This week, the HTN team joined the health tech community for a very interesting virtual HETT Show.
During the week we attended the panel discussions and covered some of the themes and key discussion points:
- NHS digitalisation and the future role of NHS Digital; an interview with Sarah Wilkinson
- Integration and interoperability; putting in place the mechanisms for sharing
- Exploring the mental health impact of Covid-19 on healthcare workers
- Addressing diversity and health inequalities alongside tech innovation
- Industry collaboration on usability standards; moving away from a one-size-fits-all model
- Industry leaders on re-defining digital maturity
- Driving pathways to innovation; funding, standards and guidance
In this article we summarise some of the additional sessions we attended.
Growing digitally enhanced teams will drive innovation forward
Henrietta Mbeah-Bankas, Head of Blended Learning and Digital Literacy Workstream Lead at Health Education England, used her HETT Reset session to outline the importance of growing digitally enhanced healthcare teams, and how doing so can drive forward innovation in the future.
The primary challenge is accommodating the 3.1 million health and care staff within the UK, all of whom possess varying levels of skills and abilities as well as different approaches to learning. Mbeah-Bankas explained that digital users can be divided into four personas based on their relationship with technology—positive engaged, neutral ambivalent, negative disengaged, and those who are digitally excluded. There is potential that some healthcare workers fall into the latter category, which means they could be left behind with the increasing implementation of digital technology.
The approach to learning is often driven by motivation. Mbeah-Bankas explained that four key elements (motives, beliefs, collaboration and support) are what often drive personal motivation, and how they are relevant to an individual’s day-to-day life will impact their willingness to learn.
She also explained the importance of defining “digital literacy,” as this may be conflated with an individual’s ability to use social media. Health Education England describes it as simply the ability to live and thrive in a digital world.
Mbeah-Bankas explained that existing learning needs to be curated to ensure that it is fit for use, and that Digital Organisations must be examined to ensure that people are able to use their services. Technology must not be used solely for technology’s sake – it must be fit for purpose.
She emphasised that COVID has demonstrated a need for digital implementation, and that growing digitally capable teams will drive innovation forward in the future. Work must be underpinned by a digital literacy framework to ensure that no-one is left behind.
As she described it, “Enable, rather than inhibit people from using their digital skills.”
How the Royal Free has adopted automation
James Davis, Director of Innovation for the Royal Free NHS Foundation Trust, shared the organisation’s automation journey so far and talked about measuring success with automation programmes.
James opened with an introduction to intelligent automation and an important lesson when starting out: “It’s a piece of software to interact with any system at the front end, and tackle interoperability, to help share information. Royal Free has been using intelligent automation for a number of years, but a key lesson learned is that you have to take people on the journey with you. You might have some big idea in your mind, but that is just in your mind.”
In the session, James highlighted the need to build a world-class team, and spoke about the importance of having NHS knowledge involved and the benefits of developing talent from within. He explained that this should be by the NHS, for the NHS.
When asked about how the trust has measured the success of intelligent automation, James said: “When we speak with organisations nationally, the first question we get is how much money have you saved. If anyone starts this journey for a bottom-line saving, you will struggle. If you change the narrative it is to measure how much time has been saved. Our resources are limited, so we want our clinical and non-clinical staff to spend time on patient tasks, and more rewarding tasks.”
One example highlighted was to automate the recruitment process specifically to manage offer letters sent out. James said: “through intelligent automation we can send 300 offer letters in a night that would take a human 12 days to complete. That’s how we measure it to release time to spend on more value adding tasks.”
Finally, James concluded the session by highlighting the value of sharing information and lessons learned with others: “Our primary objective is to share our knowledge and the work that has been done already. It’s not a scary thing or too complicated, it does take expertise to do it well.”
Secondary care triaging and managing bottlenecks to optimise patient flow
Day two’s afternoon agenda included a panel discussion on secondary care triaging, and how understanding real time data can optimise patient flow and meet the needs of users, which would save staff time and much more.
Sam Shah, Chair of the HETT Steering Committee, plugged in his headset and posed the questions to the gathered panellists. His expert guests included:
- Paul Rice, Chief Digital and Information Officer at Bradford Teaching Hospitals NHS Foundation Trust and Airedale NHS Foundation Trust
- Neil Griffiths, Managing Director of Teletracking
- Julia Wilkins, Head of Data & Analytics at The Health Economics Unit.
On the role of tech within managing bottlenecks and patient flow, Neil said: “Let me talk about the acute… there [are] so many gaps between processes, and gaps between hand-offs. And wastage that’s involved in those interventions that perhaps need to take place, to make best use of capacity.
“What we see is actually, most folk and places don’t have the ability to measure some of this waste; they don’t know it exists. One of the big challenges is just trying to measure it, [and] understand where it is. Once you do know where it is you can do something about it.
“We talk in terms of…inpatient capacity. We’ve identified what we call idle bed time…the wasted time between patients. And it can be hours and hours and hours. Multiply that across an acute hospital, I think you’re looking at at least a ward’s worth of wasted capacity. Now in the current time that’s very precious, the system needs to do something with that…how are we going to realise the benefits of that capacity?
“Technology absolutely has a role to play in measuring. It then has a role to play in, I think, helping to introduce more efficient ways of working, really.
“Automation is something which we’d say can be applied to certain basic—but really important—workflows. Whether it be portering or bed cleaning, that really drives a huge amount of value…and I think actually they are often seen as the less glamourous end of the hospital, so don’t really get much attention. But actually, they are critical to get right.
“I’ve got a real passion about this. Because I think it’s bordering on disgraceful, really, that places are managing beds with paper, clipboards…walking around counting them. And that is going on now. So surely we can move away from that and introduce something new.”
Julia gave some further background on modelling. She added: “It’s very easy to show that improving patient flow and the quality of care that results.
“For example, reducing delayed transfer of care, leading to shorter lengths of stays, [and] therefore fewer hospital-acquired infections. You can see how all of these things are linked. And by reducing these sorts of gaps, and these delays…quality of care is improved, and efficiencies are improved. And of course the patient experience, which is so important.”
How automation will play its part in managing healthcare data
This HETT Reset session shared insights from experts on how AI had the potential to innovate healthcare in the future, and what action would need to be taken to ensure it meets standards.
The session was hosted by Chris Holmes (Alan Turing Institute), Peter Thomas (Moorfields Eye Hospital), Indra Joshi (NHSX), James Teo (Kings College Hospital NHS FT) and Max Jones (Agilisys).
The group examined how AI was being implemented into healthcare services and how it had benefitted staff and patients, particularly in the past 12 months. As Jones described it, “We can’t look at the landscape of AI without thinking of COVID.”
One of the examples given of the AI projects that NHSX are working on was the National COVID-19 Chest Imaging Database (NCCID); a centralised UK database containing X-Ray, CT and MRI images from hospital patients across the country.
The usage of AI technology is not without its problems, the speakers acknowledged. Teo advised that a common platform was needed instead of having several smaller ones, and that common agreed standards were required instead of constantly trying to reinvent them.
Joshi explained that a survey conducted by Madeon revealed that participants had a lack of awareness as to what RPA (robotic process automation) was, and a lack of financial/human resources required to implement it.
She also added that NHSX had published resources in order to make understanding and implementing AI simpler for companies. The first is titled The Buyer’s Guide to AI in Health and Care, and goes through the fundamentals of the technology. The second is called the ‘the guide to good practice for digital and data-driven health technologies’ and advises what makes AI ‘good’ and what should be avoided.
With regards to how extensive the implementation of AI will become, Teo reassured that there will always be a human element to healthcare—the systems will simply help to speed up the care process.
Integrated Care Systems as the launchpad for a digitally transformed NHS
A session hosted by Cathy Winfield and Karen Kirkham of NHS England and Improvement offered an insight to the ways in which Integrated Care Services (ICSs) supported the NHS during the COVID-19 crisis.
Kirkham explained how access to data enabled the NHS to decide where vaccine centres needed to be established. Information from population data allowed them to implement the centres in areas with greater numbers of cases, rather than relying on a “hunch” to figure out which areas would benefit from them most, the presenters said.
A secondary side effect of the pandemic has been the impact it has had on the population’s mental health. Winfield explained that data has shown the areas wherein a greater number of people have been prescribed antidepressants. One street, she noted, had at least one occupant in every household prescribed antidepressants.
It is hoped that the results from this data will allow the NHS to offer greater community support for mental health going forward. Areas with a higher number of antidepressant prescriptions can give healthcare services an idea of where they need to offer more mental health resources.
The digital transformation of the NHS now allows patients to get more involved in their treatment. As Winfield described it, “patients are much more engaged in their own care plan.” Both speakers expressed surprise at the public’s willingness to get involved.
They described patient involvement as a “new phenomenon,” but also expressed caution in regard to making sure that it didn’t lead to “digital exclusion.” Patients who do not have access to the internet or smartphone devices, or may not be technologically literate, do not have the resources that would allow them to access online healthcare. This puts them at risk of being left behind.
In addition to how digital transformation has impacted patients, Winfield and Kirkham described how the introduction of new technology was impacting NHS staff.
The need to move to digital has meant that some workers have been able to work from home. Some staff are reported to enjoy the new way of working, as it offers greater flexibility and a better work/life balance. For some, working from home has reportedly been difficult as they miss “human contact” and find it “isolating.”
Winfield and Kirkham advise that anyone working from home implements a schedule to their day just as they would if they were working from an office. They advise that workers make time for breaks and get up and go for a walk when they can.
