By Jane Dwelly, Director of Strategy, HIMSS UK
The potential of e-health to bring about total change to the way we plan and deliver health brings new demands for true interoperability, new leadership skills and a global search for solutions. The next 12 months will see significant innovation across health and care and with true benefits for patients.
The e-health lever for change
In April 2017 the NHS Five Year Forward View – a strategy to shape and ensure the future of the health service in England - reaches its halfway point. This roadmap identifies three gaps in England’s health system - health and wellbeing, care and quality and, funding and efficiency - and sets out to close them by redesigning the way services are planned, paid for and delivered.
It is in the care and quality gap that the potential of technology to improve care is explored with a sharp focus on using informatics to eradicate variation across the country. Measurement, comparison and analysis of collected data is the starting point for so much improvement and gives commissioners the information they need to write contracts that deliver high quality care for their patients.
Also in April, at the start of the new financial year, the NHS enters a two-year financial cycle for the first time, underpinned by a two-year tariff and two-year NHS Standard Contract. Expect to see the intelligent use of data to inform ‘frictionless’ commissioning decisions.
New demand for interoperability
Let’s talk about paper. The Five Year Forward View makes a commitment that, by 2020, there would be “fully interoperable electronic health records so that patient’s records are paperless”. This means: first moving from an analogue system to a digital one and then ensuring that the digital systems used by hospitals, local authorities or GPs are real-time and accessible across all platforms, systems and software applications. True interoperability happens when the information that has been exchanged can be helpfully used. To make this a reality, 73 Local Digital Roadmap areas across the country have completed a three step process and are now aligning their work with local Sustainability and Transformation Plans to support proper information sharing.
The system leadership is gripping the digital maturity agenda. Professor Keith McNeil as the NHS CCIO will lead the revamped Digital Delivery Board – guiding change across all government agencies to deliver the ambitions of the ‘Personalised Health and Care 2020’ framework.
All eyes will be on the twelve Global Digital Exemplar hospital sites, identified as an NHS care provider delivering exceptional care, efficiently, through the world-class use of digital technology and information flows.
Time to stop talking and make change happen
The Economist leader notes that 2016’s global events such as Brexit and the US election represented, on one level, a demand for change from citizens. The same demand can be felt in healthcare IT where people have explored the avenues that technology opens up – and now they want that change to happen. There is an impatient mood and a demand that cultural changes happen to let innovation solve existing problems in the NHS and make a true difference. This, and the system changes introduced by NHS England and NHS Digital, requires newly skilled leadership.
Putting the ‘I’ into job titles
In his review of digital in the NHS, Professor Robert Wachter noted that England does not have enough CCIOs or enough people who are confident to use informatics to make improvements. In response the NHS is setting up the first Digital Academy, an online curriculum where people from across health and care can learn about using informatics and work towards professional qualifications. Many other groups are putting the ‘I’ for information into job titles and with this comes a new focus on professionalisation and certification.
There is also an onus on boards, chief executives and finance directors to accept the healthcare IT challenge and recognise the power of e-health to transform the way they organise and run health services. There is a moral case too. Healthcare IT has the potential to make patient care safer, cheaper, time-efficient and more effective. If this can be done, then leaders need to ensure this happens as quickly as possible. Recruit the right people, train existing staff and skill up the entire workforce to work with digital tools to redesign patient care.
Remember why we are doing this
And let’s not ever forget patients – you and me, and our families and our loved ones. We know that digital has changed almost every area of our lives: apart from health. Banking, social life, dating, dieting, taxes, travel, shopping, payslips, and pensions: all exist in the digital space and people deal with these interactions every day with confidence and a successful outcome. And yet, it is still not possible to book all appointments online or easily access our own patient records. We can carry out internet searches of our symptoms - but it often takes a phone call to book a GP appointment to discuss them and, if referred, a paper letter in the post to instruct the patient how to make a hospital appointment. This must change. The opportunity is that we use digital to empower patients. We allow patients access to their data and we ask for their feedback on services and their decision making. In return, we make care safer, we reduce demand on services and, we free up time for the people who need it most.
A new global approach
Many commentators, including the Founder of the World Economic Forum Professor Klaus Schwab, say we are at the beginning of the fourth industrial revolution. This is where digital technology changes the way we live, work and relate to one another. Healthcare IT overlooks physical boundaries such as geography and language, and in that there is rich learning to be had. Expect to see more memorandums of understanding being signed between countries keen to improve their own healthcare IT with global learning and alliances.