At the start of the year as part of the HTN Health Tech Trends Series, sponsored by InterSystems, we asked health tech leaders for their aims and priorities for 2020.
In this article we revisited this theme and spoke with health tech leaders across the country to discuss their priorities for the remainder of the year and if they may have changed.
Contributors include:
- Adam Thomas, Chief Information Officer, The Dudley Group NHS FT
- Christine Walters, Director of Informatics and Chief Information Officer, St Helens & Knowsley Teaching Hospitals NHS Trust
- Laura Mumby, Head of EPR, Health Informatics, The Rotherham NHS FT
- Chris Reynolds, Chief Information Officer, Pennine Care NHS FT
- Matt Connor, Chief Information Officer, Liverpool Women’s NHS FT
- Darren McKenna, Director of Informatics, Cumbria, Northumberland, Tyne and Wear NHS FT
- Ade Byrne, Chief Information Officer, University Hospital Southampton NHS FT
- Grace Birch, Associate Director of IM&T, Greater Manchester Mental Health NHS FT
Adam Thomas, Chief Information Officer, The Dudley Group NHS FT
“As we move through recovery, restoration and reset of the NHS, we will need to focus on the emerging needs of an integrated care system in the next six months. This is an opportunity to embed integrated care co-ordination, seeing teams working on shared care plans for patients.
Access is high on our agenda and this is both access for staff to essential information and also for patients to access care in new ways.
It has been well reported that attendances at emergency departments fell sharply during the pandemic and it is important that we tie in with the national ‘Talk before you walk’ campaign to promote locally the use of NHS111. Artificial Intelligence (AI) at triage and the NHS app as the single point of access for local services have a huge role to play.
As a Trust we also see ourselves developing and enhancing our existing high rates of virtual outpatient clinics over the rest of the year.
Key technology projects will be LHCR (local health care records), RPA (robotic process automation) and AI in imaging to clear the backlog caused by the pandemic. It is important we reset service design principles around the better use of technology for the future.
COVID-19 has been an opportunity to fast-track innovation and we are proud at The Dudley Group of the projects that have come on stream. Linked care co-ordination across our borough has made great strides, allowing specialist decision making earlier in patient journeys. We built in-house a text message system linked to pathology which means staff having antibody tests received their results via SMS within a matter of hours, and this will continue in retest cycles. We used this to support testing for all health and care providers across the borough.
We have expanded and rolled out medical device integration into our electronic patient records and are working on linking VTE risk assessments to more developed clinical decision tools to standardise care and focus expertise in the complex patient issues.
Having acted quickly to equip staff for home working, including introducing remote radiology reporting, we are now rolling out ‘always on’ VPN to community and clinical teams to further speed up secure access.”
Christine Walters, Director of Informatics and Chief Information Officer, St Helens & Knowsley Teaching Hospitals NHS Trust
“The past few months have seen such a pace of change in the way staff use technology to work and care for patients.
Literally, overnight, our priorities changed. Working practices changed with 10 times more home workers than usual, requiring access to all systems as well as many working differently practices introducing video conferencing for patient consultations, staff meetings, colleague to colleague calls, patient to family calls, joint MDTs with social work as well as being used in COVID wards to limit the number of staff going onto the wards.
Alongside this, we continued work on improving our defences against Cyber to deal with the unfortunate increase in malicious cyber-attacks throughout the pandemic.
In conjunction with NHSE, the team developed a new Mortuary Application to monitor mortuary capacity across the HCP. Telephony services were setup to allow staff to work in an agile way using ‘soft phones’ so they could continue to answer their landline number resulting in less disruption to services. Command centres, Crisis Telephone lines as well as Freephone Cancer Support telephony services are just some other examples of areas were new telephone services were quickly setup to support service requirements.
With so much new technology rolled out and working practices set to change, long term priorities have also changed to ensure all of our solutions work in the most agile way, speeding up the performance and access to systems from different locations (including home). We are continuing with work to further increase network bandwidth, standardise on VC solutions and explore how we can further optimise the use of Office 365 and solutions like Imprivata.
Looking ahead, our priorities also include the introduction of applications and solutions that will keep our patients and staff safe.
We have introduced the Netcall Patient Hub for Covid-19 results notification for anti-gen and anti-body test results. In 8 weeks there have been 12,000 tests results sent to staff and patients through the Hub with a staggering over 90% of them being accessed through the portal.
The Trust is working towards implementation of thermal cameras that will detect elevated skin temperature as staff and patients enter hospital buildings. This recording of temperature is unobtrusive and will help reduce risk to both patients and staff that enter the hospital sites and will provide fever detection in high footfall areas. The solution ensures no impact to patient movement within the hospitals, provides contact free socially distanced screening and is completely non-invasive.
The Trust is progressing with the implementation of communication “badges”. These devices can be worn under PPE and use a single button and “genie” to make a call to another person with a communication “badge” or to a standard telephone line extension reducing the risk of cross contamination in high risk areas such as ICU & Theatres and provide agility for making and receiving calls.
Utilising existing wireless networks and telephony platforms, the product integrates seamlessly and enables removal of antiquated technology such as hand held radios.
For families or carers of children, the impact of COVID and reduced visitation is especially difficult. The Trust will be rolling out a solution that enables safe & secure video messaging to minimise separation anxiety in families or carers of children in Neonatal and Paediatric units. vCreate enables nurses to record video messages securely and send them to parents. Authorised users can access the clips at any time and through any device, and the videos can be downloaded and saved to form part of a baby care diary.
Following the success of the St Helens Cares Shared Record, we are endorsing the approach to use data from the Care Centric Population Health Management integrated care record to further improve patient care during this pandemic. This will help to better understand the needs of the population, target services effectively and plan. Population health management will allow wider determinants of health (like the physical and social environment, education etc) to be taken into account as part of the health profile of each citizen in St Helens and Knowsley.”
Laura Mumby, Head of EPR, Health Informatics, The Rotherham NHS Foundation Trust
“Our priorities at the Rotherham NHS Foundation Trust over the next six months involve digitising the last few integrated care pathways, such as the elective surgical and blood transfusion. We have around 60 per cent of paper assessments, ICPs digitised and need to focus on the remaining 40 per cent.
But our main efforts will be on our ‘Digital Aspirant’ transformation programmes, where we will be enhancing patient flow across the Trust and establishing our digital command centre. We have a vision to digitally transform our out-patient services and embed products such as Rotherham Health app, self-check-in and digital weighing scales, in which all will integrate with the Electronic Patient Record.
The next six months will see Information Services focus on the Trust core objectives around Mortality, Workforce, Finance and Operational Performance. This will include developing insight models which support decision-making in each of these areas, continuing our Cloud journey for high performance compute and ensuring that clinical coding is able to meet to the changing demands of the services and giving data back to our clinicians.
As for infrastructure, there is a complete overhaul and upgrade of our data and Wi-Fi infrastructure underway with embedded location and tracking technology. We’ll complete our Win10 upgrades across the patch and start deployment of regional VMware deal.”
Chris Reynolds, Chief Information Officer, Pennine Care NHS Foundation Trust
“Our mental health and learning disability services are delivered across hundreds of different locations in Greater Manchester. During the COVID pandemic we have had to adapt the way we deliver our services with an increase in remote working and use of video and telephone consultations.
Whilst many of our services are starting to resume face to face consultations; our technology priorities over the next six months are focused on realising the benefits of remote and mobile working appropriate to our services. This includes empowering clinicians with shared information, video consultation, video Mental Health Act Tribunals, document management and the ability to work remotely.
Key projects include Office 365 for everyone to enable us to collaborate and share operational, pathway and corporate documents and work with primary and acute care; roll out of over 800 more laptops to enable more mobile working across all services and teams. We will also be rolling out our Electronic Patient Record to inpatients, outpatients and other services taking us to 100% coverage across all services – part of this roll out includes rationalising and standardising our electronic forms.
In addition, we will support our workforce and operations teams through development of robust workforce modelling systems, as well as demand and estates mapping. This will help us understand the impact of COVID on availability and wellbeing of the workforce, plus demand on our services across Greater Manchester and analysing the change in locations of service delivery.”
Matt Connor, Chief Information Officer, Liverpool Women’s NHS Foundation Trust
“We are focused on implementing a new Digital Strategy, which emphasises the importance of strong 2-way clinical engagement and co-design for our digital aspirations.
Building on the success of our GDE Fast Follower programme we are planning our Meditech Expanse implementation with a clear objective of integration, whilst simplifying and enriching the end user experience.
Infrastructure readiness is also a key priority, with a recent successful telephony replacement we are moving onto a trust wide network & Wi-Fi replacement and an end user computing replacement programme which includes the transition to O365. We are continuing the innovative work of the GDE fast follower programme with the Closed Loop Blood and Milk implementation, RPA and Theatre Streaming.”
Darren McKenna, Director of Informatics, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
“As is the case across the NHS, the COVID-19 pandemic has massively impacted our digital delivery over the last few months. However, thanks to our robust investment in technology over the past few years, we already had the right technology in place to allow many staff to work remotely. This enabled the Informatics team to focus resources on supporting staff to maximise its use and provide continuity of care for our patients during a very difficult time, rather than rolling out new equipment. It also meant we had capacity to deliver additional tablet computers to wards, so patients could keep in touch with friends and relatives during lockdown.
We were also able to quickly build real-time recording and reporting systems to provide operational dashboards for sickness levels, COVID-19 infection levels on wards, and staff testing progress.These provided the Trust’s ‘Gold Command’ emergency response team with the information needed to manage the incident effectively.
Looking to the future, we face the challenge of sustaining these new ways of working and living with COVID-19 whilst continuing to deliver our digital strategy and complete our Global Digital Exemplar programme. We hope to complete the rollout of ePrescribing and the deployment of Omnicell automated pharmacy dispensing cabinets into North Cumbria this year. We also intend to develop more patient-facing solutions through the Great North Care Record and Health Call, to support our staff and patients access our services remotely during uncertain times.”
Ade Byrne, Chief Information Officer, University Hospital Southampton NHS Foundation Trust
“Well I’m pleased to say what we said (in 2019) makes sense, more mobile and more patient facing solutions.
The recent work with COVID-19 has diverted some things but has accelerated others and the impact on the UHS Digital programme is a net positive I feel.
During this time, we have deployed Teams for home working to more than 5,000 users and deployed around 800 laptops.
We have beefed up the home working VPN resilience and connectivity performance [bandwidth] and delivered mobile records viewers and increased the use of tablets in this area by over 500.
Multi-Disciplinary Team clinical case conferences are now virtual, using Microsoft Teams, which is much more efficient.
We set up virtual wards for patients at home so they can stay under the care of the hospital consultant. The data flows through the cloud based Personal Health Record “My Medical Record” using the Open PHR. The patient’s oxygen status at home is therefore available in the same patient lists for the hospital staff to manage.
We moved to a much more virtual outpatient clinic environment and have tried not to just defer patients. We rapidly built a triage tool for this that links to the hospital EPR, so that the patients can now be tracked and seen in the appropriate setting.
Also, we installed a control room command centre video wall for up to date bed management and response. Importantly we maintained vital on-site services such as desktop support and notes scanning, as we need to recognise that not everything can be virtual.
Our priorities remain to become a paperless data driven hospital and I feel that our efforts during this time will ultimately contribute to that.”
Grace Birch, Associate Director of IM&T, Greater Manchester Mental Health NHS Foundation Trust
“Over the past four months, we have seen a huge amount of change in the face of the pandemic; not least being the switch from office-based to homeworking for a quarter of our workforce practically overnight. As a Trust we have had to work rapidly and effectively in response, to ensure that staff and service users have remained supported and connected.
Of particular note is our Improving Access to Psychological Therapies (IAPT) service, who have totally embraced the use of digital technology, moving to online virtual consultations and supporting service users through the use of digital apps. This has already seen an improvement in our ability to recruit staff who don’t live in the local area, and is getting positive feedback from service users and clinicians alike. Going forward, we will use this work as an exemplar for digital adoption, implementing what’s worked into other service areas.
One of our most significant projects has been the roll out of Microsoft Teams. Over the next six months, we are prioritising completion of the MS Teams roll out, embedding it in our working practices across the board. We are also moving on to system optimisation, getting everyone on the same platform; and further to this, looking at how we harness the power of the product and its associated tools to really release operational efficiencies. We will also be moving the organisation across to Microsoft 365 and looking at additional opportunities for moving products to the Cloud.
We will also be extending the rollout of MaST into the remaining Community Mental Health Teams across Manchester and Salford. And we will be looking at additional innovative tools that can build on the digital adoption of the past four months.
Finally, we will ensure that we have the right level of digital skills across our teams, and will continue to support the change that can be accomplished through digital adoption.”
- Thank you to the contributors
