Subject access requests (SARs) and other requests for information such as medical reports for insurers are "a huge nuisance, tedious and time consuming," according to Dr Daniel Kerley of Thorndike Medical Centre in Kent, which looks after some 13,000 patients. Dr Kerley looked for a digital solution to minimise the impact of data requests and worked with iDocs Solutions to implement a hardware and software solution that streamlines the fulfilment process across data capture, processing and compliant delivery.

THE BURDEN OF DATA REQUESTS
Producing the information required by a data request involves significant work for practices because each record requires checking to ensure it does not contain details about third parties.

Respondents to a survey conducted by GPonline/Medeconomics said that their practices received, on average, seven SARs a week - although some received many more. The majority (62%) said it took them longer than 30 minutes to process a single subject access request, and 18% said it took longer than an hour. Practice staff members are therefore spending significant time processing SARs - for which practices receive no funding. Practices also incur the costs of photocopying, printing and postage.

The British Medical Association estimated that in 2019 GPs received 1.25 million SARs. In addition, hospitals receive 500,000 SARs a year. The number of SARs in both instances has risen significantly during the 2020-21 pandemic, frequently instigated by lawyers seeking compensation for their clients.

The Chair of the BMA General Practitioners Council, Dr Richard Vautrey, said: 'We know from our members that they are concerned about the increase in SARs since GDPR legislation came in, and the knock-on effect on both workload and practice finances."

Dr Kerley is committed to improving the patient pathway and takes a keen interest in technology that improves healthcare systems. Primary care, he explained, remains heavily paper based. In order to fulfil requests for patient records the practice historically had to print, photocopy (twice in fact!) and manually redact content in records page by page. The records of patients with lengthy medical histories could extend to hundreds of pages, so the effort involved to produce compliant copies was significant.

The practice's secretarial team was responsible for the redaction process, which would have to be signed-off by a doctor once completed. Dr Kerley observed that the SARs production and approval process is a poor fit with general practice work. Requests await fulfilment until staff can find time to begin processing them, then doctors have to give up time that they could otherwise spend on patient care in order to read and approve documents prior to release.

In his efforts to reduce the burden of data requests, Dr Kerley looked for a solution to capture and redact data, and to generate digital records that could be easily and securely transmitted electronically. He also highlighted another system imperative heightened by the introduction of GDPR: "Security and compliance are important to the practice as we don't want Thorndike to become another test case for data breaches, which can result in stiff penalties and reputational damage."

STREAMLINED DIGITAL SARS FULFILMENT
Thorndike Medical Centre implemented iDocs Bindr digital redaction solution integrated with Fujitsu scanners. The iDocs software identifies content by user-selected keywords in scanned paper documents and digital documents and permanently redacts potentially regulation-breaching data.

The new system overcomes issues such as incomplete data masking associated with manual redaction and also the problem of operator fatigue that naturally occurs with repetitive mundane tasks. SARs fulfilment costs have been reduced significantly in terms of staff time, photocopying/print costs, and postage.

The iDocs redaction solution gives the practice confidence that it can fulfil data requests efficiently and more comprehensively than when it was using daisy-chained manual processes. A significant benefit is that complete digital records can now be emailed to the requestor securely, saving postage costs as well as being convenient for the patient.

POSITIVE USER FEEDBACK
It often takes time to embed operational changes, especially when they involve new technology, which can trouble operators until the technology becomes familiar. However, Thorndike reports that software installation, hardware implementation and training went smoothly and system users have no negative feedback. Dr Kerley says, "staff feel trained and confident." The introduction of Fujitsu scanners has proven to be popular and the fi-7300NX, in particular, is described by the Centre as "a good piece of kit that is easy to use."

The fi-7300NX scanner (see http://emea.fujitsu.com/scanners) is a fully networkable image scanner that supports web systems and connects directly to client systems. Users can initiate scanning from the scanner's touch screen or from applications on smart devices. The fi-7300NX scans 60 pages a minute and loads up to 80 sheets at a time. The capability to scan batches of paper documents makes data capture far more efficient and the practice has since invested in another fi-7300NX for its vaccination centre.

Thorndike can also extract documents from patient management systems, which are held in multiple formats, and convert them to PDF using iDocs PDF converter in order to redact them in iDocsBindr.

POTENTIAL FOR FURTHER ENHANCEMENTS
iDocs Bindr - which has won multiple DM Awards in recent years - has established roots in the legal sector, where leading law firms use the system to collate and transmit sensitive case documents securely. Digital redaction is relatively new in the medical sector and both iDocs and Thorndike Partnership are interested to explore ways to extract even more value from digital document processing.

The practice views the iDocs implementation as a gateway system that has the potential for future enhancements, such as the attachment of DWP forms and summaries. Once the pandemic eases, the practice and iDocs are also interested in conducting research to learn if requestors, especially patients, appreciate the new data processing and delivery methods.

A POSITIVE DIFFERENCE
Dr Kerley reports that, since the introduction of iDocs Bindr, Thorndike Partnership has been able to catch up on its post-Covid backlog of data requests relatively speedily, and "free of pain" in comparison with the tedium of manual processes. He also noted that the practice has not replaced a secretarial position after that staff member left, which indicates the contribution of iDocs Bindr to improved levels of efficiency in aspects of the practice's administration.

In conclusion, Dr Kerley stated that GP practices have generally been a long way ahead in implementing digital solutions compared with most other medical institutions. Practices function as small businesses so it is worth medical professionals investing time to explore iDocs digitisation for its cost savings, compliance confidence and improved service.

More info: www.idocssolutions.com