In our latest interview we speak with Alan Lowe, CEO of Visionable, the specialist video collaboration provider.
Could you tell me a bit about Visionable?
I’m an NHS manager by background. I started my career in London, where I managed frontline services and worked in service improvement. I installed one of the first video conferencing systems in the NHS, because I could see the potential of technology to transform clinical care and make it more accessible and equitable for patients.
I co-founded Visionable in 2015 because I could see that potential was not being realised. Clinicians were being given the wrong tools. From the outset, Visionable’s aim was to deliver reliable, fit for purpose technology that doctors can use as a tool. Now, we have a unique collaboration platform that is specific to healthcare.
It’s not just one-to-one video calling or a service that is delivered over a third-party link. It enables multiple users to work from a device of their choice and to share screens, audio and video feeds. That might be anything from a real-time CT scan to a camera used to examine the body.
So, we do not say to doctors: ‘You must use this product in a certain way.’ Instead, we say: “We have a platform that adapts to the way you need to work”. At the moment, because of the coronavirus crisis, and the need to move routine outpatient activity and primary care online, we are seeing a lot of interest in our Virtual Clinic, which supports online consultations.
But we support everything from large scale multi-disciplinary team meetings to telemedicine stroke networks and connected ambulances. The values and ethics of the business are about supporting clinicians and patients, rather than around trying to be a tech company.
Who was your first customer?
The first big one was probably the East of England stroke network. The East of England is a big, mostly rural area with a number of small hospitals. There are not enough stroke consultants in the region to make sure there is a stroke consultant present 24/7, so the network developed a telemedicine service.
When a patient has a stroke, Visionable is used to connect them with a consultant working on-call from home. We have treated 4,000 patients this way, and it has greatly increased access to thrombolysis.
Our next major customer was West Suffolk NHS Foundation Trust, which is a global digital exemplar. We have been working on a hospital wide application that doctors can configure for different use cases – MDTs, paediatric outpatients, care home care.
What was Visionable’s most significant achievement over the past 12 months?
The amount of traction with the NHS. We are in over 30 hospitals now, with our biggest competitors being Cisco and Microsoft. That’s pretty impressive to my mind, because I know the NHS and how hard it is to get into it. But I’m most proud of the way we interact with clinicians and co-develop use cases. I think clinicians appreciate that we have a shared goal in mind when we work with them.
What is next for Visionable?
We are scaling up. We are raising investment and working really closely with O2 and Verizon around connected ambulances and connected phones. If you’ve got a Visionable app on your phone, you can connect expertise to any situation.
Right now, we are working with our telecom partners to make sure that, if a patient has the app on their phone, they can connect to help and advice about the coronavirus and Covid-19. But in the longer-term, we are looking to support staff and to help redesign pathways. So, if there is a nurse at a patient’s bedside, that nurse might use the app to ask for specialist help to be brought in.
Or if you go to your GP, and they need a consultant’s opinion, they might obtain it there and then; instead of sending a referral letter, which leads to an appointment in two to six weeks, which might lead to another referral, and another wait…
We want to move beyond linear video calls. If the patient and the clinicians involved in their care don’t have to be in the same physical space, then you can redesign the whole pathway. In the digital world, you can have two or three appointments a day if they are all properly co-ordinated.
You can run care 24/7. Hospitals and primary care services are starting to realise that as they move to digital first to cope with the coronavirus. What the pandemic has done is to accelerate what might have taken five years into something that will happen in the next year or so.
What are some of the challenges for you in the market?
Video manufacture is very skilled; there are only a couple of companies in the world that manufacture their own video – Microsoft, Cisco, Zoom, us. We have 29 patents for our unique streaming technology. Yet there are vendors out there that are coming up with basic third part plug ins and calling themselves video companies.
That’s creating a lot of noise in the market that is unhelpful in the current situation. I’m worried the NHS could end up with hundreds of different systems being used for video conversations; some of which embed into clinical workflows of give the spectrum of clinical capabilities required across multiple use cases.
The NHS has got a difficult challenge. Of course, it can’t just pick one system and tell everybody to use it, but equally it can’t have 500 systems just pop-up. As the NHS scrambles to prepare for Covid-19, my advice to people being asked to take procurement decisions right now is to stop and think for a moment about whether the options they are looking at work with their organisation’s technology stack and IT strategy.
If you do that, you are much more likely to choose something that will support considered service redesign in the future. The other challenge is clinical adoption. Some call this transformation, but to me it is about whether there is a real benefit to clinicians and admin staff and the patient.
If there is, then clinical adoption should be easy. If there is not, then people shouldn’t be afraid to say: ‘This doesn’t help’. PACS scaled in the NHS because digital imaging was safer, quicker and more accurate than x-ray films. If technology is truly beneficial, it will scale fast.
Are you working internationally?
We are doing some work out in the US, where we are working with Verizon and doing some projects in New York. We are doing some trials out in India as well. We are scaling really fast and we’ve got some truly influential people who care about our citizens about to join the company – which I’m sure the Health Tech Newspaper will be covering!
What is your advice for NHS organisations?
Right this moment, it would be to repeat my plea to people who are making technology decisions to prepare for Covid-19 to keep one eye on their organisational and IT strategies. I know that is incredibly difficult, because everybody is firefighting. But there is a real pivot to digital underway, we need to build on that in the future, and that will be much easier if the right decisions are made now.
The other is that transformation has to be NHS-led. You can’t just bring in consultancy and say: ‘Change it’. You have to sit down with front line staff, operational managers and clinicians and work out what is needed, apply some joined-up thinking, and make sure that it will benefit patients.