Digital NHS: Ensure Best Value Clinical Systems (PACS/EPR)

Digital advances in medical technology help save countless lives each year, yet it is estimated that they can add over £10bn/year to already overstretched NHS budgets. The NHS needs to balance cost reductions against maintaining existing front-line services and the ever-increasing demand for improved services. With digital healthcare delivering undeniable patient benefits, denying projects and investments is no longer a viable option, now there is a better solution.

Let’s have a closer look at the challenges first.

With IT being a crucial part of the modern healthcare provision, advances in clinical systems rely heavily on advanced communications and networks. Previously centralised under N3 network provision for the health service is now being replaced with HSCN to allow more framework partners and increase competition. More choice however will undoubtedly lead to more doubt and pressure to deliver the best value solution.

Paperless NHS goals inevitably lead to an explosion of digital files with all the PACS (Picture Archiving and Communications Systems) modalities: X-Ray, CT, MRI etc. leading the way. Together with growing adoption of all-encompassing EPR systems (Electronic Patient Records) it fuels the demand for improved systems and ever-increasing storage capacity.

If choosing the most cost-efficient PACS solution provider wasn’t difficult enough, clinical teams and business often clash in a debate over system suitability. Supplier lock-in and increased functionality of their proprietary standards on one hand vs flexibility of DICOM based vendor neutral archives with the option of foregoing a PACS system all-together on the other.

To streamline such debates, many Trusts are turning to independent organisations to review their existing services and supplier contracts which includes areas such as PACS and EPR solutions to not only facilitate the discussions but also confirm that the chosen solution will deliver “Value for Money” over the life of the contract.

All-encompassing EPR systems are widely agreed to be the golden standard of patient data quality and speed of access. Yet COTS packages are not an easy fit and the journey from a patchwork of often legacy systems to the final solution is not only costly but will require a lot of widely unpopular clinical workflow change.

Enlisting a third-party organisation to review the Trust’s position and contracts allows a fresh and expert view of the starting point and takes an immense amount of unnecessary strain off the Trust, enabling them to focus on their core business. Being proactive in trying to reduce costs and improve services doesn’t have to take away from the day-job!

Proactive NHS Trusts do not wait until their contracts are up for renewal to evaluate and improve their outsourced services. Nor do they use the traditional stick of invoking their contract’s “benchmarking clause”, to validate the price and performance of their provider. Instead they bring in an independent organisation with knowledge of the sector’s challenges to “Market Test” services they are being delivered; and have them compared to the expected performance against other providers of comparable solutions in the PACS and EPR markets.

Despite a relatively short time-scale (approx. a month) Market Tests are very thorough. They involve workshops and interviews with key stakeholders capturing both qualitative and quantitative data helping to identify strengths and weaknesses of the services provided. This is then measured against the appropriate peer group with similar volumetric and complexity factors.  Outside of providing independent evidence for the PACS and/or EPR services delivered providing “Value for Money”, a Market Test will identify areas of improvement, to further enhance the quality and efficiency of the services, helping guide strategies, decisions and goal setting and gain insights into drivers impacting the price-performance

If your Trust is at technological crossroads, looking to renew their internal or externally provided service contracts, change providers or review the services already supplied to confirm their value, then employing a specialist consultancy company is a wise investment.

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