From the paperless office to the paperless NHS

The paperless office arose out of innovations in the usability of technology in the 80s and yet the vision of a paperless NHS still seems far away despite huge investments in technology. Recent reports highlight usability as a key enabling factor for achievement of the vision. Improving usability through the use of speech recognition software integrated into the EPR and clinical documentation should be a key investment.
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Applying the lessons of usability of office technology to accelerate the paperless NHS

The history of the paperless office

Many years ago, when I worked as a salesperson at Xerox, we waxed lyrical about the vision of ‘the paperless office’ which Xerox was the first to prosthelytise back in the 80s. We also described to our clients how researchers at Xerox Parc were beavering away in the human factors lab to improve the human-machine interface and the usability of our office equipment. The goal was to improve our clients’ user experience and productivity, reduce administrative burden and improve the turnaround time and quality of the clients’ business documentation. Proof of Xerox Parc’ success in addressing the challenge of ‘usability’ has been in the legacy of WYSIWIG text editors, GUIs, WIMPs and many more along with the defection of some of those same researchers and developers from Parc to Apple. The rest is history.

The vision of a paperless NHS

It seems strange to me, therefore,  that so many years later – in the pursuit of the vision of ‘the paperless NHS’ described in NHS Personalised Health and Care 2020 Framework for Action  -that usability seems so overlooked as a means of accelerating uptake and adoption of the technology so heavily invested-in to deliver this vision.

Usability is key

The mismatch between the huge UK healthcare technology investments made in recent years versus its uptake and use has been highlighted in recent reports and initiatives where ‘usability’ for clinicians and other healthcare professionals is described as key to the success of achieving the paperless vision:

  • The Wachter Review published this September 2016 concluded that clinical engagement and making it easier for healthcare professionals to engage with technology i.e. ‘usability’ are essential for the success of technology projects.
  • Nuffield Trust report ‘Delivering the benefits of Digital Health’ which on page 25 of the summary report specifically mentions voice-recognition and natural language processing as everyday technologies that will alleviate the burden of administration for healthcare professionals.
  • GP Forward View Chapter 4: Practice infrastructure. ’…We will develop the primary care estate and invest in better technology…’ highlights the need for investment in technology to deliver improved patient outcomes, flexibility for new models of care and efficiency gains much sought after in the GP world.
  • NHS England Clinical Software Usability Study (cSUS)


Speech recognition as a key enabler

Short of Vulcan mind-meld, the next frontier in human-machine interface – speech-recognition – is already here. It is a powerful, proven and mature technology for use within healthcare. Speech-recognition integrated into an existing EHR and other digital clinical documentation applications has been proven many times over to improve the usability and work experience for clinicians and to accelerate the return on those significant digital investments.

Is it time to think of speech-recognition technology in relation to the usability of clinical documentation solutions – not a niche or ‘nice to have’ – but as a key enabler. It should be one of an armory of solutions designed specifically to improve usability of healthcare technology freeing up clinicians to do what they do best and to follow their vocation – to put patients first and at the center of care.

Enable clinicians to spend more time with patients. Find out how to allow your teams to update electronic patient records, easy and fast!

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About Sarah Fisher

Sarah Fisher is regional marketing manager at Nuance healthcare division covering UK, Ireland and APAC. Sarah has 25 years in marketing and sales at companies including Xerox, Siemens and Cisco. A spell at Novartis leading a team to deliver ‘more-than-medicines’ solutions in UK healthcare combined her degree and a first job in Pharmacology research with a passion for the potential of healthcare IT to overcome the many challenges faced by all healthcare systems. In her spare time Sarah leaps fences and tackles tricky trails pursuing her hobbies of horse trials and mountain biking.