Part Two: Health tech experts reflect and share learnings

In the second part of our feature, HTN asked the health tech industry to reflect on some of their learnings this year.

In part one of the feature contributors responded to our open brief with a variety of comments, touching on the importance of people and looking after your teams, the response and agility to make changes, communication and new ways of working, and asking the question were we technologically ready?

In part two the theme continues, contributors include:

  • Sean Buttner, NHS Navigator, DigitalHealth.London Accelerator
  • Daniel Johnston,  Clinical Workflow Specialist, Imprivata
  • Dr Selma Stafford, Clinical Director​, Sussex MSK Partnership
  • Richard Strong, Vice President and Managing Director, EMEA, Allscripts
  • Paul Bensley, Managing Director, X-on
  • Nigel Cullumbine, IT Executive Director, NHS Arden & GEM CSU
  • Jane Rendall, UK Managing Director, Sectra
  • Tom Scott, Sales Director, Alcidion
  • Joop Tanis, Director MedTech Consulting and Business Development, Health Enterprise East

Jane Rendall, UK managing director, Sectra

We cannot overwhelm the NHS. This message from the UK government was one of the clearest at the start of the pandemic, at what was a scary and unsettling time. As an NHS partner, it struck us that we needed to do everything we could to support our customers in this regard.

Sectra has been involved in some very substantial NHS projects since the start of the coronavirus outbreak. Some have been Covid related, like helping the team at Barts Health to deliver the imaging requirements for the first NHS Nightingale hospital in London in a matter of days. And some have been non-Covid related – like progressing a number of very large interconnected multi-trust regional diagnostic programmes.

Through that, we’ve learned new ways to engage with our customers to ensure we support them in an efficient way. With traditional events cancelled and many opportunities for physical contact impractical, we needed to identify how to engage with our customers so that they didn’t feel abandoned.

Remote working has been a big part of this – and in some ways this has allowed us to talk to our customers more than ever. We are almost immediately available to them, not constrained by artificial waiting times of co-ordinating diaries and going to a physical location. It is really easy to jump on a call.

Our customers too have adapted. They are very disciplined about the way that meetings are conducted. Decisions can be made quickly, with the people who need to make those decisions on the calls – whether that’s a technical decision or commercial decision. This is often more productive and more efficient.

Staff have been extremely dedicated during this time, and supportive of each other – with those at higher risk protected. And whenever onsite, our team has been extremely vigilant of adherence to guidance. We are now opening our new office which we have designed to allow colleagues to meet in a safe, spacious and airy environment.

We have adapted to find new ways of delivering training, managing large go-lives, providing technical support, conducting contract reviews and even demonstrating our solutions to prospective customers. How quickly everyone has adapted has really impressed me.

And our customers have been very supportive of us as we are in trying to support them. This has been about sustaining business as usual in an unusual way.

Joop Tanis, Director MedTech Consulting and Business Development, Health Enterprise East

Despite the events of the past few months, surprisingly little has changed in what we do and how we deliver our services; we are able to be at least as efficient and effective as before. What is interesting however, is how the threshold for engagement has lowered. It is easier, and now completely the norm, to arrange a quick telephone or video call rather than needing to schedule a physical meeting. This has seen us take more enquiries from outside of the region, and from overseas – perhaps due to physical proximity simply becoming less relevant. In this sense, we’ve learnt that while communication remains key to our business, it can be channel agnostic and adaptable to the scenario.

Externally, we’re seeing a greater readiness to embrace innovation and change in clinical practice. Those clinicians previously insisting on established methods now want to go back to providing ‘routine services’, but crucially, not in the previous way.

The question remains as to whether any this will be sustained, but certainly there will be many lessons learnt that I hope will be taken forward.

Tom Scott, Sales Director, Alcidion

The challenges that healthcare professionals have faced over the past few months are continuing, and although they have abated to some extent, the prospect is they could intensify as the numbers of Covid-19 cases rise again. This makes it even more necessary that the pressures of healthcare delivery are alleviated where possible, so that clinicians and support staff can concentrate on the most important aspects of their jobs.

One way of mitigating these pressures is to adopt technology that automates routine tasks and reduces the cognitive burden that clinicians often face. Such technology can reduce time-consuming activities, make clinical workflows more efficient and unlock value from existing systems without necessitating a ‘rip and replace’ approach. Many healthcare organisations are seeing the benefits of adopting appropriate digital tools in key areas such as clinical decision support and eNoting to enable better quality care delivery.

In recent months, our conversations with NHS clinical and technology leads have shown that the appetite for new approaches to innovative technologies has not been in retreat since the onset of Covid-19 – in fact, the reverse is true.

Sean Buttner, NHS Navigator, DigitalHealth.London Accelerator

Now when I reach out to NHS stakeholders they are far more willing to engage than before. I’m not sure if it is that they now have more time for digital innovations or that COVID-19 has brought a change in culture and attitudes towards it. Probably a bit of both, but long may it continue.

Richard Strong, vice president and managing director, EMEA, Allscripts

I should start by saying that I know I have been in a very privileged position during lockdown. I’ve not been ill, and I have a house with an office that I have used for 20 years. Despite that, I have been surprised by how challenging it has been to work remotely all the time. There have been days when I have felt a touch of ‘cabin fever’.

This led me to raise the issue with our leadership regarding the mental health of the people who work for Allscripts, and we have taken steps to support them. At the same time, people have been very flexible and creative about finding new ways to do things that need to be done, and we have become more of a family.

When you have regular calls with people who are working with their partners or trying to help their children with their schooling, you learn a lot more about them as people. To an extent, that also applies to our relationships with our customers, which are more informal than they used to be.

Instead of waiting for a formal meeting, we have found that chief executives will jump on a video call, which supports a much more collaborative way of working. Our NHS customers have also become a lot more confident about using remote support for go-lives.

As we come out of the COVID-19 crisis, that way of working will continue. Of course, we will start to travel again, but we will flip our old ways of doing things. Instead of being onsite and calling in remote support occasionally, we will only go onsite if it is absolutely necessary and there are safe ways of working in place.

Paul Bensley, Managing Director, X-on

For the past few months we have been at the centre of what has been a public evolution of how GPs deliver care to their patients.

It has taught us or confirmed a number of points, and we are working to adapt to the developing needs of doctors, patients, and clinical commissioning groups, relating to remote consultation. Some of these, such as the market need to change practice call cost arrangements would not have been so prominent had there not been a global pandemic.

Another of the lessons has been a reminder not to get distracted by distorted perceptions – hype frankly – of the balance between phone, online and video in the “omnichannel” mix in how GPs and patients now communicate.

Video is developing as an exciting, informative consultation tool but is not a panacea, and the digital telephone continues as a central means by which doctor and patient communicate. We have reminded ourselves constantly to listen to what the medical profession are looking for, but above all the repeated lesson is to listen to the patient so they can choose the medium of their choice for their consultation.

Daniel Johnston,  Clinical Workflow Specialist, Imprivata

COVID-19 has provided a catalyst for change. It has provided the impetus for many trusts to start using mobile technology, both in enabling people to work from home, with doctors and clinicians providing online consultations, and within hospitals and care homes, as mobile devices are used in a variety of different ways to provide contactless consultations and communications with patients. However, we are in danger of a reactionary view where technology has been procured to solve a short-term issue, without thinking about the longer-term requirements. Now the challenge is to ensure that the investment in mobile technology pays off.

At Imprivata we’ve seen some great examples where mobile technology is being used provide a point solution, where a particular clinical workflow is made much better with the use of mobile devices. For example, I’ve seen one trust that has rolled out a fabulous app for Nurses’ patient notes and observations. At the moment it is only used by the nurses. To get better value for each pound spent, the app could be made available to everyone that needs to see patient notes.

I’ve also seen banks of mobile devices left in their charging docks because it’s so much easier for clinicians to use a workstation.  Ease of access and interoperability are key to making mobile solutions workable.  By developing a minimum viable product and testing it early with end users, so that feedback can be incorporated, IT departments can develop some really powerful apps that unlock the full potential of mobile devices, ensuring fast and efficient access to patient information whilst maintaining security and auditability.

Nigel Cullumbine, IT Executive Director, NHS Arden & GEM CS

IT professionals have always been some of the best ‘fire-fighters’ in the business, but the reaction required for COVID-19 took this up another level. By rapidly deploying remote working solutions the whole IT sector proved how it can effectively mobilise at pace and scale. During those extremely challenging early days, we demonstrated an incredible level of flexibility and resilience. The ‘shared purpose’ of working in the NHS really drove us to rise to the challenge in support of our colleagues and patients.

The pandemic undoubtedly accelerated the adoption of digital healthcare technologies at a pace never witnessed before. This created many new challenges and a shift in demand from our clients towards specialised support in areas such as online consultations. Working collaboratively, we have been able to deliver robust solutions that have enabled the remote delivery of services while simultaneously protecting patient data.

From a personal perspective, I feel the need to manage and lead staff virtually and remotely was an easier transition than most would have anticipated. While lockdown challenged many living in isolation, or with personal and family health concerns, others have found the reset of how we work and live to be a valuable experience. As an organisation, we have captured the thoughts of both internal and external stakeholders – through surveys and interviews – on how we can create a ‘better normal’, underpinned by technology, that improves productivity and protects the wellbeing of the workforce.

Dr Selma Stafford, Clinical Director​, Sussex MSK Partnership 

Here were commissioned to  set up the Covid-19 hot hub in April 2020 in response to the increasing numbers of affected people locally and the predicted increases and to support Primary Care. The intention was to create a safe environment in which patients with covid symptoms could be examined and assessed to see if they needed to be admitted into hospital or could be treated and remain in the community. It meant that no patients with covid symptoms (‘hot patients’) would enter a GP surgery and risk infecting other patients or staff in surgeries.

We designed a system where patients were examined in their cars (or in patient transport), and pared down the clinical examination to the really vital pieces of information required to make a decision about onward care, ie pulse, temperature, breathing rate and blood oxygen levels.

We learnt that finger tip oxygen saturation probes were the most useful single tool to identify how severe covid symptoms were and that patients could look reasonably well and have very low levels of oxygen in their blood. We also spoke to increasing numbers of patients who were past the acute phase of the infection but continued to be incapacitated by ongoing symptoms of tiredness and shortness of breath- now identified as ‘long tail’ covid patients, who number up to 10% of all those affected by covid.