its importance in delivering safe and efficient care to our population then surely something is going wrong with the way this is being introduced or deployed. I urge the CCGs to take a look at how care is delivered in the community and the areas where they can make improvements. It is all well and good having a state-of-the-art system that supports your working practice, but if it is not fit for use or users are not trained effectively in how to use it then it becomes an unsafe tool that can delay treatment and care causing both physical and psychological harm to our population.

So, review your operating procedures in line with the changes that are being made, have local champions who can assist others in teaching and awareness and make sure your workforce is fully prepared for what is coming before it is already in place. Always ask yourself what is this going to achieve, over what timescales and for what benefits? Unless it is a positive experience that helps improve services then why is it being done and at what cost.

This issue rings true across all services and departments within the NHS not just the community and is one of the biggest failings of our health service. If we don’t talk to each other by whatever means is available to us then we are doing something wrong. The time saved by effective communication could be spent on improving in areas that need it most.

‘The single biggest problem in communication is the illusion that it has taken place’ George Bernard Shaw.

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