This week we spoke with Paul Targett, Managing Director, RIVIAM Digital Care, and asked Paul a few questions.
Can you tell me about RIVIAM?
We first won a contract with an innovative GP Federation, BEMS+,in Bath. This was 5 years ago. They wanted to set up a weekend working service for GPs and paramedics and so, over a 6 months period, we created RIVIAM as a platform which would receive referrals and then enable them to be digitally allocated to the clinicians working over the weekend. We built a mobile application for the GPs and paramedics to be able to access information about their patients in the community. Discharges were sent digitally straight to the GP system. RIVIAM today is still built on the same encryption model that we originally used.
Today we help adult and child community health and care services, including mental health services, to improve the way that they deliver care. We are doing this by concentrating on the ‘front door’; the way they receive referrals and triage them efficiently, and the way that communication feeds back to patients and referrers.
We are focused on offering tools and services to accomplish better collaboration and care co-ordination. We do this by providing a Trust with a really good content website and secure portal for a clinician to make a digital referral. We help a Trust review the internal processes of their service centres and implement a transformation by receiving referrals directly to our workflow system. Our Email Processing service also automates monitoring, receiving and allocating email referrals to the right queue on workflow, saving thousands of hours of clinical and administrative time.
We’re about making providers efficient; our technology makes a patient’s pathway really clear – who’s on it, what stage they are in and what needs to happen for them. Operationally it’s brilliant; everyone with the right access can see one view of the patient and the process flows related to the patient’s care. In this way we enable a Trust to provide a great referrer and patient experience, achieve operational performance efficiencies and improve the way the service or services deliver care.
What are some of the recent developments in the market?
Financial pressures on Trusts now mean there’s a push to do more things with digital technology. Over the last 6 years, there has been a bit of slack for some in not having digital systems; it hasn’t significantly mattered. Now, people cannot wait for stuff to happen or tolerate a promise of future delivery. There has been a big change in the appetite to deliver, and an appetite for risk.
We work with primary care and there is a lot of pressure to deliver new models of care. In the past, there was only talk about different models of care, now there is a renewed impetus to deliver it.
It’s still really hard to have 3 or so organisations involved trying to deliver one care service with different clinical systems. This is a driver for us – to create interoperability across systems.
Third sector involvement is an area of real innovation. We understand the community health and care model well and are working with a couple of our customers to understand what we can do to involve third sector providers in delivering new models of care. We are devising ways of being able to share information securely across organisations. For example, with Age UK, we can solve how one of their workers can see the holistic view of what care is being provided to a person when they are visiting them at home. The systems that dominate the third sector are generally software packages such as Microsoft Access with additional features. As a sector, there is so little money for digital organisations to invest in the development of more advanced platforms. So, we are trying to enable effective communication between the community and the third sector to improve patient’s lives.
The NHS app is a recent and useful development, particularly with the announcement of the new login toolkit. It means we can use it to develop new services, and we can combine this work with our interface with TPP’s SystmOne™. RIVIAM can read and update a TPP SystmOne™ patient record in real-time, book and retrieve appointments as well provide access to other reference information. We can now read and write coded clinical data directly into TPP SystmOne™. These capabilities have taken us 5 years of going through a very slow process with NHS Digital. We are also an EMIS Web Approved Partner. The NHS app has the opportunity to disrupt the way clinical services are delivered because it frees up patient information from just being owned by a single GP practice.
What is your biggest achievement over the past 12 months?
Our platform is used by child and adolescent mental health services some of which are 100% reliant on using our platform to deliver their service. That means that now, if a schoolteacher or a social worker raises an issue or referral through one of our portals, within seconds of them pressing that submit button we’ve reviewed it.So, I’m proud that we’ve helped thousands of children receive care more quickly through shortening the time for that first engagement.
Also, we have an eConsent solution for immunisations which works with clinical systems. We believe we are the largest provider of digital immunisations services in the South of England.
In Bath and North East Somerset and Wiltshire, they upload the outcomes of the child vaccination clinics to RIVIAM which then only takes us 10 seconds to update TPP SystmOne™ – this saves a huge amount of time so that resources can be deployed elsewhere. The RIVIAM mobile app for immunisations will be launched in the next month and this will mean school nurses have an onsite digital record.
We’ve recently made a move into providing video consultation technology and we are now working with a few innovative customers including a GP federation to roll this out for virtual GP services and virtual multi-disciplinary meetings.
What is your advice for other digital innovators?
Avoid becoming a pilot because the NHS is full of dead pilots. The hardest thing starting out in this space is finding something that is really usable and has a level of traction and sustainability to move beyond initial funding. We’ve never received any funding for RIVIAM; everything we’ve done has been to deliver against operational needs. Your focus should be all about providing benefits every single day.
You have to realise that the NHS isn’t just one customer; it has multiple entities and each one has different motivations and drivers. It’s important to understand this and navigate the market.
What advice would you give yourself four years ago?
Firstly, the recognition that it takes many years to get a proposition off the ground to the point where it gets going. How do you coach for that?
Secondly, you can’t do consulting and product delivery at the same time. For many years we continued to help customers to deliver services whilst trying to do product delivery ourselves. It was only when we stopped consulting and focused solely on the product side that we actually began to see some real changes.
What does the future hold?
I have a lot of optimism at the moment. There’s so much pressure on the health and care system that it needs to change to survive. We solve a really important challenge: how to enable providers, GPs, referrers and others in the third sector to work better together to deliver new, efficient ways of delivering the best care.
I am now seeing customers who need to change and want to change; they cannot carry on the same way they have been working in the past. It’s a good time to be in the innovation space, and there is a much more mature set of people in the NHS now who can make more complex, commercial and balanced decisions. We will continue to provide the most cost-effective solution as we can.
– For more information or to speak with Paul, please email Paul@riviam.com –
