Over the past few weeks, I’ve had the misfortune to spend most days in a Portuguese hospital after a close relative fell ill.
This was my first experience of any healthcare system other than the NHS and being in the health IT industry, I couldn’t help notice that despite the care being of a good standard in many areas, there was a stark and obvious contrast compared to the experiences I have had in the UK – namely, the complete lack of technology used.
After calling 112 and reporting an emergency, the paramedics took more than thirty minutes to reach us. We immediately experienced the drawbacks we had never even considered of staying in a villa in a remote location. The ambulance couldn’t find us, the call centre did not have the capability to track our location and so, 35 minutes later after tirelessly running around the roads to find and direct the ambulance, it arrived to what had become an extremely critical situation.
After a few hours of my relative being observed and diagnostic tests being carried out, she was finally admitted to the clinical decision unit. Upon our return three hours later, she had disappeared. Trying to stay calm, we waited anxiously while one of the nurses flicked through page after page, folder after folder of notes and then rallied around the ward asking other doctors and nurses for the location of my relative.
I couldn’t help my frustration that they had no idea where my relative was and with the language barrier, it made second-guessing even more difficult. Even in that worried state, I was perplexed as to why they weren’t using a bed management system, not only to save my anguish but to save the 15 minutes of checking and interrupting other members of staff. Moreover, why weren’t other families more demanding that they needed to know where their loved one was at such an important time?
As days in intensive care went past, the reliance was on us, as a family, to bring in any notes around medical history as well as copies of x-rays and scans from previous visits to both public and private hospitals. Due to the condition being related to the brain, the doctors were concerned not to carry out any treatment without this information. So not to delay any treatment we hurried back to the villa to retrieve bags of notes, previous medication and images. We were fortunate enough to have kept these safe and to have the ability to travel back and forth to the hospital despite its 35 miles distance.
When trying to decipher the Portuguese drug charts two days later, I realised they did not know that my relative had been on statins, which apparently could not be used alongside the medication she was on! She stayed in intensive care for two further days in light of this.
Perhaps what worried me the most was despite my relative making some progress, she continued to be confused. On one visit, she was scribbling and writing all over a piece of paper, which turned out to be a detailed and closely monitored chart of her vital signs which were crucial to determining her progress and drug dosage. More frighteningly, my relative couldn’t walk, so one of the hospital staff must have given her these charts as paper to write on!
Even the simplest technology failed, the buzzer system didn’t work and at one point we contemplated getting my relative a whistle or one of the dog’s squeaky toys so she could get the attention of the nurses as she was severally dehydrated and needed water regularly.
As the saga continues, it has brought me back round to praising our NHS. No we don’t have a fully joined up electronic record system and yes, there has been a lot of money wasted on systems that don’t necessarily work but at least there is a demand for these systems and there is progress. At the very minimum most UK hospitals can tell you where a patient is, are able to retain and retrieve case notes, identify existing conditions from their records or diagnostic tests or at the very least make a call or email a patient’s GP to determine what drugs they are on. Many are in the process of implementing ePrescribing and at the very least have strict prescribing methods to ensure the avoidance of medications likely to have contraindications. Overall, many hospitals are going far beyond the call of duty to make technology work for healthcare professionals and their patients.
This experience has really highlighted that for the most part the NHS understands that technology is a help and not a hindrance, which for a start is a huge leap above the attitudes of so many other countries. So, on this particular occasion, it has driven home the progress the UK is actually making, despite the set backs of the National Programme for IT and that at least for now, I’d like to praise NHS IT!
