Paper records: too many dinosaurs

Less Silicon Valley, more Jurassic Park. The phrase was used by Richard Humphries, senior fellow for social care at the King's Fund, to sum up the state of IT in social and healthcare, and could have been uttered by others at Kable's Transforming Social Care Through ICT conference on 7 December 2009. A number of examples of outdated attitudes were highlighted at the conference, including a resistance to switching from paper to electronic information in primary care trusts. Terry Dafter, service director for adult social care at Stockport MBC, said many staff have been "taken aback" at the idea as the council implements its Electronic Common Assessment Framework (eCAF) demonstrator. GPs have been particular challenge. "GPs are self-employed and have been very difficult to engage them in this," Dafter said. "You can talk to them about how great this is, but if they don't want to do it, they ain't going to do it." Out of 53 GP practices in Stockport, the project has only managed to get two to use the system. Dafter suggested progress might by made by getting half a dozen practices onboard and relying on professional rivalry to give it a boost. Otherwise he was stumped. He said data mapping was a "nightmare" because of lack of commonality; delays in the NHS National Programme for IT are creating uncertainties about the necessary interactions; and the local NHS had "yet to be convinced". Nonetheless, Dafter remained upbeat. "If we can get the record in one place, shared, and strip out ridiculous processes and stop this ridiculous faxing, we should get a much slicker process, with one entry of information that everyone shares and uses to make the decision," he said. "On the back of that we should make huge efficiency savings and use the technology to deliver a much better service for people." Devon CC is in the initial phase of a project to create single electronic assessments for adults with health and social care needs. It has developed secure networks, with access to the Government Connect Secure Extranet and the NHS N3 network. Damian Furness, the council's head of information management and technology, said the project has highlighted the challenges, not least the high costs and time required to integrate information flows between different teams. "We try to work with 13 partners and that is really challenging because of the differences, including different rules of integration," he said. And the council's mobile working aims are being held back "because in many parts of Devon we don't even have a mobile phone signal, let alone the high bandwidth connection which is necessary for data exchange." Looks good on paper? Some social workers continue to make the case for paper. During a coffee break one delegate said mobile devices can be symbols of officialdom and wealth to clients, many of whom are among the poorest people in society. But Terry Dafter told delegates that IT is an underrated resource, and that research at his council revealed that social workers spent just 20% of their time with clients and an "awful lot of time" filling forms. More upbeat perspectives did emerge during the day. Brendan Murphy, head of ICT at Cordia, a company owned by Glasgow City Council and providing ICT for home care staff, painted a positive picture of mobile working. Glasgow began equipping its home care coordinators with BlackBerrys in 2005, to provide secure access to client records in real time. Murphy told the conference that before this staff wasted a lot of time making unnecessary journeys back to head office picking up faxes, data entry was sometimes inaccurate, "and you could say it was dangerous, because there were lots of errors and delays." The cost of setting up the scheme was £40,000, but Murphy said that savings totalled £1m within the first year. "The scheme has created front line access to back office data in a very secure way," he said. "And we have saved one hour per coordinator per day. That's 2,000 hours per year, a significant saving." Rick Wilson, chief executive of the Community Lives Consortium (CLC), which supports people with learning disabilities to live in the community, said his favourite gadget is the Flip, a cheap video camera. Clients use it to take photographs to alert care workers to, for example, something which needs fixing. CLC has also given its clients access to computers and a social networking tool called Swansea Lives. "Many of the people we serve have spent a lot of time in institutions and have not controlled their own history," he said. "So there needs to be a fundamental cultural shift from us as professionals contributing to their personal histories, to their lives contributing to our organisation." Asked about security risks, Wilson said Swansea Lives is a registration site and only known people are allowed into the online community. Technology such as this shows there is the potential to take the service out of the Jurassic age and into one of hi-tech efficiency. * This article appeared in the January issue of GC magazine . Click here to apply for a subscription.