This is why we must trust the NHS with our digital patient records.

The NHS has been subjected to a large scale cyber security attack which has caused havoc either directly impacting computer systems or causing health professionals to close systems to avoid malware infection. There is no indication that this attack will have exposed patient records but questions will be asked. How could this have happened? Why do we digitise our patient records in the first place?

What caused this cyber-security attack?

Ransomware is a type of malware that encrypts a user’s data, then demands payment in exchange for unlocking the data. This attack was caused by a bug called “WanaCrypt0r 2.0” or WannaCry, that exploits a vulnerability in Windows. It seems that this vulnerability is most prevalent within the Windows XP operating systems which amazingly is still being used by up to 90% of hospitals. In 2013, Health Secretary Jeremy Hunt pronounced that “the NHS cannot be the last man standing as the rest of the economy embraces the technology revolution… only with world class information systems will the NHS deliver world class care.” With that, he laid out his ambition for the NHS to be ‘paperless at the point of delivery’ by 2018 and so it seems incredulous that four years later we still have Windows XP so prevalent in our health service when Microsoft ended support for XP in 2014.

The Government has some really strong arguments for taking the NHS digital and has realised the enormity of such a challenge and revising their deadline to 2020. Ensuring the NHS is fit for purpose in the 21st century does mean that we will have to accept that our records will be digitised but the systems that maintain, access and store these records must be secure and robust enough for us to have confidence.

A spokesman for health information service NHS Digital said: 'Like all organisations the NHS is subject to malicious attacks on its systems and, like all organisations, these attempted attacks are rising. But we are taking action to ensure information is as safe as possible.' This really isn't going to be good enough the public will need more than this.

Why do we need a paperless NHS and is it going to be viable?

The Government has recognised the need to be paperless since the 1990 and they have four main objectives.

The first objective is to make the NHS more transparent and responsive to the needs of patients. Providing online access to patient records should make us feel part of our own care and encourage us to be more involved. Online services will save an enormous amount of time for both patients and doctors; enabling patients to update their own records, make their own appointments and access basic online advice. Our future engagement with the NHS will be a blend of physical and digital interaction reducing the impact on staff and increasing the availability of services. The future will see wearable technology also contributing to the management of health conditions adding valuable information to our medical records.

Secondly, digitisation will enable healthcare to be much more effective. Most people consider the NHS to be a single organisation but actually there are many separate agencies both private an public that contribute to our care. All of these agencies have separate systems and technology which are not generally good at communicating with each other and this means that valuable patient information is stored in departmental or organisational silos, which are difficult to access from the outside. Most records are paper-based, and paper records can only ever be in one place, so information sharing requires duplication, time-consuming transfers, or both. Paper documents are also easier to lose or misplace. Electronic patient records, accessible from anywhere in the organisation, will ensure that healthcare practitioners have the right information at the right time. Decision making will be improved, and with it, clinical outcomes.

The third objective is greater efficiency. With an ageing population the NHS faces constant drives for efficiency savings and productivity improvements. According to a recent review, up to 70% of a junior doctor’s time is taken up with paperwork and he some cases whole hospital wards have beds removed and filing cabinets installed. Electronic records will reduce that burden considerably, by making much easier to locate information, speeding up information transfer and eliminating duplication. Storage space will be reduced and internal and external mail costs will be greatly reduced.

The fourth and final objective is probably the most exciting. Locked away in all of those patient records is hugely valuable information which can when aggregated and analysed it will provide valuable information about probability and could in the future change how we manage individual care based on our characteristics. Digitising NHS data presents an unprecedented opportunity for big data analytics to identify the most effective use of resources and to improve the targeting of healthcare initiatives. We cannot let this cyber security breach reduce our confidence in digitising patient records because there is the potential for NHS data to become a rich resource for medical research, to the benefit of all.

The government need to work hard now to ensure they protect our confidentiality and maintain our trust in a truly digital NHS, this is the future of healthcare.

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