Interview Series: Anil Madhar and Mark Smith, Enovacom

In our latest interview we spoke with Anil Madhar and Mark Smith, from Enovacom, an Orange Business subsidiary that provides health and care organisations with interoperability tools that delivers the secure exchange of data between the health economy stakeholders promoting collaboration.

We asked Anil and Mark a few questions to explore some of the challenges of interoperability and to discuss some of their customer projects.

Could you take me through the Enovacom business and background?

Mark Said: Enovacom has nearly twenty year’s experience as a software editor, delivering best of breed interoperability and data security access management software to its 1,500+ healthcare client base across a whole health economy footprint. The success of the company was realised by The Orange Group who acquired the company in 2018.

The philosophy of the organisation is to look to solve problems in healthcare around interoperability, with such a wide coverage of customers, including acute, mental health, social care, private clinics, public and private laboratories, and all back office functions like HR, logistics and finance. The company is in tune with every aspect of integration and data security access requirements, which can be both varied and complex.

Our message to the market is simple, you can be independent because the software tools are designed to be easy to use, and we will only support you when you need it. Many organisations in the UK are looking out for somebody to help them develop their own in-house capability to deliver interoperability capability; this is one of the things that we have witnessed a growing demand for, especially where resources are limited with a high turnover of software developers. Only a basic level of IT skills is required to use our tools, you don’t need to be a software developer with advanced technical knowledge.

There is an extensive demand for interoperability in the UK. Our strength is being neutral in that we will collaborate with software editors, integrators, medical device manufacturers, and partners, empowering collaboration. We are very agile in being able to help organisations achieve their goals of sharing and exchanging of healthcare data.

What are the biggest challenges faced by organisations in terms of interoperability at the moment? 

Mark: The agenda of interoperability is huge as it covers the health and social care landscape, which is changing again. With new organisational structures and mergers and demergers where services are realigned, creates new demands of interoperability which haven’t existed previously. For instance the creation of Primary Care Networks with multiple team stakeholders across the health economy requires data sharing across that network that is centred around the patient need, this covers services in the community, hospital, mental health, and voluntary sector for instance meaning that it is essential that the data is available at the right time and place.

With the drive from NHS Digital of making it easier to connect up the system by using open health standards for data exchange , one of the other significant problems is that vendors that have provided software solutions to the NHS for a long time may not have these health standards in place and it is costly for them to make these changes. This is where our expertise as a middleware provider can help, as we can create the interfaces for them and transform the data into the required format to meet the demands of NHS Digital. As part of our company strategy we decided we would invest in the creation of any new standards working with NHS Digital, at whatever development stage they were at, to ensure we can offer the latest version. Some software vendors are reluctant to invest if the standard needs an extra tweek here and there before final sign off. For instance we are currently helping our Global Digital Exemplar (GDE) clients deliver the new health standard ITK V3 FHIR Transfer of Care E-Health Summaries.

It is encouraging to see that NHSX are looking at setting a minimum digital technology budget for each trust in the NHS, as one of the biggest problems in healthcare has been the short-term outlook regarding the budget.

What would you say is the biggest company success over the last 12 months?

Mark: The biggest success for us was the recognition by Oxford Health NHS Foundation Trust, a leading Global Digital Exemplar trust that we were a trusted and valued international partner that could guide them and support them in their ambition of delivering their own interoperability projects.

This recognition was received after the initial project delivered surpassed their expectation and as interoperability is such a strong strategic work stream at the trust, the NHS team soon realised the value we could bring to them.

Another big success was the opportunity to help the Wirral Teaching University Hospital NHS Foundation Trust, another GDE trust and one of the ‘most wired’ hospitals in the world, according to CHIME, with a specific problem they had regarding the connectivity of new ventilators in their ITU department. One of the key requirements of the project was to ensure the secure and accurate exchange of patient’s vital signs data from a variety of new ventilator devices and automatically place the data in the right place in their electronic patient record.

In terms of interoperability, do different countries face similar challenges?

Mark: Of course, interoperability is an international language and each country can learn from each other when looking to solve problems.

There is a huge transition of the health landscape all over the world, in France the similarities of the creation of larger entities like the current transformation in the NHS is a good example where new demands of interoperability are required. The STP / ICO footprint in the UK is similar in size to the GHT organisational structure in France where regions of the country are bringing individual organisations together and creating larger groups of stakeholders with new interoperability demands in volume and complexity.

An interesting emerging area of healthcare interoperability requirements in the UK, is in Life Sciences and Research industry. The organisations in this industry can benefit from the work already achieved in France where a joint venture between Enovacom and Rennes University Hospital Group has enabled access to research data being made more readily available in real-time and shared across the academic and research community and health professionals covering seven hospitals. This type of “Big Data” project requires very scalable and water tight security products all of which are relevant for the UK market.

The project in France is called eHops – a big data digital platform which centralises clinical research data and helps healthcare researchers by gaining access to it in real-time.

I recently attended your webinar about medical device integration, could you provide an overview of the session?

Anil: When I joined Enovacom and heard about Enovacom Patient Connect, I was excited as during my time working as a Business Analyst, I was always aware of the time spent transcribing medical device data onto paper and/or electronic systems. I was also aware of the challenges of device integration presents with the varying ages of devices/firmware and also the varying communication capabilities of medical devices.

In addition, I was unaware of the amount of data that exists within medical devices that are not used and I feel can provide some real clinical value.

My real passion with Enovacom Patient Connect is being able to help nursing staff/clinicians reduce the time spent transcribing by automating vital signs collection by connecting the device and integrating the data directly into the electronic system; you’ve also got more data for a clinician to make a decision about something proactively or through research, which might impact the changes they had originally planned for the patient.

We are a vendor neutral software solution organisation, you do not get into the realms of having propriety software concerns and being locked down by the supplier; that is a big thing for me, as actually we are providing a lot more flexibility to allow organisations to not just connect to one manufacturer, but many different manufacturers – so Enovacom Patient Connect is a strategic medical device interoperability for your whole organisation. We are adding more value for the clinician, making it much easier to connect to lots of different devices because all you would need to pay for is the driver as this is just a one-off licence. For instance, in one of our many projects with Enovacom Patient Connect we connected and integrated data from hospital gowns feeding directly into the electronic system, this was a very interesting IoMT project for us at the Vaudois University Hospital. We can also connect and integrate data from smart beds in Canada amongst the many devices we have in our constantly evolving medical device driver library.

If you would like to find out more about interoperability and Enovacom’s projects, please see their latest guides: “Beyond boundaries: the interoperability world tour” and “Energising mental health digital transformation through interoperability