Headlines: November 21st, 2014

Mark Winstone discusses how technology is dealing with a growing problem in the NHS: photography management.

Hospitals often need to take photographs of patients to record injuries or the progress of specific conditions, e.g. of injuries, severe rashes, a nasty bed sore and so on. Historically these images were taken and maintained by in-house photography teams with their own-on-site darkroom, but in the age of the digital camera such facilities are being wound down.

The problem that we have inadvertently created is growing chaos when it comes to the proper management and support of all that imagery. The nurses now tasked with taking these pictures with the digital cameras that are now so common instead of the old wet-film, structured approach are too busy to adequately log and label these images. Typically, they are not being routed to the hospital’s main PAS (patient administration system) or other databases: in most cases, they are going on the nearest memory stick or CD or laptop or desktop – or who knows where!

This is a real problem, as if any legal action arises once the patient is discharged, the Trust needs the photography in order to evidence its side of the story. And clearly, if you can’t find the photography of the rash as it was presented on the first day in hospital five days later, lack of easy image access will also detract from the delivery of the highest-quality patient care.

Storing images securely

What’s required to address this digital camera chaos? An extension can be easily slotted into the back of all those digital cameras that intelligently routes the images to a safe place, i.e. not any kind of a thumb or shared drive but to a central repository the Vendor Neutral Archive.

The system then prompts the clinician to enter the NHS ID number of the patient, thus linking the image into the main hospital database where the patient’s case notes should be residing. We have built such a system for a major London Trust recently, and it’s a system that offers a fully backed up, accessible and searchable, secure and properly indexed solution.

Note that not only have we addressed the image issue, but we have started to build the connected, holistic electronic patient record we are seeking in the NHS.

It should also be noted that the argument here about digital image capture and management is starting to be applicable to video, e.g. of endoscopies, which is almost as big an issue for the NHS as still photography.

Benefits from photographic management

To sum up: there are four big winners from such photographic management tech:

• the nursing staff – who can get this small but important job done much more efficiently

• the Chief Clinical Information Officer (the IT leader in hospitals who looks after the health-IT interface) who gets compliance and a proper way to manage clinical information out of the solution

• the CIO or IT Director of a Trust – who will be able to see that a currently chaotic process, leading to proliferation of files on all sorts of media, is going to be carried out in a controlled and validated way

• last but not least – the patient, who will see more efficient wards with clinicians able to spend more time on care while storing away information that will be highly useful to refer to in an accurate, dated and detailed way.

This issue has largely slipped under the radar of the champions of change in the NHS. But is without question one that could seriously hamper the vision of a paperless, connected NHS if not addressed now.

Finally, whatever photographic solution you elect, make sure that it’s part of an expanding Vendor Neutral Archive solution set for NHS users; namely a system, which by definition is a system that can capture and help manage any sort of digital information, without the need for investment in special viewers and such like.

VNAs make digital information available therefore to everyone, anywhere – which mean that, once again, you have the connected, holistic electronic patient record we have been waiting for.

It’s the way all patient information systems really need to go – and better patient photography could be a great way to start your hospital’s journey to it.

The author is Sales & Marketing Director at SynApps Solutions: his firm has developed a special new system called ConXPhoto to help NHS Trusts, such as Kingston Hospital NHS Foundation Trust, get to grips with photography management issues.