Posted by: ayrshirehealth | June 29, 2012

eHealth success: Revolution or Evolution? By @markfleming1

EHealth: Revolution or Evolution?

Today eHealth is seen by governments and healthcare professionals as the cornerstone of modern healthcare systems. The Scottish eHealth Strategy and the Healthcare Quality Strategy explain how eHealth can support improvements in our patients’ experience, something I have seen firsthand in NHS Ayrshire & Arran’s Mental Health Services.

Large revolutionary projects across the world stall in delivering eHealth benefits, as they frequently fail to fully engage with key stakeholders. Scotland’s approach, using a technical, financial and supportive change framework, provides great opportunities to locally tailor these developments. Using this approach we, technically and clinically, have the structure to engage with the right people and provide opportunities to develop more focused person centred care.

The European Health Telematics Association in 2009 described a change model which effectively describes our eHealth journey within Mental Health Services in Ayrshire.


Our discovery, of the potential of eHealth, emerged around 2001 and stemmed from our vision to improve patient experience and provide safer clinical practice. As a community nurse working out of hours I often made decisions on care without access to health records. Patients had to retell their story and looking back I can see this how impacted on safety and diminished our ability to deliver person centred care.

With government funding, as a small group of stakeholders (including patients and carers) we explored how eHealth could improve the patient and carer experience. The plan was to have a networked ‘care records’ system that allowed important clinical information to always be available at the point of need.


Our stakeholders had an important and seemingly revolutionary vision – however we had to gain acceptance across a complex organisation.

Healthcare is about people and if our eHealth Programme was to make a major contribution to this then we felt it had to be more people orientated.

Leadership/change management was identified as a key success factor which led to the joint funding of my unique post between the Mental Health Services and eHealth Directorate.


Our eHealth system deployment  journey has taken over 10 years and continues to evolve to meet the almost daily  challenges which come from both a care and government strategic perspective, our core vision, of patient safety and improved person centred care, remains.


New technologies like tablet PCs and PC pens take the eHealth system to our patients and help them contribute more fully to their assessment and treatment programmes.

We still have challenges with some clinicians fully accepting the eHealth benefits, but we are confident evolution will resolve this over time.


Successful deployment in my view is all about having a clear vision, stakeholder engagement, strong leadership/change management and a lot of hard work. All of which I feel have been the critical success factors of our work in Ayrshire.

Our next challenge is to better use the clinical information from systems to improve care and I feel we are starting to change that culture within our clinical services.


To me we have experienced an eHealth Evolution across Ayrshire as we have worked together from within to achieve our success. I hope that our teams’ work to date has left an eHealth legacy on which our future services can build upon.

References used in this Blog

European Health Telematics Association (2009), The 3 ages of EHealth – A Briefing Paper

@markfleming1 is the Programme Manager for eHealth and Mental Health Services in NHS Ayrshire and Arran. He works closely with clinical staff on Integrated Care Pathway developments and their application within an eHealth framework.

Comment from Anne Cooper who is the National Clinical Lead for Nursing at the English Department of Health Informatics Directorate:

‘I enjoyed reading Mark’s blog and hearing the journey they have taken in Ayrshire and Arran.  I too believe that we face an evolution for e-Health; my reason is that this isn’t a journey with a fixed destination, as the pace of change in technology means that new opportunities will emerge all the time.  That means that we will continually have to adapt and change.  When you have this happening leadership becomes even more critical.  Leaders need to be able to take stock and change direction on some occasions and on others hold firm to a promise or commitment.  I think the availability of technology in health means that we all have to ‘up our game’ and be prepared for the changes that are needed to be modern practitioners, whatever field of practice we work in.’

Next weeks blog is from @mz_kimb who is a recently qualified mental health nurse:



  1. evolution in technology, therefore ehealth, is perpetual, which will always facilitate change and development. Well done, enjoyed the read

    • thanks for your comments Elaine. its has been a fascinating journey full of experiences, happy to share our knowledge with colleagues still to move in this direction

  2. mmmm.. i might take you up on the offer at a later date?

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s


%d bloggers like this: