Comment / How can digital support the productivity challenge?

NHS England’s transformation directorate’s digital productivity programme is using evidence-based research to identify the most impactful, benefit-realising digital technologies that improve productivity and efficiency to free up capacity and release time to care. We have prioritised three technologies that can realise significant results.

The first is automation, specifically robotic process automation (RPA) as a transformation enabler, which can accelerate the adoption of other digital technologies within health and care. In addition, this technology in its own right continues to play a key role in elective recovery by supporting and enabling staff to digitise and/or enhance clinical and business processes across all levels of the organisation.

The second area is automated identification and data capture (AIDC) systems such as radio frequency identification (RFID) and real time location systems (RTLS). AIDC refers to any technology that collects information from objects, sounds or images without a person needing to manually enter the data.

RFID and RTLS use tags attached to objects to track them without the need for the physical process of scanning, and they are already widely used in distribution, logistics, aviation, retail and banking. In healthcare, the current main uses of RFID and RTLS are for asset management and tracking. Organisations with this capability are seeing significant reductions in asset loss, maintenance and repair and vastly improved inventory error rates and stock control accuracy.

The third technology involves extended realities (XR), which refer to all combined real and virtual environments and man-machine interactions, generated by computer technology and wearables. Covid-19 has fuelled providers to accelerate their digital transformation journeys and adopt novel and innovative solutions to navigate the impact of the pandemic. This has presented a rise in extended reality technologies across pockets of the UK including virtual reality (VR), augmented reality (AR) and mixed reality (MR).

Benefits and outcomes

All three technologies are having beneficial impacts. And, ensuring our work is underpinned by evidence, the benefits are measurable and return on investments are calculable. The successful introduction of these technologies would enable organisations to achieve key outcomes – from increased staff productivity and satisfaction by reducing administrative burden; to improved safety and reduced error by monitoring patients, equipment and medicine.

The transformation directorate has just published the first ever national guidance for RPA in the form of a ‘how to’ guide for designing, delivering and sustaining RPA within the NHS. The primary benefits of RPA are operational efficiencies, which help drive better quality of care with faster turnaround times and reduced cost. Looking at speed, RPA undertakes tasks four to 10 times faster than a person, freeing up staff time to focus on patient care.

From a cost reduction and return-on-investment perspective, robots are cheaper, faster, available 24/7 and can improve productivity and data quality, resulting in lower operational costs and hence better value for communities. Most organisations report 20% to 30% cost reduction and 30% to 50% return on investment on RPA projects.

And from an auditability perspective, robots collect information on everything they do, allowing for full, retroactive inspection on every transaction undertaken.

Moving on to RFID and RTLS, many NHS organisations are already using this technology to locate needed medical equipment, which reduces the time to find a tagged asset to less than 25 seconds and could release over 140,000 hours of clinical time back to patient care.

During the pandemic this technology was widely used to track and monitor the availability and whereabouts of beds and vital medical devices, such as ventilators. The top three application areas for use are: medical device asset management; patient pathway management across emergency and surgery departments; and medicine inventory management.

Every NHS trust could potentially save up to an estimated £5m if RFID and RTLS systems were implemented across all three applications in hospital emergency and surgical departments.

Extended realities usage across the world is already seeing benefits in the delivery of services, education and training. XR enables remote delivery of care at home and can improve the experience in clinics, providing more regular and reliable access to experience and therapies, freeing up ageing estate and unlocking novel ways of delivering services sustainably.

Clinicians can use XR to engage patients better and free up time by automating certain elements of the therapeutic process. VR can also be used for vital surgical and medical training. This could have significant benefits given the cost of avoidable errors within the NHS has been estimated at up to £2.5bn.

To help NHS and social care organisations take the next steps in using productivity improving technologies, a benefits framework and evaluation structure has been created for automation and RFID and RTLS systems. This should help organisations to capture, benchmark, measure and monetise any benefits. Organisations can also access extensive case study libraries, resources, tools, ROI calculators, pre-populated business case sections and much more in our RPA, RTLS/RFID and XR communities of practice.

As part of our work to develop a repository of innovative best-practice case studies we would love to hear from you. If you have any suggestions or stories to share then please get in touch at [email protected]

The HFMA, supported by Health Education England, is delivering a programme of work to increase awareness among NHS finance staff of digital healthcare technologies. More details here.