Paperless NHS - plenty of clouds on the horizon

Jeremy Hunt's vision for a paperless NHS is an idea with a long history but is a long way to implementation

Back in the 80s when the world though big hair and padded shoulders were the height of fashion and mobile phones the size of housebricks were the acme of sophistication, there was much talk of the paperless office.

The vision was that office employees would no longer be shuffling paper around, everything would be handled by computer as electronic transactions would pre-dominate. There’s some history here: although it was the 80s that saw talk of the paperless office become widespread, the roots are much older. In a 1975 Business Week article, Xerox’s George Pake is quoted as saying “There is absolutely no question that there will be a revolution in the office over the next 20 years. I'll be able to call up documents from my files on the screen, or by pressing a button," he says. "I can get my mail or any messages. I don't know how much hard copy [printed paper] I'll want in this world."

We all know what happened to that vision: I look around my office today and see three large bins within 10m off my desk purely for recycling paper. We’re addicted to the stuff more than ever and that 80s talk of paperless offices looks as quaint as the notion that by 2000 we’d all be commuting to work with jetpacks.

But the paperless concept is still floating around – now it’s health secretary Jeremy Hunt who is calling for the NHS to be paperless by 2018 - a move a report says could help save the health service billions of pounds a year.

The strange thing about the paperless office is that the technology is there: we use email and social media to communicate – the ritual of spending 40 minutes opening the day’s post banished forever; we can book events online without the pain of printing off a form and sending a fax over and we can retrieve information from the web. But that hasn’t done away with the need to use paper ... and lots of it.

So, a paperless NHS does make some sort of sense. It’s the sort of situation that has almost been tailor-made for cloud implementation. The reports are a bit vague as to what exactly is being planned but a cloud-based infrastructure could certainly lead to greater efficiencies and considerable cost savings.

So, a paperless NHS does make some sort of sense. It’s the sort of situation that has almost been tailor-made for cloud implementation

But, there are big issues to overcome: there’s the thorny problem of security, a factor to be taken into account with any cloud implemention, but something particularly sensitive in health issue: it won’t be long before a pensioners medical records are accidentally leaked and the story is all over the Daily Mail.  There’s also the accompanying issue of identity: the NHS – like many public institutions sends out a lot of letters as email is not deemed secure enough for widespread use. And, of course, are all patients going to have access to a computer?

Then there’s the accompanying infrastructure: a paperless NHS is going to lead to a huge leap in bandwidth demands, both fixed line and mobile ... and it’s going to be especially huge if X-rays and scans are going be sent,  Are hospitals and health centres going to be ready for this? The NHS is a massive institution and the data centre(s) needed to support a move to paperless delivery are equally going to be huge. Of course, cloud providers will be able to meet many of the challenges of scalability but be prepared for howls of protest when patient data is sent outside the UK. Remember the howls of protest from the tabloids when David Cameron suggested that Google could hold NHS records? There will be plenty such opposition to any similar moves.

There’s no doubt that the NHS would be a good fit for cloud-delivered services and that such a move could make paperless delivery a reality but there are a host of challenges to overcome first: cultural challenges, political challenges, technical challenges and financial challenges. The government could well have the political will to force through the changes required but I wouldn’t bet it – but if they could effect such a massive change then anything’s possible. Better start looking into jetpacks now.

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