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Digital transformation of healthcare will remain a pipe-dream without involving nursing, RCN warns

8 Jul 2018

Consultation finds nursing teams struggling with out-of-date computers and inadequate systems.

Health and care services will never be able to realise all the benefits digital technology can bring for patients and staff unless they take full advantage of the expertise and views of nursing staff.

That’s the warning from the Royal College of Nursing (RCN) today as it launches the results of a consultation with nursing staff on what is needed for nursing to play its full part in the digital transformation of healthcare (note 1).  The results come as the NHS celebrates its 70th anniversary, when a succession of health leaders have cited the development of technology as the best route to the future transformation of healthcare.

Almost 900 nurses, midwives, students and health care support workers took part in the online consultation earlier this year, with over 100 more attending five in-depth focus groups held by the College across the four countries of the UK.  Participants were invited to describe their vision of the digital future, outline any barriers they were experiencing to making that vision a reality, and list any specific initiatives they knew of or had been involved in that are making a difference.  

Positive findings from the consultation were the articulation of what the report calls a ‘clear and compelling vision’ of a health and social care system that makes services more efficient for patients and staff.  Contributors also gave examples of digital technology already in use at some hospitals and community services including mobile systems that allow nurses and other clinicians to input patients’ vital signs such as heart rate and blood pressure, and which then alert them to any deterioration that might indicate conditions like sepsis; digital networks that link up community staff such as district nurses while out in the field; and apps that allow patients with long-term conditions such as diabetes or COPD to relay data to nurses.  This response from a nurse on how technology could be properly utilised to help patients was typical:

“As a nurse, my dream would be to go online and see any patient's records that I needed to see. They would be together, well-curated, under that patient's name/identifier. It would include GP, acute, community interventions and interactions and all correspondence.  There would be click-through contact points for details of other staff involved.  As a patient, my dream would be the same…”
But in contrast to this vision of how the future could look, significant numbers of contributors cited what the report described as ‘depressingly mundane’ barriers to the full use of digital tools to help patients and transform healthcare.  Common themes that emerged from the findings were:

Out of date and inadequate IT systems: 

“I hate to think how much nursing time is wasted each day waiting for computers to switch on, load emails, bring up blood results - that is if you can find one that is free”.

Programmes and systems designed without any nursing input:

“[Decision-makers] often do not know the extent of our work and have never walked in our shoes, yet they make decisions on our behalf and bring in systems for us to use. They have no idea about workflows and how information is used.”

Commenting on the findings of the consultation, Ross Scrivener, eHealth Lead at the RCN, said:

“In the past few weeks leading up to the 70th anniversary of the NHS, we’ve heard a succession of healthcare leaders arguing that the best way to transform health and social care services in the UK is to utilise the full benefits of digital technology.  But our consultation shows that that aim will remain a pipe-dream unless managers, technology providers and IT staff take more account of the views of nursing staff.

“The responses to our survey reveal some depressingly mundane barriers to nurses’ full participation in digital transformation, from WIFI that doesn’t work to computers that take too long to log on. 
“But the single most important theme to emerge from the consultation is that involving nursing in the design and implementation of programmes and systems to improve patient care is not an optional add-on – it is absolutely vital if those systems are going to provide the benefits they’re supposed to.”

Ellen Hudson, Associate Director, RCN Scotland added: 

“The Scottish Government’s digital strategy launched earlier this year recognises the need to invest and develop digital capability. We now need to see that translated into resources on the ground and a clear role for nursing leadership in developing the digital health agenda. 

“Nursing teams see very clearly the potential of technology to transform their and patients’ lives, and want to play their full part – but that won’t happen until their views are listened to."