In the first of a two part series we asked the HTN audience via LinkedIn for their views on the main challenges in healthcare technology and we asked if there is progress to be made, what could be done to address these challenges?
Following a post on LinkedIn on Saturday, 10th August we received a fantastic response in just a few hours, with some very insightful and interesting perspectives from across health and care.
In this article we share some of the comments, and also invite you to contribute to the ongoing discussion. You can contribute to the LinkedIn discussion thread here or you can email your views to press@thehtn.co.uk before 20th August, when part two of the series will be published.
Comments included:
Umesh Prabhu, Medical Director of NHS for more than 15 years (Bury NHS Trust 1998-2003 and Wigan ( 2010 -2017)
Important challenge is Culture, 2 Increasing demand, 3 shortage of workforce, 4 Working in silos, 5 fear of blame bullying and litigation complaints, 6 Too many regulation and bureacracy, 7 Poor teamwork, 8 Poor digitalisation. Mosty Poor leadership and management Culture.
David Waller, Director, Keldale Business Services
We can’t / won’t apply health economics to our health IT. We don’t understand its comparative value against alternative investments so we don’t pick the right things in the first place, implement them with the necessary sense of urgency or manage them in service to get the most out of them. What can we do? CXOs can talk seriously about strategy and benefits at the start. And spend some time talking to someone who can explain what a ‘benefit’ actually is.
Graham Evans, Chief Digital Officer / Chief Information and Technology Officer, North Tees and Hartlepool NHS Foundation Trust
Key challenges include; (a) getting the basics right, i.e. essential infrastructure, security by design etc. (b) Leadership, technology not seen as a cost, but a strategic investment, a difficult argument when funding is stretched. (c) technology on its own will not enable and deliver the healthcare transformation we need, people and process (including cultural aspects) to be an integral part of the implementation methodology. (d) we need to stop reinventing the wheel, share and learn from others to speed up delivery. Other than that, not much to do really!
Vicki Cooper, Head of Digital Transformation, Walsall Healthcare NHS Trust
Apologies if this sounds a bit of a rant, it’s really not… Main challenges I’ve observed is legacy infrastructure which is painfully slow making the use of paper easier, so it’s difficult to digitise without significant investment, Finance Depts not supporting the move to a revenue model for IT, still holding onto capital, but then cut it via CIP. Behaviours such us lack of forward thinking senior IT leads, or IT decision makers in positions of power and clout, who are risk averse (not all of-course).
Many of our clinicians know what they want and what they feel restricted by not being involved in designing the IT they need, so ensuring IT is clinically led, IT could listen and partner with their customer clinicians more, spend a day in the life to understand their struggles, then support through their contacts to research the market and find the best solution, affordable for the tax payer.
So to address the challenge, move to revenue based funding, weed out the risk averse managers, and replace with proven strategic leaders, co design IT with clinicians, and give concepts and innovations a go. Be creative
Tom Micklewright, Medical Officer, Push Doctor
Fragmentation and Silo-working. It echoes much of what’s been said, but across the NHS, there already exists a wealth of technologies, experience and valuable health data which is already being under-utilised because we are unable to operate at scale and share information.
Whilst not wanting to hamper innovation, its crucial that funding doesn’t just go towards those at the leading edge of innovation, those which grab the political headlines, but also goes into developing an infrastructure that enables inter-operability, electronic networking and shared learning.
Even networking GP electronic health records across a federation or PCN is exceedingly difficult and gaining access to current digital systems, like the Electronic Prescription Service, is challenging. NHS Digital needs added resource so that they can build this infrastructure, share learning and take a more leading role in supporting CCGs, Trusts and GP Practices to embrace new technologies.
Sam Shah, Director of Digital Development at NHS X
A major challenge is to start focussing on the intended outcome, benefit and value, followed by trying to avoid micro prescribing the technology solution. Need to take time to understand the users and their requirements as part of any design process. That means consulting with the stakeholders of the right type. Senior policy makers are not necessarily going to be the right stakeholders to offer optimal service design or deep technology solutions.
Another challenge is to develop sustainable mechanisms of funding and reimbursement that both support technology but more importantly deliver the outcome.
We also need to overhaul the perception of innovation. I hear it mentioned a lot but far too often things cited as innovations are no more than digital versions of analogue processes. For example people that download an app aren’t necessarily innovators because they download an app, and downloading an app doesn’t mean it’ll be used or will be useful.
Focus on user needs. Help address the cultural issues across the health system. Become more inclusive as a health system with a different leadership approach.
Crystal Dennis, Operational lead for Digital – Empowered self-care, Our Dorset Integrated Care System
Lots of very good points. Yes, culture needs to change, yes leadership needs to be strong, yes digital should include clinical leadership, yes we need to get the basics right, yes we also need to define digital transformation from innovation and yes the money needs to be fluid.
The biggest challenge to healthcare technology is that we need to define the problem clearly…clinical teams and transformation teams look at the requirements needed to solve the problem and the digital teams in partnership can help shape and guide this conversation. Once the problem is clearly defined to help build the sustainable business case for the DoF the digital teams need to look at its enterprise architecture to define if there is already something that can be utilised or layered up to fix the problem. Often we jump to solutions that may fragment the enterprise further or duplicate functionality.
When looking at person centred design there is often underlying digital user centred design infrastructure that is required to support across clinical networks and that needs to be uniformed.
Defining the culture and setting the plans for change are different to managing them and require different audiences.
Darren Mills, Populo Consulting Founder & Director
Challenges now, demand, capacity, money and workforce. The NHS being used as political football….. A question which may draw more focus. How will the NHS evolve over the next 10 years and how can we mitigate the same challenges. How will Healthcare change over the next 10 years?
Steven Haken, Odelle Technology
It fascinates me that Germany France and some of the Scandinavian countries have well established models for the introduction of healthcare technology and its evolution into clinical reimbursement and patient care pathway and we never seem to investigate it. We have placed several SME ICT Medtechs into Frances and Germanys portal successfully while all we encountered in the NHS was institutional apathy.
Neil Fogarty, Co-founder of the world’s first true AI Psychotherapist
As a company developing healthcare technology, there feels like a generally high opacity when it comes to finding the right people to engage with – it’s almost as if it’s a test of human endurance when it comes to communicating. After trying to speak with NHS Trusts in the UK, we have had Scandinavian hospitals proactively contact us and invite us in to talk about our Psychology AI. Why is that?
Farhan Amin, Founder, Concept Health Technologies
It would be helpful to bring to the table technology entrepreneurs and listen to the barriers they face. Both sides need to understand each other to move forward!
Here we have curated some of the comments from the discussion, to view the thread please click here.
We would love to hear your thoughts on this too, join the conversation here.