In the current NHS digital transformation landscape, a huge amount of emphasis is placed on Electronic Patient Records (EPRs). From the national to individual digital strategies produced by NHS Trusts, the message is loud and clear: if you don’t have an EPR, you need one, and if you have one, you need a better one!
However, there is an aspect of record keeping in the NHS which no currently available EPR can adequately solve, and yet often goes overlooked: the stubborn persistence of paper medical records. Lingering at the edges of NHS trust operations like a messy loft everyone would rather ignore, trolleys of manilla folders continue to be core components of many trusts’ care delivery models, even in the third decade of the 21st century. A recent Times article highlighted that the NHS spent £1.19 billion over the past 5 years storing records alone; the original target of “paper-free at the point of care” by 2020 was blown past, and 12% of Trusts are reported to still be “paper-based”.
The focus on EPRs has enabled many phenomenal transformation programmes, but in many cases no plan for what to do about their old paper libraries. Like the messy loft, these libraries do not appear to be going away even as they’re ignored. There are products designed specifically to address this problem: Electronic Document Management solutions (EDMs). Yet well over 100 acute NHS trusts in England, even several with well-established EPRs, have not undertaken to deploy such a solution. Why, in an era of digital evolution in the NHS, does this core component of modern record keeping get forgotten or not prioritised?