Few things in life are more annoying than your computer freezing in the middle of an important task.
If you work in general practice and have a waiting room full of frustrated patients, it’s more than a bit irritating: it can have far-reaching consequences, as Pulse explored in July.
Serious problems that can ensue following an IT crash in general practice include near misses, safety concerns, and an increase in workload – not to mention having to face the wrath of those frustrated patients who have been waiting weeks for an appointment only to have it cancelled at the last minute because you can’t access their records on the system.
This happens all too frequently. A snapshot Pulse survey of GPs in June revealed that IT systems go down on average almost twice every month.
SystmOne users fare better with an average 0.94 monthly outages, while EMIS users – that’s around 4,000 practices in the UK – deal with 2.19 outages per month. It’s no wonder 42% of practices responding to an RCGP infrastructure survey reported that their IT and support services were not fit for purpose.
Unable to log in and check a patient’s medications and allergies, clinical staff cannot prescribe safely. They may miss an urgent blood test result coming through, putting patients who might need hospital treatment at risk.
Meanwhile, appointment systems are thrown into chaos: staff can’t access appointment lists for that day and patients can’t rebook.
According to the snapshot Pulse survey, most respondents (80%) attempt to carry on as best they can, handwriting notes as they go, then entering them on to the system and arranging deferred prescriptions later on – doubling the workload.
Some 6% of GPs said they cancel routine appointments when the IT fails, while a third (32%) of admin staff decline all patient requests until systems are back up and running. The result is angrier and more alienated patients.
The longer the shutdown lasts, the more potentially dangerous the ramifications. In May, technical problems with EMIS Web left practices nationwide locked out of their systems for around four hours and unable ‘to provide a safe service for thousands if not millions of people’.
Worse still, practices in Kent and Medway lost use of all internet-reliant systems for five days in March thanks to a ‘faulty firewall’ that brought their IT crashing down.
The outage affected email, EMIS, prescriptions, QOF, payroll, end-of-year reporting, phone lines, accuRx, Kent’s Document Organisation, Referral and Information Service (DORIS), and Docman, which is used for clinical letters and discharge summaries.
Unsurprisingly, GPs reported serious concerns for the safety of their patients during the outage. The ICB’s arcane response – to revert to pen and paper – was rebuffed as ‘downright insulting and ridiculous’.
NHS England is arguably doing little to make things easier, providing limited options from its list of approved suppliers, should practices want to switch to an alternative.
At the same time, it has required practices to implement cloud-based telephony as part of the new GP contract imposed in March. NHSE has put together a procurement framework for the new technology to ‘assure value for money’.
GPs might do better spending their hard-earned money stocking up on pens and notepads, and hoping for the best.
I was on various Connecting For Health Committees.. I protested at every opportunity but CfH was determined to have cloud only solution… that is was to beno server of any kind within each surgery. There should have been practice store and forward with cloud backup. A laptop is powerful enough to be such a server nowadays. Is that fails one surgery goes down, nobody anyone else. If internet failed then surgery still has its own server. The current system is nuts for if internet or cloud service fails everyone loses everything. Predictable and cheaply avoidable.