Sport on TV has a lesson for tech in the NHS

What does the streaming of live sport on TV have to do with EPR implementation? They both need to deliver a better experience for the user, argues Martin Farrier

I’ll be cheering on Team GB at the Olympics with some degree of caution. Because the last time I got excited about a great international sporting event, the experience was ruined – not by the disappointment of defeat but by poor tech implementation.

It was 89 minutes into the Euros semi-final. The score was 1:1. I was watching the match streamed live on the TV in our lounge. Suddenly, there was a cry of joy from the kitchen. I guessed immediately what had happened: my wife had switched channels from Wimbledon to the football. The TV in the kitchen is about 90 seconds ahead of the one in the lounge. I was now watching what felt like a replay. When Ollie Watkins slipped the ball past the Dutch keeper, I could hardly even manage a cheer. I was furious with my smart TV.

The whole point of sport is that you don’t know what’s going to happen. Seconds matter. The flawed implementation of streaming technology, the inability to synchronise it with terrestrial TV, has managed to suck the joy out of sport.

Pointless progress

It’s the sort of problem that you would imagine would have been solved long ago. But it is typical of technology. We often don’t get the implementation right, and this can make progress feel pointless, a fix we didn’t really need.

We know that electronic patient record systems are often let down by poor implementation. Whatever your view of what makes for the best EPR in the business, the implementation of that software will be the difference between pointless ‘progress’ and a helpful leap forward.

The letters from one of our local organisations have got much worse recently. They had a very expensive new implementation of an EPR system. The resulting letters are difficult to read and much less human than the ones they used to send. People using the new system tell me that the software is fine but it’s not easy to use and they are taking longer to do their jobs. That’s been the experience of many people working in healthcare, regardless of the EPR.

Even in my own organisation, 10 years after the initial launch, we have never been back to the system to remove unnecessary clicks and checks. We put new ones in but don’t remove the ones that are no longer needed. The result is a system that isn’t designed to improve the experience of the user. People have become used to the system, so it is quicker than it was, but we could undoubtedly make their experience and their productivity better if we went back and removed the things that caused them delays. We could even implement some Robotic Process Automation to complete tasks; but that’s a long way from where we are.

Make old systems work better

One of my clinics has just gone paper free. I’m pleased about that. However, I now need to fill in an electronic outcome form. Instead of two ticks on a sheet of paper, I have to enter a document in the patient’s notes, click five times and enter a number. Then I scroll to the bottom and submit. It takes me a couple of minutes. It used to take me a couple of seconds. The clerk who used to input the paper sheets into our PAS system did them all in one go. The total size of the effect on my clinic is perhaps that I lose 10 minutes. The same thing happened when we introduced digital dictation.

Just imagine if each tech change made my clinic 10 minutes faster. It wouldn’t take much. Just better implementation.

When we look at implementation of new software components, we focus on systems that will replace outdated tech or introduce something shiny, or systems that will save money. I don’t think I have ever seen a business case that suggests we go back and make an old system work better. If we did, it would be more likely to save time and consequently money.

I’m planning to watch the Olympics in the same room as my wife and whoever else is in the house. That should result in better implementation of the TV streaming software – a DIY revision based on user experience. I’d like to suggest this as a model for the NHS.

Consultant paediatrician Martin Farrier is a chief clinical information officer working in the NHS