Our penultimate day of HTN Digital Week we welcomed and opened with Beth Lawton on Keeping Digital Human.
Beth is Chief Digital and Information Officer for Sussex Partnership NHS Foundation Trust.
She begins by telling us how they have responded to Covid-19 through digitising, virtualising and mobilising.
Beth explained how they increased VPN users from 125 to 4,000 + as well as moving meetings and training to online only, “we even had a clinician working from Turkey, as that’s where he was when we locked down.”
“There’s a lot that we have implemented that we will not go back on post-Covid.”
“We also set up a virtual mental health line”, Beth explained the health line was run from staff member’s homes through secure telephony.
Prior to Covid-19, Beth explained only a small number of teams were offering a very small number of virtual consultations and some teams were not particularly engaged with digital technology.
From the 16th March, the trust adopted Attend Anywhere and increased clinical leadership to manage projects.
“There were over 6,000 consultations in 6 weeks over the Attend Anywhere platform.”
The uptake of Attend Anywhere across the trust is broad and huge; Beth explained that nurses are the main users of the platform, but it is also used by social workers, psychiatrists and so on.
“We were using it for virtual consultations, MDT meetings, meetings with carers and patients, and ward consultations by self-isolating consultants. Things we didn’t expect was the platform being used for things like music therapy and yoga.”
“If you give people the right tools at the right time, they’ll run with those tools. At the end of that 6-week period, we were the highest users of Attend Anywhere in England.”
Beth explains that the main road to where the trust is based in Sussex is a constant traffic jam, and Covid has pushed staff to avoid wasting time in traffic and conduct consultations online.
“The key difference for us is the human factor; Attend Anywhere was relevant to clinicians’ needs and it was timely in delivering services efficiently and safely.”
“It was a good enough product; we spend a lot of time in the NHS in the pursuit of perfect, which can lead to a terrible sort of paralysis.”
“We gave people that framework to make sure your data is safe as a service user and your environment is safe as a clinician. It is a tricky balance to get that standardisation vs customisation.”
“We stripped out a hell of a lot of the bureaucracy. It’s about getting something out there and in use, then improving it from there.”
Tony Tarpey, Service Delivery Lead, Clinical Applications at the Wirral University Teaching Hospital, Mark Smith from Enovacom and Sébastien Delecolle from Enovacom talk us through how a single interoperability platform can connect any medical device from your ICU with any healthcare IT system or application.
“At this time of unprecedented pressure on healthcare staff across the world with the COVID 19 virus outbreak, it has never been more important to be as efficient as possible, it could literally save a life.”
A recent predictive model suggests that 30% of people who are hospitalised with the virus will need intensive care treatment; what is crucial is having real-time data at the point of care available, to make a decision quickly regarding the patient’s care.
Mark Smith said “Anaesthesia workstations, blood gas analysers, dialysis and haemodialysis machines, infusion pumps, EEGs, ventilators and respirators are the medical devices in an Intensive Care Unit that are used for diagnosis, patient monitoring or therapies. This means that a lot of data is produced and its utilisation isn’t always optimised.”
“To ensure the best utilisation of the produced data and enhance patient care, medical devices must be connected directly with the electronic patient record. This will allow medical staff to automatically deliver a complete patient record, reducing the risk of errors associated with manual vital signs recording.”
Tony took us through a case study from the Wirral University Teaching Hospital NHS Foundation Trust where the aim of the hospital over the past 10 years is to become paper light.
“I truly think we are seeing the end of paper case notes, reports and the like. Waterstones has recently enacted a policy where touching a book results in that book going into quarantine for 72 hours; how will that work in an environment where paper is constantly being passed around?”
The Wirral Hospital is one of the largest and busiest acute trusts in the north-west of England. It is recognised as a global digital exemplar and recognised as an NHS new care model vanguard site.
“Because we became a digital exemplar, we were able to move towards our model of having a fully integrated ICU, theatres, cardiac and so on all part of the electronic record.”
Emlyn Jones, Technical Lead and Fran Draper, Engagement Lead from Connecting Care discuss the scalable sharing of Covid-19 related information across local shared care records.
Connecting Care is a digital care record system for sharing information in Bristol, North Somerset and South Gloucestershire. It allows instant, secure access to health and social care records for the professionals involved in care.
Fran explains the technical set up of the Connecting Care portal: “People only have to enter data once, then the data is pulled into the portal where we work with our main technical partner Orion Health.”
“The data controllers then decide what data is put into the view in the portal. We have an electronic master index and we can also display documents in the portal; letters, discharge summaries and so on can be displayed as soon as they become available.”
“We try wherever possible to be standards based; Emlyn has been very clear about using FIHR standards in the future.”
The dashboard is always being improved to be more useful says Fran. The dashboard itself is colour coded and provides the user with graphs and charts. There is also a timeline which provides a view of what events and appointments people have had or if a someone has been an inpatient; useful for home visits and so on. Trends can also be spotted where someone has visited A&E or their GP in abnormal frequencies.
“We are all about reducing the number of clicks users have to make.”
Fran explains that some of their colleagues have had to find new ways of working, in particular with a homeless service, where Connecting Care fully supports new ways of working wherever possible.
For our penultimate webinar of day 4, Wes Wright, Chief Technology Officer alongside Daniel Johnston, Clinical Workflow Specialist, both from Imprivata share stories and lessons from the front lines of IT during working through the Covid-19 pandemic.
The customer stories shared include quickly enabling secure remote working, protecting digital identities, facilitating telehealth and virtual visits, and risk mitigation and response.
“I don’t think we can do any presentation without mentioning Covid.”
Wes started by taking us through the health delivery organisation (HDO) market.
“We stopped all elective procedures and immediately those that claimed could never work from home, started working from home.”
Wes presented a graph which showed the peak and trough of Covid-19 alongside virtual care and remote working.
As the Covid-19 crisis peaked, as did virtual care and remote working; except now virtual care and remote working is maintaining pace with a slight increase as we emerge from the Covid crisis.
“We’ve done work that would be expected to be completed in 5 to 8 years in a matter of months. I suspect video conferencing will become a mainstay post-Covid and continue to flourish.”
Wes went on to talk about the need for digital identity in an increasingly complex environment.
“They are using many different devices from their home PC, laptop, and mobile phone. Different devices demand different applications.”
“The digital environment is not just complex, but now hyper complex, and we now throw on the top Covid-19.”
To demonstrate that increasing digital complexity, Dan took us through managing patients through iPads to facilitate telehealth: “each iPad must have a unique sign-on for in-patient telehealth, but this must be accomplished as hands-off as much as possible.”
Imprivata have also been using technology to safeguard staff and patients and also re-provisioning recycled phone for patients in isolation.
“Patients in isolation or in care homes need a safe way to communicate with loved ones. Phones for patients was set up as a not-for-profit enterprise.”
A use case was then shown where OneSign can be used to comply with mandatory temperature checks for clinical staff. OneSign has also been used to rapidly simplify access to new applications.
Wes then spoke about the lessons learnt in digital identity implementation: “securing digital identity is not as important as ever, it is now more important than ever.”
“What we ourselves have learnt in doing all this manipulation of digital identity, is you can move fast and you can adopt digital identity in a short space of time. There’s a need for an automated identity governance system in place to manage changes in the workforce.”
“We have learnt the need to maximise adoption of solutions and track movements of staff to safeguard clinicians and patients. We have learnt to optimise implementation of solutions and speed up learning.”
“Finally, we have learnt that changes in technology have provided opportunities for better care.”
Lesley Soden, Programme Director of Innovation Theme at the Health Innovation Network hosts Sara Nelson, Programme Director at DigitalHealth.London Accelerator, alongside Carole Morgan from London & Partners’ Business Growth Programme and the NHS Innovation Accelerator (NIA), in a discussion about their Accelerator programmes, what they offer and what you can expect.
Sara started off by sharing with us her passion for supporting great health tech.
“The Digital Health London Accelerator is now in its 4th year and supports 20 companies per year. We identify organisations where the product can be used to benefit. “If you work with us, you will have an NHS Navigator, or a buddy, who will help you develop and evolve.”
“We believe inclusion and diversity being at the centre of long-term success. I am immensely proud of all the organisations we have supported and the success they have achieved.”
“Engage with us and work with us to transform the NHS digitally.”
Morgan McKean of the NHS Innovation Accelerator:
“We work with each of our innovators to help them build their entrepreneurial skills. We are happy to work with innovators of any background; we are really open in this regard.”
“Our remit is to share the knowledge of our fellows and feed that back to the system to influence how national policy is formed in the NHS. We have a pool of mentors who provide a huge range of expertise.”
“The only requirement we have is that you provide us with evidence that your idea will help to innovate the NHS.”
Carole Morgan of London & Partners on the Business Growth Programme:
“The programme is one of two support programmes offered to London based companies. It is a 3-month based accelerator; quite fast paced, and we give you access to up to 35 events in a 3-month period.”
“During 3 months, you also have access to mentors and partners as well as a dedicated business growth manager. The programme is based on business challenges you’re likely to have with customers and users; developing toolkits, sales skills, developing a clear message for your company, and we also help you to raise finance such as grants.”
“We can also help you develop your team; leadership skills, recruitment and managing people within your business.”
“We have supported over 600 companies since June 2017.”
