Going paperless “would save the NHS billions,” says Jeremy Hunt. It’s a bold statement and particularly topical in this economy – in fact, so big and public a statement that I started getting phone calls as early as 07:30am the morning that statement was made. Hardly surprising, given that our company provides consultancy to NHS Trusts on how to deploy a range of solutions. Some of our electronic document management (EDM) solutions have been in place in NHS Trusts since 1998.
Over the last 15 years, we’ve seen the good, the bad and the ugly of deploying EDM solutions to organisations of the scale of an NHS Trust. We’ve learned a lot. Turning a business into a more sustainable operation for whatever reason (be it to create savings or to live brand values), is a challenge and requires a substantial culture shift.
The trigger for the BBC headline was on the publication of a PwC report and a ministerial speech by Jeremy Hunt, recommending “better use of technology in patient care.” Just to set right an initial confusion, more than £9bn proposed savings are linked to better use of data systems and not just “going paperless.” This is an important point to make. The two are naturally connected and there is no magic formula to just “going paperless” – the process required to make it work is quite complex.
The huge savings figure actually covers a broad spread of efficiency gains – not just from information sharing between different components of the NHS but in patient self-service (access your own data, make choices, report on outcomes) and reduction in areas of risk/liabilities. The actual “paperless” bit – which I read as “removing a large chunk of paper filing and providing that information to be used electronically” – is based on a number of case studies and anticipated results.
What struck me as very good in the PwC study was the inclusion of best practices from a wide group of organisations outside healthcare. There is also a detailed analysis of the challenges involved in this kind of organisational change – winning support, nurturing the early adopters, and measuring the benefits.
Clearly, the report is talking about a large piece of work but leaves aside the peculiar challenges that come at such a scale. These challenges mirror those we see time and again in organisations big and small. Whilst the NHS doesn’t have the best track record of IT implementation, the “on the ground” problems of system implementation are no different to those encountered elsewhere.
Understanding how to make our businesses more sustainable, more productive and more efficient is a challenge many of us face. However, it is not an overnight transition.
Here are a few simple steps that would get you started on the right tracks if you’re considering how to go paperless:
1. Get end users involved early or they will not come along for the ride
Ideally, they should be involved in the decision making and how the system will be used. It sounds obvious, but even just a few end users who will champion the system can make a difference. With any process change there will be a learning period and your users should want the system to be a success rather than a failure.
2. Be pragmatic
As overall “usability” is the aim of the system, paper is still the best tool for some jobs. Involving users will highlight areas where 100 per cent paperless just won’t work. Sometimes a piece of paper is the best way to capture or share information – accept this and look at complimentary technologies to produce documents and capture the data from paper. This isn’t failing to go paperless, it’s just providing a solution which is fit-for-purpose.
3. Select key short-term goals to win support for the initiative
Having a particular team or business area lauding the benefits they’ve had from document management will create interest from everyone else. Even if you want to have a “big bang” change, someone has to go first and this should be managed carefully.
4. Set realistic measurement parameters and make sure they are used to appraise progress against the plan
Ideally, these measures should be quantitative – which can sometimes require a creative way to define softer benefits. There is nothing quite like a number to prove the benefit of the system. It’ll also tell you how well your project is progressing.
5. Get management buy-in across the organisation
This is important even in the areas who aren’t going to be paperless straight away. Sharing a vision creates “pull” and energy – it also avoids pockets of nay-sayers.
6. Be aware that information is used for many purposes
As well as allowing for efficient retrieval, think about how information is created/collected/modified (forms, updates and extra notes added to existing pages). What are the appropriate tools for each situation and what technology is already in place?
7. Think of who needs to see the information and where
Accessibility is vital to a successful implementation, without it you’ll just have printouts. Ensure you are making it easy for those who need to access it, otherwise you will have failed before you’ve begun.
8. The flip side to accessibility is security
Make sure yours is upgraded. Paper can be lost, but electronic data can be lost (or stolen) in vast amounts and many board directors are nervous about that fact. So build in appropriate security from the start.
9. Think about the structure of what you’re storing
Consider what indexes are required to allow the information to be retrieved quickly – once you start storing information you will be locked into a structure which can be hard to change.
10. Consider the different ways that information comes into the organisation (for example, paper, e-mail, electronic data)
Aim to consolidate this to a single path based on purpose rather than managing where it came from – this is the next step towards managing your processes, as well as controlling your paper.
These all seem obvious things to do but we’ve seen plenty of examples where one or more has been missing – always to the detriment of the overall initiative. It is possible to reduce your paper usage in a large organisation and improve your business processes at the same time – but only if you have a clear plan.
Taking these points on board, the NHS may have a better chance of realising those billions of pounds they have earmarked in savings and other businesses of all shapes and sizes can also look forward to an efficient 2013.
Neil Maude is general manager at document management provider Arena and regularly advises clients on making the most of technology to get more efficient, sustainable systems and processes.
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