Highland Marketing tech and security predictions, 2019

What will be the key health tech and security trends affecting the NHS in the coming year and beyond? Highland Marketing asked members of its advisory group for their predictions.

James Norman, healthcare CIO – EMEA at DellEMC

I think there are going to be a few key initiatives that will continue through 2019 and some innovations that take off in a niche way. The key initiatives are interoperability platforms and data analytics, by which I mean machine learning, deep learning and, to a lesser extent, AI. What the papers call the “rise of the bots”.

Interoperability platforms will be built through a combination of cloud and hybrid on-premise environments. There is a push from the centre to use public cloud, but a large percentage of the applications in use in the NHS will not run in a cloud environment; whilst long term storage ofdata in the cloud can be prohibitively expensive, because of the cost of retrieving it when needed.

Nevertheless, people are starting to accept that cloud is going to be part of the story; and some of the big providers have just made it easier to move data to and from their clouds: Microsoft Azure and AWS have announced systems that will make it easier to consume cloud services.

This should enable people to take advantage of the flexibility of cloud, while maintaining the security that comes with managing patient data on premises, and the cost benefits of archiving data on disk or tape.

At the same time, people are starting to understand that different cloud environments are good for different things; and in 2019 I think we will start to see the spread of what we call multi-cloud, with people managing data between different providers.

The exciting part of all this is that once you have built your interoperability platform, or your collaboration and research platform, you can start using the data differently. Until relatively recently, people either had to build their own analytics platforms or, if they wanted to go down the AI route, they had to work with companies like Google DeepMind or IBM Watson.

Now, there are new entrants writing applications for healthcare that organisations can plug and play; and we are starting to see trusts adopting them for simple things, like audit, readmission planning or drug dose checking, because they save time and improve efficiency.

Around the world, we are also seeing pockets of interest in using machine learning to identify disease and treatment trends, to risk stratify populations, change clinical decisions in real time, or even tell patients that they might be better going to a GP practice with open appointments than staying in A&E.

We will see a slow rise of this in the NHS in 2019; and it is the direction of travel for the LHCREs, especially now the research agenda is being brought in. My niche innovations, finally, are augmented and virtual reality. There is a lot of investment going into this area; and they’re definitely going to be featuring in future predictions with pockets of clinicians trying them out in 2019

Dr Saif Abed, founding partner and director of cybersecurity at AbedGraham

When it comes to making predictions, there’s the risk of making outlandish or wildly ambitious claims about what the future could look like. The technology sector is particularly guilty of this; there will undoubtedly be claims the 2019 will be the year of technology x, y or z or, even more cliché, the year of disruption.

The world of cybersecurity is no stranger to this. However, there are some inescapable facts that – as much as being predictions – are warnings to heed.

  1. The cyberattacks won’t stop
    In fact, the volume of attacks targeting the NHS will go up. It’s simple maths. We continue to digitise NHS organisations with more applications and devices that are network connections; so there are more things to try and break or take control of.
  2. The cloud brings new risks
    Transitioning to more cloud-hosted services in 2019 is going to yield productivity, workflow and security benefits for the average trust. That doesn’t mean it’s risk free. It simply means there will be new types of vulnerabilities that we have to be aware of and contending with. Attackers will be keeping a keen eye on this.
  3. Interoperability and contagion
    Interoperability is the name of the game for 2019. We need major healthcare IT suppliers to work together to support regional workflows. However, if insecure networks and systems are connecting with each other then they introduce risks to one another that mean a single attack could compromise an entire region.
  4. The Internet of Insecure Things
    IoT devices are now everywhere. That includes medical devices and more of them is going to be another upward trend. Unfortunately, many of these devices are woefully insecure. We will see more IoT attacks hitting the headlines in 2019 that will hamper everything from hospital facilities to patients’ medical devices.
  5. Insecure start-ups
    My final prediction is the only one I think isn’t guaranteed for the coming year, although I do think that it is ultimately inevitable. In 2019, a major digital health start-up in the UK will suffer a major cybersecurity event that either takes down its services or leads to a patient data breach. Start-ups are notorious for paying little attention to security and regulatory standards and that’s no different in healthcare.

So those are my predictions for 2019. They might sound like doom and gloom; but in reality most of these are perfectly manageable if we work together to tackle them head on.

Andy Kinnear, director of digital transformation, NHS South, Central and West Clinical Commissioning Group, chair, health and care executive, BCS, The Chartered Institute for IT

I think 2019 will be remembered for three things. The first is the start of real consumerisation in the health and care space. We are going to see the launch of the NHS App, a big expansion of the NHS Apps Library, and an explosion of personal health record platforms of one form or another. This agenda has been bubbling under for a while, but this year I think that it will surface and be really exciting.

The second thing is a huge change in digital leadership. I think we will see boards start to take their responsibilities seriously and give a lot more time to the digital agenda. That’s because [health and social care secretary] Matt Hancock has signalled that we need the system to engage, but also because we are seeing a lot more interest in putting digital into the NHS operational model than we have done in the past.

Again, it is something we have been talking about for a while: but I think we will go from rhetoric to action this year. The other side of that is that we will continue to see investment in the calibre of digital leaders in the system. With the growth of FEDIP [The Federation for Informatics Professionals, part of the BCS], the success of the Faculty of Clinical Informatics, and the first cohort coming out of the NHS Digital Academy, there are influencers ready to change things.

It we want to increase professionalism in the IT space, I think we need to target leaders, because they bring their teams with them. I think we will see that in 2019. I think we are on the road to professional accreditation and that’s a good thing. I often say I want the people who do my job to be properly trained and accredited, instead of falling into it by chance.

The third thing is interoperability. It feels like 2018 was foundational, with the consolidation of the Professional Record Standards Body and INTEROPen, and the establishment of the local health and care record exemplar programme. So, I think that in 2019 we will see active spending on building interoperable health and care and the creation of regional platforms to support data flows. If that happens, and the NHS sorts out its regional and transformation structures, I think we will be in for a bright future.

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