As we reach the festive season and prepare to welcome 2021, there’s a lot to reflect on. It’s fair to say that 2020 has been an eventful year but, away from the headlines as the year comes to a chaotic close, there’s also plenty to be proud of. And even more to share and learn from each other.
The COVID-19 pandemic has posed enormous challenges, but the NHS, as well as healthcare and tech professionals and scientists across the globe, has risen to the challenge – constantly innovating and adapting. With this in mind, we decided to send out an open brief to ask health tech experts and professionals what learnings they’ll be taking away from 2020.
We’ve been really pleased by the response, as we’ve received comment from a huge range of specialists across many organisations, including: East London NHS Foundation, Healthcare Gateway, Northumbria Healthcare NHS Foundation Trust, Barts Health NHS Trust, The Martin Bell Partnership, Cambridge University Hospitals NHS Foundation Trust, Greater Manchester Mental Health NHS Foundation Trust, Silverlink Software and many more.
You can find a curated selection of the responses below – we hope you find them as useful and informative as we have.
Professor Ben Wright, Associate Medical Director for Clinical Information, East London NHS Foundation Trust and Visiting Professor NOVA Medical School
This has been a year of tumultuous change; homeworking and associated challenges from COVID-19 have moved many services onto a digital footing, which has challenged both digital teams and staff to deliver transformation at pace.
Where services have been maintained, many service users have continued to experience high-quality care, but now in their home environment. And in some services, for example primary care mental health IAPT (Improving Access to Psychological Therapies) services have actually seen an increase in engagement and improved recovery rates.
Liam King, Commercial and Customer Experience Director, Healthcare Gateway
As 2020 draws to a close, this marks an important time to reflect and take stock of the remarkable digital transformation of healthcare within the pandemic, and the changes seen and felt across the nation.
From the outset this has been a year of significant change. Following the Government’s instigation of the national lockdown, we swiftly transitioned, like most, from a predominantly office-based workforce to 100% remote working in a matter of days. With big changes happening overnight, our employees’ health and wellbeing was paramount.
With these points as a basis, the united approach within our industry to support the NHS in responding to COVID-19 inspired us to continue driving forward in digitally connecting health and care. The expansion of our connectivity, to allow the flow of patient data wherever needed, became the year’s priority.
I am proud to work within an industry where we all pulled together. Hats off to all NHS staff and in particular frontline staff across our NHS health and care space, I am sincerely thankful for the world-class care you have provided every day.
Rosie Atkin, Project Implementation Manager, Connected Nottinghamshire
2020 has been an “incredible, absolutely unforgettable” (to quote Gary Barlow) year, perhaps not for the reasons we had all hoped, but certainly a year that has seen us adapt to change, problem solve, introduce and accelerate revolutionary health tech to support both patients and professionals like never before.
I want to reflect on what the year 2020 has meant on an area I’m particularly passionate about and links quite closely with Public Facing Digital Services – Digital and Social Inclusion. [The] Get Nottinghamshire Connected project was established, a number of innovative schemes were in full swing from Digital Support Hubs on the high street, pop-up roadshows and Digital Champion training – only to be halted in March. Over the last nine months we’ve had to adapt to the changing landscape, transferring our face-to-face help to a digital support line, hosting virtual training sessions and working with third sector organisations to ensure sustainability.
Although the COVID-19 pandemic has highlighted the significant inequalities people face and that large groups of our population are being left behind…it has also begun to really change a key obstacle: motivation. Individuals who initially never saw the benefit in what technology had to offer are more motivated to try it.
Over the last 12 months, Get Nottinghamshire Connected has: supported 327 people to improve their skills or confidence through in-depth support via our Digital Inclusion schemes; engaged with 1,024 individuals and raised awareness of the importance of digital inclusivity.
Whilst there is certainly a long way to go in tackling the digital divide, I like to concentrate on the little wins we have on a daily basis. So, as we begin to close the door to year 2020, I’m looking forward to seeing what 2021 brings for digital inclusivity.
Bryn Sage, Chief Executive, Inhealthcare
Twitter: @InhealthcareUK @brynsage
My reflection is that the regional approach to digital healthcare delivers the best results for the NHS at a local level. Technology needs scale to succeed and serve up the most benefits for a healthcare system. We have seen this in a number of large regions with the roll-out of our remote monitoring technology across population areas covering millions of people. It is providing services that are locally responsive, yet operating at a broad level.
Martin Bell, Director, The Martin Bell Partnership
As I write this, both my wife and I have tested positive for COVID-19 and are utterly ill with it – a really grim week, weekend and no doubt week ahead. If this doesn’t sum up 2020, nothing does. (Martin and his wife have confirmed they are now back to full health).
We should take a moment to remember all those who have left us during 2020, and all those who have suffered both directly from COVID-19, and from the knock-on impacts, whether on physical or mental health.
Some digital technologies during the pandemic moved from infancy into late teens or early adulthood – more remote monitoring, online consultations, online meeting platforms, scaling up equipment and networks for homeworking, shared care records systems, the NHS App, the NHS Website, online 111 and the interest in apps from the public to support them during the pandemic. And the explosion of MS Teams [has] been incredible to behold.
The care sector proved more of a challenge, both digitally and in other ways. Much central talk, resulted in frequent central inaction, and despite looking after many of the most vulnerable from COVID-19, the care sector seemed at times abandoned by central government.
Digital health staff worked tirelessly during 2020 – as did all their clinical and non-clinical colleagues. A huge thank you to everyone in the NHS and care sectors.
Dr Afzal Chaudhry, Director of Digital, Cambridge University Hospitals NHS Foundation Trust
This year has undoubtedly presented many challenges within healthcare, but it has also greatly showcased the importance of digital technology in support of continued safe and effective running of hospitals during a time of rapid change and uncertainty, brought about in the main by COVID-19.
At Cambridge University Hospitals our COVID-19 efforts involved adapting our existing technologies and expanding our digital capabilities at pace to be able to support our staff and help keep our patients safe. Our skilled in-house digital team successfully scaled up our Trust-wide integrated Epic electronic patient record system to support changes to care, utilised extensive data and analytics tools to support management and national reporting requirements and extended our technological capabilities to a regional-wide level to support the care of shared patients.
Our MyChart patient portal has also proved pivotal this year. Our clinicians have been using it to engage with patients to share information about COVID-19 and any changes to their care/appointments as a result. We have also added additional functionality this year – proxy access allowing parents/guardians access to their child’s hospital health record, and the ability for patients to upload images of wounds or rashes to help support better care and treatment. We began 2020 with almost 25,000 patients registered with our patient portal and are ending it with almost 80,000.
It has been an extremely busy year with huge efforts by all and topped off with the incredible achievement of obtaining HIMSS EMRAM Stage 7 – the highest rating of the eight-stage (0-7) international quality standard that recognises the use of technology, data and analytics to support the delivery of high-quality patient care across an organisation. An achievement made possible by hard-working staff and teams across our hospitals.
Kevin Fletcher, COO, Intouch with Health
It has been a year of significant disruption and rapid change for the NHS, but what has been achieved in the last 12 months proves that this complex organisation can, in fact, transform at pace – and that it can do so in extremely challenging circumstances.
We’ve seen the rapid adoption of certain technology, video consultations being a prime example, in a bid to stop the spread of the virus, and some digital projects that would normally have taken months to deploy happened in just weeks or days.
There is no doubt 2020 has proved a somewhat unexpected catalyst for some key NHS targets and drivers, such as reducing face-to-face appointments, taking a digital-by-default approach, and supporting patients outside of hospital through increased adoption of digital solutions.
Now, it is down to health tech suppliers across the industry to help the NHS harness this change and take a long-term approach to deploying technology that will not only help staff and patients now, but way into the future.
Kenny Bloxham, Managing Director, Healthcare Communications
Over the past 12 months or so, there has been a shift in attitudes in the NHS towards solutions to support the ‘digital patient’, and whilst it has been a turbulent year for the health service, it has been great to see more and more people accessing care remotely.
However, for many healthcare organisations, 2020 was their first experience of using these new technologies, and so it has understandably taken time for them to learn how to deliver them across the patient pathway, particularly given the limited functionality afforded by some of the more basic solutions.
Jenny Thomas, Programme Director, DigitalHealth.London
There is no doubt that 2020 has been a difficult and challenging year. Digital health has been at the forefront of the NHS’s response to the pandemic. At DigitalHealth.London we experienced an increase in applications to our flagship programmes, the Accelerator and the Digital Pioneer Fellowship, suggesting there is a growing demand for tailored support, networking and information in the digital health space. Millions of people have engaged with digital health products and services for the first time this year.
Liz Ashall-Payne, Founding CEO of ORCHA
What a year it has been. COVID-19 has created a terrible situation for the world to face and for front line health and care workers the challenge must be truly daunting. It has been fantastic to see digital health helping these frontline workers. For example, 30% of consultations with GPs used to be via phone or video. Now, this number has reached 90%. Overall, this year has seen a 25% increase in the use of health apps – that equates to a jump from four to five million downloads every single day. And across our libraries, we’ve seen a 200% increase in traffic and a staggering 6,500% increase in doctors and nurses using apps.
More significant are the growing numbers of clinicians and professionals acknowledging that these models of care are not just suitable for the strictures of the COVID-19 challenge. COVID-19 or not, these models and approaches to care delivery are likely to have provided significant patient and health service benefits, had they been the norm long before now. The recent uptake of digital health solutions also suggests these may be a central element of care going forward, beyond the unique circumstances of 2020.
Richard Strong, vice president and managing director, EMEA, at Allscripts
2020 was the classic year of two halves. As COVID-19 arrived in the spring, we saw some IT projects put on hold, but then deployments picked up and there was an explosion of health tech adoption.
In the first wave, there was a focus on making sure that people could work from home and carry out appointments and consultations remotely.
One of the great things about that period was that we saw everybody give up vested interests and work together for the common good. That happened across the NHS and across the supplier community, and I really hope that can be retained as we move forward.
John Sainsbury, Innovation Manager, Greater Manchester Mental Health NHS Foundation Trust
Reflection from 2020 spans the social dynamic challenges of health tech adoption during lockdown and the benefits of frameworks for thinking through complexity.
We have utilised the Nonadoption, Scale, Spread and Sustainability (NASSS) Framework when exploring health tech activities from conceptualisation to transition to business as usual. The Framework provides an evidenced-based complexity assessment mechanism to evaluate the degree of complexity across health tech-related domains. One example of this is our project to implement Otsuka Health Solutions’ Management and Supervision Tool (MaST) within GMMH.
In the adopter system domain, the benefits of home working are numerous, however, one of the challenges faced by staff involved in health tech adoption has been the limited opportunity for peer-to-peer influence: water cooler moments, over the shoulder screen glances and office colleagues interacting with their infectious enthusiasm for new products.
Alternative ways of enabling peer-to-peer learning are being tested, but formal structures are required to achieve this in the absence of the organic influencers, for example scheduled virtual coffee and share time, which are known to have both local and widespread impact.
When conceptualising the technology domain, the use of data driven analytics in mental health is growing, and this has certainly been the case with MaST. It is with this in mind that we turn to 2021 to provide staff, across Greater Manchester Mental Health NHS FT’s four localities, with this decision support tool in the confidence that it is a reliable system which can aid complex decision making, clinical priority setting and resource allocation.
Paul Bensley, Managing Director, X-on
This was a tumultuous year globally, with the pandemic impacting on every facet of life and, in turn, testing healthcare and delivery beyond any limit previously contemplated.
Working routines and systems within UK primary care had to change overnight and a new ‘total triage’ model for general practice rapidly emerged, with new technology and sophisticated cloud-based telephony systems enabling GPs to work in different environments.
The mantra of ‘digital first’ primary care developed as a reality for hundreds of GP practices, with staff who could work from home, in hubs, call patients back, not be limited by line capacity, integrate with video and also measure the response. At the height of the first lockdown more was achieved in eight weeks to digitally transform general practice than in the past decade. The face of general practice overall changed forever.
Not all primary care provision was in suitable technological shape though to try to cope with the demands of delivering care remotely, and it was clear that many practices had insufficient bandwidth. After an initial focus, particularly by central primary care policy makers, on the benefits of video, there emerged a more considered view that it was important, but not a panacea.
Telephony was re-emphasised as having an important role so that GPs can offer a mix of face-to-face, telephone, video or online consultation, as required by the Primary Care Network contract guidance, and continue to evolve the face of modern, digital-first primary care.
Nigel Cullumbine, IT Executive Director, NHS Arden & GEM CSU
Healthcare technology in 2020, like everything else in healthcare, has been dominated by the response to the COVID-19 pandemic. While recognising the terrible impact on patients and the wider NHS, it has undoubtedly accelerated the digital journey. For instance, it proved overnight how relatively easy remote working is for many people.
I think we have learnt, like all organisations, that while much of the initial focus on enabling homeworking was technological, the main impact has been psychological, and that people need to be supported to make use of these technological capabilities in a way that works for them.
For me, the most important learning has been to continually revisit what has been done through necessity, so that those rapid solutions don’t become the default without evaluating their impact on experience and outcomes.
Annie Laverty, Chief Experience Officer, Patient & Staff Experience, Northumbria Healthcare NHS Foundation Trust
Twitter: @annielaverty @northumbriaNHS
The Staff Experience Team at Northumbria developed Corona Voice in response to the pandemic, collaborating with Open Lab at Newcastle University to create an innovative employee engagement and wellbeing platform using web-based technology.
We wanted to capture the views, thoughts and feelings of our workforce throughout the COVID-19 pandemic, without the need for extensive surveys. The latest iteration of this work is Northumbria Voice; the software has been developed to allow for quick reflections and “check-ins” from our busy and dedicated staff, via their computer or mobile device.
This platform has allowed us to collate and process vital information received directly from our staff, and feed back to our executive team in real-time, so that any areas of concern can be quickly escalated and acted upon.
It is a great way to stay engaged with our workforce and foster a sense of unity, enabling staff to see how their colleagues and peers are feeling, on their site, at any given time. It has also provided meaningful information to feed into bespoke wellbeing initiatives.
Reflecting on 2020 as a whole, our team have managed to harness the power of technology to gather meaningful information and implement positive change during a very challenging period. We look forward to carrying this work forward into 2021.
Adrian Byrne, University Hospital Southampton NHS Foundation Trust
Worked well: Being given a mandate to go ahead and change things, particularly home and remote working. I think we have delivered a sustainable change.
Not worked well: A tendency to use COVID-19 as an excuse to do some illogical short-term things, change priorities, or provide reporting on new data points.
Dr Murray Ellender, NHS GP and CEO of eConsult Health
The events of 2020 have expedited the use of health tech and in particular digital triage more than anyone could have predicted. What has been fantastic is the overwhelming acceptance of tools that have been around for years but have previously not seen this level of usage.
Since the COVID-19 outbreak, digital triage has played a very important role across all NHS healthcare points. Through the pandemic, we’ve also partnered with experts in their field such as Q Doctor for video consultations and Healthinote for their information-sharing platform, incorporating video content from HCI Digital, to offer patients high-quality self-help information.
For us, partnering with other clinically-led and founded companies is the right approach. We’re all more aware and experienced in the challenges the NHS faces and how we can support it because we live and breathe it. We feel strongly about using technology to enable a more efficient and sustainable NHS.
Steve Roest, CEO and Co-founder of PocDoc
This unprecedented year has witnessed some huge innovations and changes to healthcare, and COVID-19 has accelerated the requirement for pioneering health tech of all kinds. This year has also underlined the value that digital healthcare solutions can have when the health landscape changes rapidly and in unpredictable ways.
Due to our ability to offer digitally integrated, cost effective point-of-care testing for major diseases, the issues PocDoc solves for healthcare providers have been exacerbated and made more urgent by the pandemic. In addition, we were able to adapt the PocDoc platform to help directly in the fight against COVID-19.
The NHS Long Term Plan targets already included achieving a reduction in footfall to GPs and hospitals and increased equality of healthcare – all of which have been put under renewed focus as a result of COVID-19.
Our expansion into COVID-19 testing has seen us screen thousands of people across the UK, either in workplaces, in communities, in hospitals or through our own network of dedicated clinics. We even screened the cast and crew of the ‘Aladdin’ pantomime at the Newbury Corn Exchange – the show must go on!
David Hancock, Healthcare Executive Adviser, InterSystems
Software usability has been really important to clinicians and administrators – and poor usability has been a major contributor to burnout.
However, COVID -19 has [also] shown the issues of poor usability for patients. Despite the national adoption of solutions…the experience is that both doctors and patients revert back to telephone because it is easier and guaranteed to work. Too often, it is just too difficult for patients to use software and large numbers of video consultations have been abandoned because it is too hard to get to work.
Dr Gareth Parkes, Consultant Gastroenterologist at Barts Health NHS Trust and Co-founder of Ampersand Health and the My IBD Care app
Working in the NHS’ outpatients’ clinics, I see a variety of people living with the challenges of long-term inflammatory conditions like Inflammatory Bowel Disease (IBD – an umbrella term for Crohn’s and Colitis).
Due to the success of our digital therapeutic methodology, we’ve been able to transfer our learnings from IBD to other long-term inflammatory conditions, such as arthritis and even more widely into haematological disorders, which means that more and more people will be able to benefit from our tried and tested approach.
By helping to improve outcomes we can also reduce the outpatient burden on the NHS.
Vijay Magon, MD, CCube Solutions
While the shift from paper to digital has been ongoing for years, many industries remain behind the curve, but this year embracing digital transformation is no longer an option – it has become an essential strategy. The next processes to be digitally transformed will, in comparison, become easier to implement.
In the post-COVID-19 world, 50% of the people will go back to offices, but many will realise that they were wasting a lot of time travelling and adding to the pollution, thus choosing to work remotely. Remote work is the ‘new normal’.
Dr Chris Whittle, CEO and Founder of Q doctor
2020 has been a year like no other. Almost every industry in the UK has been negatively impacted by the pandemic, and none more so than the healthcare sector. However, in these strange and uncertain times, it has been remarkable to see how medical practitioners, nurses, scientists, entrepreneurs and investors have rallied together in the face of these challenges and used their expertise and skillsets to provide the much-needed solutions.
We have also seen a big shift in how developments in health technology are approached. In the past, the NHS faced numerous obstacles when implementing new technology due to a lack of infrastructure and digital maturity, funding, skills and roles and clear guidelines. However, during the current pandemic, the barriers to change have been overridden by necessity, so it is critical that we’re able to maintain the momentum to ensure people can access the healthcare support they need, when they need it.
There is also much to be learned from the COVID-19 pandemic so that collectively we can build a sustainable solution that supports and benefits clinicians as well as patients. Ultimately, health tech is there to support our frontline professionals by giving them a solid infrastructure within which they can work – freeing up their capacity to focus solely on ensuring their patients get the right care, at the right time.
Tim Quainton, Managing Director, Silverlink Software
The level of commitment across the entire health and care service during the pandemic has been truly humbling. And while it may not be sustainable in the long-term, I do hope the collaborative approach between providers and suppliers, and the shift-change in the use of digital in-service provision is maintained well beyond COVID-19.
During what has been a difficult year for all of us, as a company we have learned a lot about the way we approach our work and the importance of being able to adapt to situations quickly to meet the needs of our customers and staff alike.
With the demand for non-face-to-face interactions at an all-time high, we prioritised the development of a new eLearning platform for our patient administration system (PAS). We are also immensely proud to have supported the NHS Nightingale in Harrogate by supplying our PAS free of charge from when it was opened in April 2020, ensuring that clinicians could access underlying data about patients from across the region quickly and easily.
Lastly, we realised how valuable our business continuity plan has been. Each year over the festive period we normally review and update it — none of us thought we’d need to roll it out in March, as we made plans for staff to work remotely, or that we would still be running it in December!
Dr Elina Naydenova, CEO and Co-Founder, Feebris
The challenges of 2020 have accelerated the implementation of health tech and have meant that frontline workers have faced unimaginable challenges and have adapted and transformed their work to integrate solutions like ours to fight the pandemic. Without them our technology is inanimate, so we have always strived to innovate whist keeping the patients and users at the core. NHSX has now funded the deployment of our platform as part of the UK’s COVID-19 technology response and we have effectively supported care homes and GPs across East London in implementing remote monitoring for elderly patients, enabling vulnerable individuals to receive quality care whilst staying safe and isolated during the pandemic.
Richard Craven, Chief Executive of CliniSys
There have also been some permanent changes to pathology services. There has been a huge investment in testing for Covid-19 screening, and I think that surveillance will continue to be a big thing, not just so we are ready for future public health incidents, but because further investment in diagnostic services and technology will increase capacity and demand.
On data, the coming thing is computational pathology, which means that, as diagnostic data becomes fully digitised smart use is made of it to help our customers run their labs and clinicians at the workbench make better, more informed decisions. We also need to join up wet-lab data with other sources, like the information coming out of our new genomics LIMS, GLIMS Genomics as well as other observed data from electronic medical records.
And we need to integrate our systems with our new remote working tools, so it can be used by clinicians for informed diagnosis and treatment choices. That will encourage a shift in clinical expectations; if people can work from anywhere, they will do that. We will see pathologists basing themselves where they want to be and working for different hospitals and organisations.
Finally, we expect to see further changes in patient engagement, with a shift from the virtual consultations that we have seen this year to virtual everything.
In the longer term we expect to see the ‘Amazonification’ of healthcare. People have lived their lives online in 2020. Starting in 2021, they’re going to expect to order their own tests and get their own results; and the impact of that is going to be fascinating.”