Leading Digital Transformation to Enhance Quality Service Delivery of Primary Care Within the UK Health System, Dissertation – Conclusion Example

Introduction

Background

The coronavirus has changed the way primary healthcare is delivered and will be delivered in the future. The pandemic, which has resulted in a global health crisis, has proved current general practitioners’ (GP) practices futile. Due to social distancing restrictions, face-to-face consultations have significantly reduced, and this makes it hard for GPs to deliver quality care. According to Pettigrew, Kumpunen, and Mays (2020), COVID-19 pandemic has put a strain on primary healthcare through delayed treatment, presentations, and investigations (1). General practices have also suffered from workforce shortages, as the staff has occasionally self-isolated since others are forced to take long leaves due to falling sick (Fisher and Asaria, 2020, p.4). GPs practising in low-income areas are more affected by the pandemic because they are at a higher risk of contracting the disease and suffering from inadequate resources to help communities. For instance, Fisher and Asaria (2020) found in their research that one in three GP practices are run by GPs at a very higher risk of COVID-19, and this situation is more likely to be experienced in less affluent areas (8). Hence, the pandemic has affected GP practices prompting the UK government to come up with solutions to overcome these challenges.

Due to the continued spread of the virus, it has become necessary to protect patients and GPs alike by offering services remotely. For instance, NHS England issued its first recommendation for GP practices on March 5th, saying that appointments should be shifted from face-to-face to online through either telephone or video (Clarke, Pariza, and Wolters, 2020, par.4). This means that GPs have had to provide services remotely, and this can be challenging for patients used to face-to-face consultations or those who do not have the means to make remote consultations, perhaps lack of appropriate technology. For example, one research already shows that GPs in urban areas were more likely to have reduced numbers of patients seeking face-to-face consultations than those in rural areas (Scott, 2020, p. 6). Despite this challenge for those in rural areas, there is a need to transfer GP practices online to reduce physical interactions. Hence, there is a pressing need to reshape GP practices through digital transformation, which will help to deliver services in more sufficient and secure ways. Accordingly, this research is aimed at examining the use and practicability of innovative technology in reshaping GP practices. Therefore, the objectives of the study are:

• To promote personalised care in the treatment of all patients in GP practices.
• To identify some of the ways of adopting digitally enabled tools in carrying out diagnosis, treatment, and management.
• To achieve enhanced information flow between primary care providers and patients, within and beyond the healthcare environment.

Project Drivers

The main motivation to conduct this study is to develop an understanding of how technology can solve challenges that the current COVID-19 pandemic has imposed on primary healthcare practices. Since normal ways of consulting and providing patient care within GP practices are no longer feasible, there is a need to integrate digital technology. The use of technologies in healthcare was already in place in the UK even before the coronavirus hit (Hitchings, 2020, p.1). However, when the coronavirus emerged, it brought about changes that the NHS had not anticipated, including social distancing when offering care, treatment, and management. Before COVID-19, about 80% of GP practices, including appointments, took place face-to-face, but by 2020, June, the number has fallen by half, with appointments majorly taking place through telephone (Hutchings, 2020, p.3). Most GPs in England have started doing remote consultations with some GP surgeries asking patients to only come to the facility after being called when their appointment is ready (Postelnicu 2020, par.9). Yet, more innovative technology is needed to handle GP practices as the number of patients continues to rise due to coronavirus, as well as the challenges of reaching out to patients in rural areas remotely.

Moreover, it will be beneficial to adopt innovative technologies in primary healthcare to improve quality care delivery in the future. In the aftermath of the coronavirus pandemic, there is an opportunity to promote positive behaviours, such as using virtual GP, among the public (Morris et al., 2020, p.7). Although there currently exists digital health apps that track patients’ adherence to treatment and even offer self-care, more technologies remain unexplored. These technologies have the potential to improve the usability, reliability, and trustability of GP practices in the NHS. For example, telehealth technologies can be used to diagnose patients remotely by GPs using audiovisual, real-time, or interactive systems (Kritikos, 2020, p.7). The advantage of such technologies is that they reduce contact between people and primary providers, thus limiting the spread of the virus. Additionally, it helps GPs to be kept clear for confirmed cases, thereby offering further advice to patients on how to manage the symptoms and seek further specialist assistance. Finally, the use of telehealth technologies ensures that, in the future, GPs can provide care for infectious diseases to people in areas that lack access to speciality care (Kritikos, 2020, p.8; Ye, 2020, p.2). Therefore, the pandemic has created an opportunity to make lasting changes to the primary healthcare environment, and the adoption of digital transformation will have this long-term impact.

Research Question

How can digital transformation be used strategically to enhance the quality service delivery of primary care within the UK national health system (NHS)?

Structure of the Dissertation

The research paper will first describe the importance and practicability of technology transformation in GP practices in a well-developed literature review. The review aims to find studies explaining the importance of technology in the primary healthcare environment. Next, it will examine studies that have proved the successful implementation of technology in GP practices in the context of healthcare within the UK. The aim of examining these studies is to tell whether technology is useful for GPs’ practice or not. Finally, the review will include studies that show the need for technology transformation in GP practice following the COVID-19 pandemic, which has greatly proven that normal GP practices are futile.

The research will then proceed to conduct primary research based on the evidence collected from the literature review. It means that topics or gaps found in the existing literature will be examined in thorough primary research. The plan is to conduct interviews on selected primary care clinicians across the UK health care system after consent is gained. The interviews will determine GPs’ attitudes and experiences in digital health technology. In turn, the findings and discussion of results from the interviews will contribute to understanding the need and practicability of integrating digital transformation in the primary healthcare environment in the UK.

Conclusion and Recommendations

A better understanding of new technologies is needed in healthcare settings to enhance communication, operational efficiency, and collaboration among health professionals to improve the delivery of care services and patient safety. New technologies will ensure nurses easily collaborate with a broader range of other healthcare professionals, breakdown geographical silos, and improve care delivery. Nurses need to learn and reskill on using new technologies. For example, nurses can be educated on the advantages of telehealth and how it allows them to collaborate with other healthcare disciplines and professionals to improve patient care. Healthcare facilities can also invest in training and development programs where nurses can learn new skills and competencies needed to run new technologies.

Managerial leadership in a healthcare facility is also essential to manage the change that accompanies the implementation of a technology-related initiative. Nurse managers are required to establish a vision for subordinates to follow. This vision would act as a goal of what we need to accomplish. It is imperative to have open communication among departments to ensure clear instructions are given and followed, and there is a channel for feedback. Besides, it is beneficial for a manager to be involved in managing trust and in ensuring there is effective interaction during their entire implementation process. Effective change management is single-handedly the most vital factor in implementing a new technology-related initiative. The success of a technology-related initiative in the healthcare setting depends on the overall effectiveness of change management strategies. An effective change management strategy is necessary to assess and address the needs and differences of each stakeholder and keep them engaged and motivated. For example, if a facility is implementing an enterprise resource planning (ERP) system, it is important to ensure everybody is onboard, address their concerns, and ensure there is open communication to avoid resistance. Studies have shown that technology-related initiatives that come along with authoritarian decree, are likely to face rebellion most likely through subtle resistance. Thus, it is imperative to incorporate change management factors when investing in a technology-related initiative to ensure it is successfully implemented.

Patient safety is increasingly gaining recognition as a significant global public health challenge.  The Institute of Medicine (IOM), in its report “To Err, Is Human,” stated that medical errors are rampant in healthcare facilities, and they adversely affect the mortality and morbidity rate as well as the patient outcome. Following the release of this report, there has been a revived effort to reduce adverse events and enhance patient safety. The adoption of appropriate interventions to enhance the quality of care by improving patient safety is necessary to address the potential harm that patients may endure while receiving care. Healthcare facilities should adopt disruptive technologies such as electronic health records (EHRs), electronic immunization registries (EIRs), mobile health (M-health), telemedicine, and telehealth to reduce medical errors, near misses, and adverse events. Particularly, EHRs systems have become a crucial part of health information technology. They are real-time, patient-centered digital records that make patient’s information readily and instantly available and secure to the authorized users. An EHR system can be designed to go beyond the realms of data collection and storage to a wider and inclusive system that addresses the patient’s care needs. These disruptive technologies will contain and accommodate patient’s health history, treatment and intervention plans, diagnoses, medications, lab tests, and radiology images, ensure there is timely access to evidence-based tools and methods that care providers can utilizing in making relevant decisions regarding patient care, and automate and streamline the workflow of care providers

Data-driven key performance indicators (KPIs) are needed to reduce notable adverse events in healthcare including diagnostic errors, healthcare-associated infections, complications due to unsafe surgical care, unsafe injection practices, hazardous transfusion methods, radiation mishaps, sepsis, and venous thromboembolism. Both near misses and adverse events expose the weaknesses in patient safety during healthcare delivery. Health practitioners may be reluctant to report near misses because no harm has occurred to the patient. However, near misses occur more frequently than adverse events, and hence, the former gives more comprehensive information regarding factors underlying medical errors. Typical KPIs such a readmission rates, mortality rates, length of stay, and use of incident reporting systems are designed to collect information regarding healthcare incidents and facilitate its translation into organizational learning. An incident reporting system such as good catch program would ensure that recognizing near misses provide critical information that may be useful in modifying health systems to improve patient safety. Medical professionals are also likely to welcome such programs because, despite the occurrence of a mistake, no harm will be inflicted on patients. An effective good catch program should also encourage communication among health professionals to disseminate findings of near misses in the organization. This way, this system maintains a high level of awareness of potential errors in the facility and prompts personnel to continuously engage in preventing the occurrence of such events

Future Development of this Dissertation

When used correctly, digitalized healthcare systems can serve as valuable tools for long-term quality monitoring. The ability to exchange health records electronically help health facilitates to provide high quality and safer care for patients while creating tangible enhancement for an organization. Going forward, the dissertation will focus on ways disruptive data-driven technologies can be used to improve healthcare quality and continuous improvement. Additionally, the paper will explore ways in which these technologies will improve communication and collaboration among nurses, departments, facilities, and patients. The focus will be centered on technologies such as EHRs, telehealth, telemedicine, EIRs, and incident reporting systems (good catch program).

Reference List

Clarke, G., Pariza, P. and Wolters, A., 2020. How has COVID-19 affected service delivery in GP practices that offered remote consultations before the pandemic? The Health Foundation. https://www.health.org.uk/news-and-comment/charts-and-infographics/how-has-covid-19-affected-service-delivery-in-gp-practices

Fisher, R. and Asaria, M., 2020. How might COVID-19 affect the number of GPs available to see patients in England? Health Foundation. https://allcatsrgrey.org.uk/wp/download/primary_care/How-might-COVID-19-affect-the-number-of-GPs-available-to-see-patients-in-England.pdf

Hutchings, R., 2020. The impact of Covid-19 on the use of digital technology in the NHS. Nuffield Trust Organisation. https://www.nuffieldtrust.org.uk/files/2020-08/the-impact-of-covid-19-on-the-use-of-digital-technology-in-the-nhs-web-2.pdf

Kritikos, M., 2020. Ten technologies to fight coronavirus. European Parliamentary Research Service (EPRS). https://www.europarl.europa.eu/RegData/etudes/IDAN/2020/641543/EPRS_IDA(2020)641543_EN.pdf

Pettigrew, L.M., Kumpunen, S. and Mays, N., 2020. Primary care networks: the impact of covid-19 and the challenges ahead. BMJ. https://www.bmj.com/content/bmj/370/bmj.m3353.full.pdf

Postelnicu, L., 2020. How the world of health and tech is looking at the coronavirus outbreak. Retrieved on November 27th, 2020 from https://www.mobihealthnews.com/news/emea/how-world-health-and-tech-looking-coronavirus-outbreak

Morris, D., Solon, L., Simpson, J., Read, O. and Abel, J., 2020. Tech powered healthcare: A strategic approach to implementing technology in health and care. PwC Report. https://www.pwc.co.uk/healthcare/assets/documents/making-healthcare-digital-tech-powered-health.pdf

Scott, A., 2020. The impact of COVID-19 on GPs and non-GP specialists in private practice. ANZ-Melbourne Institute, Health Sector Report. https://melbourneinstitute.unimelb.edu.au/__data/assets/pdf_file/0003/3436014/UoM-MI-ANZ_Brochure-FV.pdf

Ye, J., 2020. The role of health technology and informatics in a global public health emergency: practices and implications from the COVID-19 pandemic. JMIR Medical Informatics, 8(7), e19866.