Efficiency in the NHS is a key focus for the Health Department. Last month, Chancellor of the Exchequer Philip Hammond announced he would not provide Health Secretary Jeremy Hunt with the money to give doctors and nurses a pay rise, unless the NHS became more efficient. That would mean cutting costs elsewhere, or reneging on the promised abolition of the public sector pay cap in healthcare.
But where do these efficiencies come from? Reading between the lines, we recognise efficiencies to mean 'doing a better job for less money', a concept that is met with scepticism and fear because the two don't seem to go hand in hand. How do you provide a world class health service, pay healthcare workers a fair wage, and save money at the same time?
In 2016, it was announced that the NHS will receive £4bn in investment as part of a 'digital transformation' plan, which appears to be a cornerstone of this efficiency drive. To what extent has digital transformation already been implemented across the NHS and how effective has it been? And given the increased cyber security threats posed to critical infrastructure, how well are these new digital services protected against attacks that could compromise sensitive patient information?
Cloud centric NHS computing
In order to cut costs, increase efficiency, and improve productivity, the healthcare sector is moving technology stacks to the cloud, taking advantage of easier access and the higher security provided by multi-layer systems of encryption. Not only do cloud solutions reduce costs, allowing the healthcare industry to benefit from the affordability of subscription models, but they remove the time-consuming responsibility of hardware maintenance associated with legacy equipment.
One such cloud service currently being adopted by the healthcare industry is call recording. Call recording on its own serves a number of compliance purposes, but harnessing the voice data of patients to improve care presents a significant opportunity for GPs and other healthcare providers who deliver services and consultations over the phone.
Developments in speech intelligence and the infinite scalability of cloud call recording services allows for huge amounts of voice data to be analysed. Using AI, voice data from patient calls can be analysed — opening up opportunities for health trends to be identified and treatment plans developed in order to anticipate a patient's future needs — all while keeping patient records confidential and secure.
The future of speech intelligence will be its application to real-time, rather than recorded, consultations. Patient calls could be routed to the most appropriate number using keywords spoken by the caller in order to receive the best treatment, while sentiment analysis could identify patients in distress and allocate them a higher priority in a call queue. With time regained that might otherwise be spent answering and transferring calls, doctors can spend more time caring for patients.
In the same way voice analytics can be used to detect distress and anxiety in a patient, it can also be used to assess a doctor's performance and bedside manner, with a repeat pattern of mannerisms and actions creating flags in the system to be reviewed and analysed.
Securing patient records against cyber attacks...and human error!
Cloud services are an instant hit for efficiency: saving the NHS time, money, and even space as cloud solutions do not require capital expenditure, on-premise storage, or lengthy installation processes. Most importantly, cloud call recording enables a high volume of calls to be processed and stored with end to end security, allowing fast access to patient information only for doctors with approved access permissions and a secure space in which to store a large amount of data efficiently.
Cloud computing is at the forefront of developments in innovative security systems. Amazon Web Services S3 storage system for example, offers one of the world's most secure and resilient data storage options. The resilience figures provided by Amazon on S3 are 99.999999%: this is achieved through simultaneously writing all data to three separate encrypted data stores.
This storage is inaccessible from any system outside of AWS, and is only accessed within AWS through time-restricted tokenised links, ensuring protection from breaches as well as maintaining strict user permissions internally. This doesn't stop doctors, nurses, and other healthcare professionals collaborating and sharing data to better diagnose and treat patients, but it does ensure that data isn't being shared in insecure ways, or to those without the appropriate access permissions.
There have been numerous reports over the years of patient records found on unencrypted USB sticks in car parks, or on second hand NHS computers, but there are increasingly fewer excuses for the working practices that lead to this type of data breach.
GDPR compliant healthcare
Of significant note in the appropriate protection of patient data is the well-publicised and looming deadline for GDPR compliance. All organisations need to review their data storage in advance of the new legislation to ensure the personal information they hold is properly protected and stored in an appropriate location. It will apply from 25th May 2018 and it is expected that GDPR will still apply to the UK post-Brexit, meaning uncertainty over Britain's future in the EU is not an excuse for non-compliance.
GDPR goes above and beyond current data protection laws, truly prioritising the rights of patients. Retaining accurate and up to date records are essential to an efficiently run NHS but it is a fine balancing act between retaining relevant information and storing it securely. Cloud solutions have many benefits to help GDPR compliance, including advanced security, scalable storage, and smart search functionality. The speed of deployment also means that even though the deadline is incredibly tight, and NHS procurement processes notoriously lengthy, there is still plenty of time for trusts to get their houses in order.
Efficiencies and compliance coming together
Speech intelligence was initially only affordable for enterprises that could invest the CapEx required to install proprietary solutions, but the introduction of software as a service (SaaS) solutions, has democratised speech intelligence by making it available on a monthly subscription plan. It has become accessible and affordable for the NHS, and voice data, which historically was retained primarily for compliance purposes, can now be used to deliver significant improvements in the care provided.
Efficiencies are possible in the NHS without compromising on service. Collaborative and innovative cloud computing solutions, integrated into existing and new systems, will deliver a better NHS Digital, benefiting patients and staff alike.