Health Tech Trends, News, Secondary Care

HTN Trends Series: Health tech leaders highlight challenges and responses during COVID-19

As part of the Health Tech Trends Series sponsored by InterSystems, HTN spoke with tech leaders from across health and care to hear about some of the challenges and how digital teams have transformed services over the past few weeks.

Last week we spoke with Kelvyn Hipperson, Chief Information Officer at the Cornwall Partnership NHS FT and Royal Cornwall Hospitals Trust to hear about the group’s work with scaling platforms, video consultations, Microsoft Teams and the overnight change to user pull rather than tech push.

CIO, Sonia Patel, recently called on SMEs to develop an app within 48 hours. Made Tech stepped up and built a solution to support virtual visits for COVID-19 patients.

Graham Walsh, CCIO at Calderdale and Huddersfield NHS FT explained to HTN how the trust is using voice recognition to document into the Cerner EPR, without staff removing protective gear. The trust also introduced Microsoft Teams for virtual visits.

University Hospital Southampton NHS FT has utilised Microsoft Teams to scale chatbot functionality to automate many common tasks. Clinicians can create a request for a service and be alerted when ready, such as COVID-19 results or pathology results.

In this article we hear from tech leaders from across health and care on some of the challenges they have faced, what has been delivered and the huge impact their digital teams have made.

Hugo Mathias CIO, SIRO & Director of IT, Northampton General Hospital NHS Trust told HTN about the challenges digital teams have faced:

“From the trust perspective, the big challenges have been getting staff to work from home with laptops / bandwidth for connections / phone lists etc and getting accurate numbers for COVID patients by tapping into the Pathology system and linking to the PAS system so we can see requested and results.

“Other challenges have been to enable reporting of deaths by COVID with the challenge of results coming from Germany and being 2 days old at times.

“Also getting Mortuary space information regularly from a Mortuary that is not digital at all, but tapping into the spreadsheets they use (and starting a programme of work to digitise the morgue).

“Another challenge has been to get data for oxygen use by measuring the use per oxygen tank (the big tanks outside). We are using RPA to collect the data from suppliers’ websites and are building a system to report that data to the COVID operational flow to provide hourly updates on oxygen flow.

“Finally, to enable the COVID incident room to have screens and information at their fingertips.

“It has been a busy time and the teams have worked hard to build solutions to help the operational teams understand the flow of patients as well as collect the required information for national reporting (which is constantly changing).”

Lisa Emery, CIO, Royal Marsden NHSFT said to HTN

“Probably like most, the biggest challenge has been scaling up home working and collaboration/remote meeting tools at scale and pace. We’ve focussed our efforts on minimising change to the clinical and corporate systems that we use, and rather making them accessible on a wider range of devices, and from any location – we decided on this policy quite early on and it seems to have helped with the transition to home working for staff.”

“We’ve been working closely with our infrastructure partners and have been able to rapidly build and implement a ‘virtual desktop’ environment for use on home devices, alongside deployment of tablet devices to enable staff to hold more virtual meetings, and for patients to be in contact with relatives.

“In terms of learning, a huge positive has been the strength of peer networks, spanning both NHS and supplier colleagues, who have been fantastic in terms of sharing advice, materials and offers of help which we have been so grateful to accept.

“Also, on a positive note, support from clinical colleagues at the Trust has been a real highlight, as they embrace new ways of working at a staggering pace!” 

Tim Cropley, CIO, Hampshire Hospitals NHS FT told HTN of the positives that have emerged as a result of Covid-19

“The COVID-19 crisis has brought technology front and centre into what is a person centric business. Despite these challenging circumstances there are many positives emerging, forced by critical need and less hindered by cost constraints it has happened at an unprecedented pace.

“As we have had to deal with the challenge of self-isolation and the escalated need for remote working, we have significantly expanded our hardware and software offerings to all staff based on their work-related needs. We have increased the number and usefulness of devices and connections which has bred a much greater trust in digital working.  Four weeks ago, we were supporting 20-30 clinical staff at any one time, working either from home or from remote sites accessing their clinical systems. We have expanded that capacity to around 2000 staff who are primarily working from home or at remote locations such as the local private hospitals HHFT is using during this time.

“The use of collaborative tools such as Microsoft Teams has transformed the way we communicate, as we have less opportunity to meet face to face it has enabled us to work and communicate in a more flexible and efficient way. From a standing start and very limited training, we are a seeing usage figure of over 2000 staff each week, amongst other tools: video conferencing, shared document spaces and text-based chat.

“Two specific examples are worth a mention, to keep people in care homes out of acute hospitals, we have accelerated our telemedicine offering.  By using video and call centre technology and working in close collaboration with the local primary and social care systems, we are providing high quality care without exposing this vulnerable group unnecessarily.

“Our Paediatricians have continued to provide a high-quality service without needing to bring very sick children into a hospital environment with some extremely creative processes and use of video technology. This has required a lot of thought in how to organise tests and physical examinations to minimise hospital exposure and to follow up with longer video-based reviews off line. They have no intention of going back to how they worked before.

“Strong clinical leadership has been instrumental on making these changes; it has felt like a real team effort to use technology for the benefit of our patients.  We hope that these improvements to how we provide care will provide a positive legacy from this crisis.”

Andrew Raynes, Director of Digital and Chief Information Officer, Royal Papworth Hospital NHS FT on rolling out hardware to staff

“There has been lots happening, a few projects include: we have pushed out hardware to our teams including PCs and Wows to enable maximum numbers of staff working in the frontline and we have also mobilised many to work from home through laptops and increasing VPN availability.

“We are helping our staff to do online consultations through tele-clinics but also video consultations and will push out Attend Anywhere to support video clinics for key clinical areas.

“Our teams are looking to introduce a wider VDI solution to mobilise people at home providing a secure hospital environment at home and we have also set up IT outside the hospital to help test patients on arrival.

“To support patients at end of life care we have introduced iPads so patients can talk to loved ones who due to COVID aren’t able to visit the site in person.

Dr Afzal Chaudhry, CCIO, Cambridge University Hospitals NHS FT talks about scaling up their EPR system

“Cambridge University Hospitals’ in-house eHospital digital team has been working around the clock to support the Trust with its COVID-19 efforts. The exceptional work of the team includes tailoring the Trust’s Epic electronic patient record system in-house to enable clinicians to track and monitor patients with suspected or confirmed COVID-19, and utilising extensive analytical tools within the system to manage and report screenings, test results, and resources.

“Significant extensions to our secure mobile and remote access capabilities has enabled a 300% increase in offsite working by staff as and when necessary, with clinicians able to access our Epic system to provide detailed support to colleagues whether on-site or off-site 24-hours a day.

“As a trust we now have in excess of 31,000 patients using our Epic integrated MyChart patient portal to access their hospital health records, so clinicians are also using this effective tool to engage with patients outside of our hospitals to share information about COVID-19.

“An incredible digital team, supported by our primary IT providers Epic and Novosco, playing a fundamental role in supporting frontline staff to care for all patients of Addenbrooke’s and The Rosie hospitals during these unprecedented times.”

Deborah Needham, Chief Operating Officer/Deputy CEO Northampton General Hospital NHS Trust  

“Many people in the hospital have been able to cease the BAU work during the covid-19 response. The IT team however have not.

“The team have rallied around to set up the incident control room in the space of 24hrs with PCs, TVs and screens they have responded immediately to developing databases to capture information, setting up new email addresses and even adding themselves to work overtime in clinical areas when the need arises.”

Kate Warriner, Chief Digital and Information Officer, Alder Hey Digital Futures Service stating the speed at which strategy has been implemented

“In the last 3 weeks, the team have moved from early days implementation of our Digital Futures strategy with focused and extreme rapid delivery of:

  • Telemedicine from a standing start form Community to Specialist Services, providing digital care to children and young people
  • Rolled out Microsoft Teams as THE key communications tool for every meeting, from Trust Board to daily Live Broadcast from CEO to MDTs
  • Established and had over 1000 people through our new “digital genius bar”, running seven days a week to support staff
  • Delivered personal tech to enable all staff to work remotely
  • Rapidly adapted the EPR to support clinical configuration changes

“The Digital Team has truly worked round the clock as a team, going above and beyond normal working to be responsive to all requests for help and advice, wherever that may be needed; from the CEO to the clinical support staff – always with a smile.”

Judith Nicholson, Assistant Director, STHK Health Informatics on how communications have been scaled up amidst the crisis

“The St Helens and Knowsley Health Informatics Team has been supporting partner organisations – St Helens and Knowsley Teaching Hospitals NHS Trust, 85 GP practices, St Helens, Knowsley and Halton CCGs, Bridgewater Community Healthcare NHS Trust and North West Boroughs Healthcare NHS Foundation Trust to mobilise their business continuity plans in light of the current COVID-19 crisis.”

“Between 23 and 28 March 2020, 455 PCs and Laptops have been set up and delivered, ‘always-on’ VPN has been enabled for all partners, the Service Desk has taken 5200 calls in 8 days, over 850 skype calls a day have been made along with 5000 instant messages with 1800 staff now using the systems from home (increasing every day).”

“The team has enabled Desktop Virtualisation, updated numerous websites and issued guides and e-learning packages for everything from ‘Plugging your PC in at home’ to ‘Using Skype for Business’. Many changes have been made to systems to facilitate the collection and reporting of data and the creation of new wards, letter changes and clinic changes to support Telehealth.”

“Several telehealth clinics have gone live in a rolling programme – it has already been remarked by clinicians that this will change the way clinical services work forever.”