Clinical information demands can drive change in NHS procurement

EPRs hog the limelight when it comes to NHS procurement. But Steve Hopkins, Capture Stroke’s new CEO, says it’s time to refocus on the capacity of clinical decision support systems to support the growing information needs of speciality care services.

Under intense economic pressure, it isn’t surprising that the NHS is focused so heavily on the transformative potential of EPR systems for clinical support. Millions of pounds are being spent on them – and the reasoning is sound, as far as it goes. These are good systems, which promise a great deal. But what is less talked about is the length of time it might take for that promise to be realised for the needs of clinical users.

Essentially, EPRs are holistic, corporate systems – great for management but currently less agile when it comes to supporting the needs of clinicians in specialty care. There is no doubt that flexibility and functionality will evolve in time. But the NHS is also looking to streamline the pathway between acute and community care – as is happening in stroke care – and the demand for data-led systems to support clinicians is more urgent than ever.

System evolution

Systems like Capture Stroke are ready to meet that need today. They have already been through a transformative evolution from their roots principally as data collection tools to becoming fully fledged clinical support systems. That evolution has happened alongside a growing emphasis on the stroke care continuum, with the requirement to look beyond data collection to recording and understanding the patient journey, and helping the clinician to make important decisions about the use of scarce resources.

This seamless data transaction capture runs from acute care right into community care, enabling the management of issues such as delayed transfers, which can often fall into the gaps between acute, community and ongoing care. This is critical in stroke care – when it comes to therapy, for example, which is a key focus of the forthcoming new SSNAP dataset.

EPRs are not always a good fit with a specialty and its needs. Capture Stroke can provide that additional functionality, which an EPR might not currently aspire to – and even if it did, would require significant development in competition with multiple other developments that are constantly ongoing with big-ticket institutional software.

Reality hits

This is where there is a little naivete in the way the NHS is procuring digital solutions right now. It’s understandable that if you’re spending up to £50 million on a lead system, the benefit of that investment will have to be ‘sold’ internally. But what happens when reality dawns post-implementation, and clinical users discover that it doesn’t provide the specific decision support they thought they were going to get, and that they are not being helped to manage their resources more efficiently?

Making the case for an alternative approach to procurement is increasingly in their hands – the clinicians and therapists who actually are delivering the service. What do they need to provide effective healthcare? A tool that isn’t onerous to use, that’s simple to access and simple to read, but contains the relevant information to help them make the most effective clinical decisions.

So, there is a gap in the market for the specialist software solutions that meet different types of specialty requirements, including those of acute and community stroke care. That gap can be bridged if there is a shift in approach to investment.

There might be perception that during a financial squeeze, prioritising an EPR is essential while clinical systems that could fulfil speciality needs are discretionary – nice to have but not essential.

But why is a small clinical system that fills the gaps which an EPR can’t service discretionary? After all, you aren’t going to achieve the benefits of a full EPR implementation unless you have total functioning availability at specialty level.

Essential data

When you look at the cost benefit studies that we’ve done for Capture Stroke, they have always shown a good positive net return on capital employed. That data should not be ignored when stakeholders and trusts are making decisions about this type of system. Too often, those decisions are imposed on rather than driven by clinicians. What they need is a system they can own themselves, not one owned by a central administrative body or a non-clinical executive.

Events will start to influence change. With the arrival of the new SSNAP dataset, and the need for more data to inform community care and therapy, the demand for more granular information is only going to grow. The more clinicians are required to justify their actions and decisions in stroke services, the harder they will press for systems that support them. The good news is that Capture Stroke is already extended into the community. As a system, it’s meeting these challenges as they happen.

Author Steve Hopkins

Title CEO

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