Track and trace: The answer to efficiencies on the NHS frontline?

Following the publication of the NHS Five Year Forward View and the Personalised Health and Care Strategy 2020, industry experts reveal the importance of tracking and tracing medical supplies and clinical care

The efficient movement of goods and sharing of information will be crucial to fulfilling the Government’s vision for the future of the NHS, experts said this week.

The NHS as a whole has been slow to recognise and capitalise on the opportunities presented by emerging technologies, and with systems that don’t talk to each other, there has been a failure to harness the shared benefits that come from interoperable systems and processes

The comments come after the publication of the NHS Five Year Forward View and the more-recent National Information Board’s Personalised Health and Care Strategy 2020.

The first document sets out the Government’s vision for the NHS moving forward, forecasting a significant gap in funding that will need to be met through efficiencies. The latter strategy calls for greater exploitation of technology and transparency in order to meet these demands.

One way for the NHS to do this, according to industry leaders, is by exploiting the information revolution.

“The NHS as a whole has been slow to recognise and capitalise on the opportunities presented by emerging technologies, and with systems that don’t talk to each other, there has been a failure to harness the shared benefits that come from interoperable systems and processes,” said Alaster Purchase, chief operating officer at information standards organisation, GS1 UK.

The Personalised Health and Care Strategy 2020 encourages the use of GS1 standards to enable the efficient movement of goods and sharing of information, providing a significant part of the ‘electronic glue’ that will allow different parts of the health service to work together. It enables efficiency savings through visibility to inform decisions, administer medication, find products quickly, optimise procurement and spend while reducing ‘never’ events.

Speaking to BBH this week, Purchase said: “The challenge is that, if we continue on a trajectory of current spend and real-time increases, we will be faced with a £30billion chasm. It is about how we realise the necessary efficiencies while facing even higher demand for services.

So far there have been some great localised initiatives that can all deliver piecemeal benefits to the bottom line, but these lack the true economies of the NHS scale, so there has to be a root-and-branch approach

“So far there have been some great localised initiatives that can all deliver piecemeal benefits to the bottom line, but these lack the true economies of the NHS scale, so there has to be a root-and-branch approach.”

Key to the future, he said, will be managing products throughout their lifestyle, from sourcing, buying, managing and use to recall and disposal.

“At the moment hospitals have inventory in various places and internal ward management systems do not talk to each other,” he added. “In cases such as the PiP breast implant recall, we still don’t know who has those implants. Devices are not linked to specific patients and, moving forward, we need to have absolute visibility so we know what is being done, when, to whom and by whom.

“This will create the efficiencies we need, and in addition we will have a much better view of what we have and where it is and as a result patients will ultimately be able to move through the care pathways more quickly.”

One example of where GS1 standards could help to drive efficiencies is in pharmaceutical products. For one particular item, one pharmacy receives orders under 120 different product descriptions.

We need to compare health to retail, where it is very clear what the customer wants and how they can get it. There are clear expectations on both sides, and there is no reason this cannot be transferred to the healthcare sector

“If you order something in 120 different ways then the likelihood of getting and administering the right product are significantly reduced ,” said Purchase.

“We need to compare health to retail, where it is very clear what the customer wants and how they can get it. There are clear expectations on both sides, and there is no reason this cannot be transferred to the healthcare sector.

“At the moment in health we are looking at an environment that has been around for years and people are used to doing things the way they always have done. There has not really been a transformational change, so it is left to individual initiatives, and while there are some forward-thinking trusts embracing GS1 standards as part of the technology and process change, it is not a standard approach.”

GS1 standards involve the use of unique numbers for patients, products and places. These numbers are encapsulated in barcode and radio frequency tag technology as well as electronic messages, such as orders and invoices. This is used for patient wristbands and medical devices and supplies and means everything can be tracked throughout its lifetime.

“Instead of 120 descriptions for one thing, it has its own unique code,” said Purchase. “No matter where, or when, the patient receives care, you have certainty of the information.”

An example of the impact this technology could have is if there was an outbreak of infection in a particular ward or operating theatre. GS1 standards would mean all equipment and all patients and staff who used the area could be traced easily and further cases could be avoided.

“Some trusts are doing this already,” said Purchase, “but it is not across the board. A lot of trusts use barcode wristbands, but they do not have a scanner so that this track-and-trace process can be used to full effect.”

In terms of helping to secure efficiencies for the NHS moving forward, GS1 standards will also save clinicians time.

Better use of data and technology has the power to improve health, transform the quality and reduce the cost of health and care services

Purchase said: “We conducted a study two years ago which found that nurses spend a third of their time, on average, trying to find things, substantially reducing their time with patients on the frontline. Rather than doing what they are trained to do, they are rushing around trying to find notes or locate drip stands. GS1 standards would help to cut down on this wasted time and make health services much more efficient.”

A DH statement supports this approach. It says: “Better use of data and technology has the power to improve health, transform the quality and reduce the cost of health and care services.

“It can give patients and citizens more control over their health and wellbeing, empower carers, reduce the administrative burden for care professionals, and support the development of new medicines and treatments.”

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