HTN Summit 2020 Day Two included 6 sessions from a range of speakers from across health and care. In this article we round-up all the action from the webinars that took place.
Starting us off we welcomed Helen McGuire and Ainhoa Arjona from Royal Brompton and Harefield NHS Foundation Trust, on a session taking us through their journey so far as Assistant Nurse Information Officers (ANIO).
Helen started the presentation by providing us with a brief recap on what’s happened since they both started the ANIO role in January.
Helen said: “MS Teams was deployed trust wide to help with the Covid effort. This included being able to communicate inside of red zones, facilitating end of life video calls for families, and staff communication and aiding of social distancing during meetings. 500 cameras were donated by TechBuyer as well as huge volumes of home kit from the public.”
In terms of future plans, Helen said: “We are going to be merging with GSTT to streamline our EPR as best as possible to line up with EPIC who have been also been working with GSTT.”
Ainhoa then presented and updated the audience on her journey as an ANIO, and spoke about how they are generating awareness for the new position and providing key input into the digital strategy at the trust:
“Many of my colleagues ask me what the transition was like from clinical nurse to IT nurse; we are still learning many different specialist terms; many clinical nurses have never heard of the ANIO post, which is why we think it important to promote the role.”
“The important aims for our role is to meet CNIOs and other ANIOs to share support and advice. We also want to meet health tech companies to promote our role too.”
Paul Volkaerts, CEO at Nervecentre, Andy Carruthers, Chief Information Officer and Graeme Hall, Associate Chief Pharmacist/Chief Pharmacy Information Officer both at Leicester’s Hospitals presented the EPR programme at Leicester’s Hospitals.
Paul started the presentation by providing an introduction on Nervecentre’s EPR solution: “We have very much harnessed the power of mobile in our solution, and we have no baggage of old software or data models; you can build world class architectures now than you could a couple of decades beforehand.”
“We have a real speed of deployment, and of course being a UK company, we design our product for the NHS and focus on NHS priorities.”
“The journey of a trust adopting a full EPR can be staggered to reduce stress and impact to patients. The key aspects of a next generation EPR are as follows; loved not tolerated, intuitive not change-managed, chosen not enforced; real-time workflow, not retrospective data entry, all clinical data in one place, integrated, with rich clinical decision support; everything mobile, closed loop prescribing; clean data, actionable insights, and with real-time business intelligence.”
“Business intelligence is harder than people think, but clean organised data makes this easier.”
Paul described mobile as being key to clinical adoption, particularly in clinical photography: “At Leicester we conducted a case study on clinical photography where images were being viewed over 70,000 times.”
Andy then took to the webinar platform to tell us about Leicester’s approach to the EPR: “One of the key points for us is that the programme is clinically led, which means it is not IT asking the organisation to work differently. This way has been critical in adopting the EPR.”
“The emphasis on patient safety was to ensure we were adding value, and are also always try to see how we can improve involvement from patients to receive their views and input.”
“We have seen far greater adoption of Nervecentre by our nursing team due to it being in their pocket and the ability to use it all the time.”
“We are increasingly shifting to more agile ways of working; presenting solutions to clinicians and taking onboard their feedback.”
“One of the nuances of this approach is that we are doing the PAS last; the value to be gained from replacing the PAS system isn’t great, so we are adding elements to it to enhance the system. Usually, the first 12 months are spent on replacing the systems you already have, we are switching this method.”
Finally, Graeme rounded off the presentation by discussing the eMeds (ePMA) workstream and its main safety features.
“The drug file and dose sentence build is highly configurable and allows for dose range checking to be set up to improve patient safety. It allows vital signs or pathology to be visible in prescribing scenes and allows form creation to gather data at point of prescribing for audits of how and when we are using drugs.”
“The system is very much standards based and complies with NHSX standards to be interoperable and is FHIR compliant. The system architecture is very modern with current messaging standards.”
“The system also has bar code functionality, where patient and drug identification can be attained through bar code scanning. This is matching the drug name, strength and form. It will give us full ordering of medication to fill drug trolleys.”
Katy Lethbridge, Client Engagement Director and Jonah Aburrow-Jones, Client Engagement Director at Ideal Health on defining the new norm for EPR implementations.
First off, Jonah began the presentation by informing us of who Ideal Health are, and a bit about the company’s background.
“We work only in healthcare and we’ve been working with the NHS for over 20 years now. We focus very much on outcomes and we work with just about all aspects of digital health, and our approach is to be very agile.”
Jonah described the impact that digital health has faced over the past 6 months as “profound” and highlighted some of the changes that have occurred over this time period.
“Our typical implementation programme (of a digital system and EPR) is vast.”
Ideal define the ‘right way’ of EPR implementation through the following steps: agree milestones, success criteria, deliverables, and outcomes; identify risks, dependencies and pinch points; create effective workstreams and planning; plan assurance reviews and readiness gateways; amongst others.
Jonah passed over to Katy who explained the key challenges of implementing such a programme;
“You need to make sure all the information moving around under remote delivery is secure and conforming to IG rules. There are different aspects to be taken into account for remote delivery; are your clinicians and other stakeholders culturally ready for this methodology.”
“You have to make sure you’ve got the right people and resources at the right times to ensure implementation. How you engage with stakeholders will be different and a part of that is down to communication methods. You will certainly need more clinical oversight than normal, and your clinical champions will be key.”
“In the new environment, make sure you’ve got decision gateways.”
“Remote delivery methodology is really important and has to be planned at this early stage. Are you going to go with MS Teams or are there more dedicated tools that can be utilised.”
“There is the possibility that remote delivery can be positive and not all doom and gloom. You need to plan and facilitate and rules of engagement, decide on platforms to use and make sure people are familiar with them.”
Katy summarised with the key areas in this new norm:
“Your risks and dependancies need to be understood and conducted early on. Your super users are going to be key to the training element.”
“It’s massively important to make sure you have a strategy and plan for that post-go live area that embeds skills and knowledge as that’s how you will get sustainable use of your EPR.”
Henrietta Mbeah-Bankas, Head of Blended Learning and Digital Literacy Workstream Lead at Health Education England presented on defining ‘digital literacy’ and the importance of digital capabilities in the delivery of health and social care.
Henrietta returns for HTN Summit after she took part in HTN Digital Week in June. To begin, Henrietta discussed the importance of digital literacies and the definition of the term and why that is important.
“Health Education England is embarking on a massive piece of work around enabling a digitally ready workforce.”
“Digital literacies are those capabilities that fit someone for living, working, learning, participating and thriving in a digital society.”
“The digital capabilities framework looks at digital capabilities from 6 domains: information, data and content; teaching learning and self-development; communication, collaboration and participation; digital identity, wellbeing, safety and security; technical proficiency; and creation, innovation and research.”
“The type of change we are seeing in digital is different to what we have seen recently; patients are now encouraged to manage their own health through digital apps.”
“Since Covid hit, technologies are flying in but our ability to adopt and use it is at a slower pace. We need to govern smarter and learn faster, but is that going to address that rate of change?”
“We need to think about other interventions to support us in that change.”
“Digital readiness is around adaptability over anything else; being adaptable doesn’t happen smoothly and has its challenges.”
Henrietta then described the challenges around ‘people’ becoming more digitally literate.
“Digitally negative, digitally ambivalent, digitally engaged, and digitally excluded, are the types of challenges that we face when developing the workforce on digital literacies.”
“The challenges around technology centre around design of the tech we are using and is it user centric?”
“The ethical questions are at the forefront of any professional; the increased usage of AI for example and the worries of the ethics around it.”
“We need to ensure risks around the technology we are using is understood and assurance is received in terms of GDPR.”
Henrietta finalised her presentation by listing the resources that can be used to support culture change. Some of which include:
Social Care – The Centre for Creativity and Innovation in Care; Industry – The Netflix Pressure Cooker: a culture that drives performance; Dyson: care study for experimentation for success; Health – Imperial College: Quality Improvement is Everyone’s job; Leeds Teaching Hospital: Our Five Year Strategy All Inclusive; Learning from failure: Museum of Failure and Failing the right way.
Nadine Miles, Director of Market Development at Spirit Health Group and Simon Applebaum, Managing Director at Spirit Digital presented on the Covid-19 catalyst and how the pandemic has optimised the opportunity for digital health.
Nadine begins the presentation by giving us background to Spirit Health Group’s credentials in the UK.
“The Spirit Health Group has been in the UK for around 10 years, and we have a number of divisions. These divisions are Implement, Access, Digital, Healthcare, and Clinical.”
“The division that has been most affected by Covid-19 is our amazing clinical team; we have four GP practices and we look after around 20,000 patients in Leicester and Rugby, and they’ve had a huge opportunity to help with the pandemic and primary care.”
“We also have a healthcare division, which offers a range of products and services into the NHS, and we sell into the NHS in England and in Scotland.”
Spirit Health Group are currently working with Leicester, Leicestershire and Rutland Health and Social Care; with COPD heart failure, cardio pulmonary rehabilitation and Covid-19 discharges national Ageing Well Accelerator site;
The group also work with Yorkshire and Humberside and East Midlands Dementia Clinical Networks on the digitalising dementia screening tool DiaDEM; the Welsh Government on post-Covid-19 response in Cardiff and Vale; Supporting care homes and creating a digital escalation model with East Midlands AHSN and Derbyshire CCG, and finally with GP surgeries across Leicester and Lincolnshire for monitoring deterioration in care home residents.
Simon then talked about remote monitoring and their product CliniTouch, which allows a patient at home or in a care home to record their clinical measurements and answer a set of tailored questions with a staff member.
Following that, a clinically created calculation automatically generates a red/amber/green risk rating: “The underpinning vitals for someone who is acutely affected by COPD might be different to somebody who has relatively mild symptoms of frailty.”
A case study was then presented by Paul explaining their relationship with Leicestershire Partnership NHS Trust: “Covid-19 arrived and we were asked by Leicester to risk score up to a thousand patients, and we had to be ready to do that in 3 weeks. By the end of April, we had hundreds more patients using CliniTouch.”
For the final session of the day we welcomed Paul Tsang, Head of Collaboration Solutions at Redcentric.
Paul first presented the company and the wide ranging customer base it supports.
This followed with a presentation exploring collaboration tools, and new ways of working for healthcare providers. Paul talked about the technical positive and limitations with various technologies and finished the presentation discussing one of the company’s customers, King’s College Hospital NHS FT.
