In this HTN Industry View, sponsored by Highland Marketing, the series returns to explore the biggest challenges facing health tech professionals in 2021. We asked the industry to tell us about the hurdles both they and their organisations are facing, as well as what they expect the sector as a whole to tackle as the year progresses.
But more than that, we also wanted to hear your ideas and solutions for how to address these issues, and share these with our audience. We received a broad range of replies from industry profs, considering a number of different perspectives on topics such as funding, COVID and the cloud, through to the need to speed up innovation but also sometimes why it’s important to slow down, too.
The big four
First up, health informatics expert and former NHS CIO, David Kwo, outlined his top four areas of focus.
He said: “The four main challenges for UK health technology are: vision – we need a unifying digital vision for the NHS and ICS; core values – this requires leaders to change NHS values from competition to collaboration, empire building to collective planning and “my trust at the centre” to “the patient at the centre”; conversation – we need open, empathetic conversations to co-design the vision and agree the role of shared care records, open systems platforms and EPRs comparing functionality, scalability, deliverability, and data quality.
“We need to measure data quality for each of these options,” he concluded.
Money, money, money
Our health tech respondents raised financing as a key area of concern. But not necessarily the lack of it, focusing instead on the need for funds to be funnelled into the correct places – and more equally distributed.
Martin Bell, a digital and tech consultant with the The Martin Bell Partnership, explained that, “money does flow, but [is] not always evenly or timely in its distribution.”
“Recent announcements about the amount of digital funding available for primary care are welcome,” he said, “but equally, there remain significant gaps elsewhere and a complete absence of a long-term, sustainable, overarching NHS IT strategy that is properly funded over more than the life of the next comprehensive spending review.
As a solution, he suggested: “Surely, it’s time to have a comprehensive, long-term, sustainable NHS and social care digital funding settlement, to reduce complexity, drive appropriate uptake, usage and delivery across health and care.”
Dr Ewa Truchanowicz, Managing Director, of Dignio UK also discussed costs, but from an end-user perspective. Placing the responsibility also at suppliers’ feet for this, she noted, “if a patient has diabetes and goes on to develop cardiovascular disease (CVD), mental health issues, or any number of conditions, the technology deployed to monitor diabetes needs flexibility…if suppliers are truly interested in person-centred care, that expanded technology use should not cost more. This agility is key for patient experience – we can no longer expect someone to adapt to a myriad of apps for single conditions; technology should adapt to their needs.”
Tackling the red tape
Many of our replies also brought up that, despite such rapid improvement and acceleration during the COVID-19 pandemic, many obstacles still remain. With recent events having arguably proven that red tape can be navigated in a much smoother manner when there’s urgent need, there’s an enthusiasm for using this as a springboard to implement quicker…
Bryn Sage, Chief Executive of Inhealthcare, said: “As healthcare technology becomes more mainstream, the market becomes more attractive to new entrants. Within the NHS, there are different levels of knowledge at different organisations at different stages of their digital journey. But over the last year, we have seen a sea-change in attitudes towards adoption of healthcare technology.
“We have various initiatives from the centre to help put more integrity into the procurement process, such as the Digital Technology Assessment Criteria for health and social care (DTAC),” he continued, “which, coupled with medical device regulations are putting a great deal of attention on compliance. While necessary, it is overcomplicated, risks duplication and could divert energy from innovation and transformation.”
David Newell, Managing Partner, Gemserv Health also urged health and care systems to keep up the momentum, stating we”must build on the pace of change and capitalise on what has been learned”.
He added: “We know that, historically, technology adoption in healthcare has been slow, with NHS paperless targets coming and going over the years. But the pandemic has necessitated major changes and demonstrated that digital services can bring great benefits. The rapid adoption of these processes has highlighted that technology can have a major positive impact on the delivery of care, and that it doesn’t require £100m of investment or a three-year lead-in time with an acute trust.
“We need to build on this momentum while also looking at how to tackle the issues around health inequality as related to socio-economic factors. Let’s focus on how we can drive change efficiently and effectively: rapid piloting of digital services; iterating and refining; rolling out at scale; and being agile to make quick changes when required, to deliver huge benefits to all.”
Dr Lloyd Humphreys, Head of Europe for SilverCloud also highlighted the need for a better regional approach to collaboration, and using existing solutions to quicken outcomes. He said: “It is essential that rhetoric does lead to ringfenced spending on preventative approaches, using digital solutions that have an evidence-base and that may already be used in other workstreams.
He also suggested, “encouraging a more creative and collaborative approach for the use of digital technology.”
“This should entail wider dissemination within a trust, for example, of digital solutions that might be effective across a number of clinical teams, to “sweat the assets”, but also taking a more unified regional ecosystem approach, whereby clinicians and patients – safe in the knowledge of interoperability and ease of use – can find digital technology from multiple vendors in a single place.”
Lynette Ousby, UK Managing Director, Alcidion, added: “Technology vendors must support clinicians in making the right thing to do the easiest thing to do, now more than ever. Consolidating data from existing systems, and clinical insights drawn from that data, can play a big role here. Technology vendors have a responsibility to make data easily usable and useful for frontline NHS staff.
“Whatever digital strategy organisations have embarked on, NHS trusts, ICSs and health boards need ongoing flexibility to choose which technologies are applicable for their needs. If NHSX continues to work with providers and suppliers to build an open ecosystem, we have an opportunity to overcome many historic IT challenges rapidly.”
Speeding ahead at scale
Equally, while some commentators expressed the need for greater speed in health innovation, many also spoke of concern over pace – citing that as one of the challenges, rather than always a solution.
Infinity Health, CEO, Elliott Engers, commented:–
SMEs and the life science sector are already doing great work on evaluation. There now needs to be a focus on the system, supporting senior decision-makers so they can confidently drive adoption.”
If there was, say, an innovation portal where trusts could publish their priorities, it would make matching solutions much easier.”
Nader Alaghband, Founder and CEO Ampersand meanwhile felt that, “while digital health solutions have been adopted at ground breaking speed to overcome the pandemic, the policy makers have struggled to keep up with the pace.”
T for training
Focusing on similar themes, Dr Alex Young, CEO of Virti explained that the pace of innovation in the healthtech sector has “accelerated rapidly over the past few years and, although this is incredibly exciting, it’s also presented a new challenge: how can we make sure that healthcare professionals can access the best training in the use of each new tech tool?”
“It’s essential that the intended users of any new technologies properly understand how to deploy them for maximum impact. If poor quality training is delivered, the full benefits of any new tech, system or solution will not be realised. Modern healthcare professionals need on-demand access to training that is cost effective, scalable, interactive, evidence backed, data-driven and reflective…[and] which offer the chance for learners to explore new tech tools, make mistakes and refine skills in a virtual environment.”
Bobby Zarr, Senior Director of Healthcare Strategy at ANCILE Solutions focused on training as well, in regards to the implementation EPR, which he acknowledges can be “costly and time-consuming”.
“Organising training to help clinicians and administrative teams to use it, can also be a logistical challenge,” he stated. “But if staff don’t fully understand how the technology works, they might not use the system properly, leading to frustration, inefficiency, and even patient safety concerns. If clinicians and healthcare staff can access the training they need, online, in bite-sized modules, when they are actively using the EPR, they are more likely to get the information they need.”
Paul Bensley, CEO of X-on also added further thoughts on this topic. He said: “The pandemic has accelerated adoption of technology into healthcare, particularly in the fields of remote monitoring and consultation where investment has sometimes been haphazard. Suppliers have had little option but to join the gold rush. In primary care we have significant success stories, but then also cases where the new tools have been cast aside as “too hard to use”.
“The challenge will now be to see how the quick fix solutions can be rebuilt into integrated workflows that benefit patient choice. There are tools to manage patient demand and improve self-care without removing accessibility, but these need more than technology. The business process consultancy is a difficult challenge particularly when dealing with the granular business structure of General Practice. We expect to see an acceleration of the scaling process over the coming year.”
As agreements put in place for the pandemic also begin to expire, Alan Lowe, Managing Director at Visionable, sees this as a positive moment for all to reassess. “Some of the national contracts that were placed in the early days of COVID-19 are now coming to an end, giving emerging ICSs the opportunity to evaluate whether the solutions they adopted then will work for them in the new world,” he said.
“It will also give them the chance to consider how technology such as video calling can be combined with other solutions to create a platform for digital first services that work for the system, clinicians and users.”
The COVID-19 pandemic has, of course, still figured prominently in most people’s thoughts, with the long-forewarned NHS backlog and concerns around that now taking centre stage, as clinicians are likely to be more stretched than ever. How will long waiting lists impact the implementation and buy-in for new innovations going forward?
Martin Bell’s thoughts on this were: “Head space in health services to push forward with transformational change, even if it might help with the awful pressures that exist, remains limited – and at best variable between organisations and geographies, yet many are doing it. It does create a variable and challenging landscape for suppliers.”
Susan Venables, Founder and Client Services Director at Highland Marketing, instead chose to put the spotlight on how COVID learnings could be crucial – if only we could see greater collaboration.
“There is broad agreement that one of the main challenges facing healthcare is to build on the digital gains that we all saw during the first wave of the COVID-19 pandemic,” she explained.
“For that to happen, healthcare organisations and their suppliers need to be able to share news of what has worked and how it can work for others. Unfortunately, it has not always been easy for them to do that over the past year. The NHS state of emergency has enabled the centre to exert a close control over the communications that trusts can put out, and there have been times when this has stopped or delayed them telling others about great ideas, projects, products and vendor partnerships.
“We hope that as the NHS resets and integrated care systems come on stream there will be a renewed spirit of transparency and co-operation. We need these stories to be told, so digital solutions can be adopted at pace and scale, to enable the more efficient, high quality and responsive services that we all want to see.”
Following on from Susan’s thoughts on the need for clearer communication and greater co-operation, many suppliers have been choosing to showcase how they’re putting clinicians front and centre of their processes.
“We know that collaborating directly with clinicians is the key to success and therefore bring them into the process as early as possible so that they feel a sense of ownership and can directly see the potential impact,” said Rudy Benfredj, CEO and Co- founder, Mendelian.
“The world and healthcare has changed so much in the last 18 months, it’s important not to lose sight of how we can support busy healthcare professionals to reduce their workload in a meaningful way that also improves patient care.”
Clouds on the horizon?
As more and more companies also begin to now make their solutions available on the cloud, some of the responses also touched on this area and NHS adoption of such services.
Jane Rendall, Managing Director, Sectra said: “Answering the challenge of how the NHS can move more complex services into the public cloud merits focus from leaders. The onset of the pandemic saw a rush to mobilise services traditionally carried out in hospitals. This included moving complex and expensive workstations into professionals’ homes, to allow them to continue reporting on crucial patient imaging.
“This raises an important question: how can we understand the requirements of those services so that they don’t require that complex equipment onsite, and remove intensive computing from the physicality of a home or hospital? Answering that requires partnership: the NHS needs to talk to cloud experts in industry and the cloud experts need to listen, and respond. Resulting understanding could release scarce expertise from bricks and mortar and make it available to many more patients. But we will only find answers if we take the time to understand where and why cloud transition isn’t already happening.”
Fenner Pearson, Managing Director of AMaT, added: “Audit is one of the most important, yet often overlooked, tools in tackling some of the fundamental challenges in healthcare. By embracing modern, cloud-based systems, NHS hospital trusts and health boards can more easily determine problem areas and, crucially, set up action plans for improvement and then monitor these through to conclusion.
“This is far more efficient than paper-based auditing and demonstrably leads to improvement,” he said, “leading to higher standards across any hospital organisation. As readily available but highly secure digital methods are rolled out to the entire NHS, national benchmarking and sharing of best practice will be hugely simplified. Given that all hospitals already carry out huge amounts of improvement projects and auditing, using cloud-based, collaborative tools provides an easy method to leverage improvement from this activity.”
Looking after each other
However, as well as all of the logistical and technical challenges mentioned above, some of our readers reminded us of the need to ensure our digital progress also takes into account the human element.
Dr Humphreys of Silvercloud shared his opinion on this, stating: “Addressing the nation’s mental health needs is a huge challenge but it was heartening to hear the Queen’s Speech and the government’s commitment to addressing mental health both through treatment and prevention. Intervening early will be key to reducing the mental health impact, especially amongst younger people.”
Bruce Elliott, CEO and Cofounder at Memory Lane Games Limited, added: “The pandemic continues to take a great toll on the elderly in our society. The effects of COVID-driven social isolation are there to be seen: rising frailty rates due to inactivity; growing depression rates and even more worryingly, declines in cognitive function.
“But what we’ve also seen with our young team is their need to be back together in the office. It is not just our elderly friends and families around the world that have faced social isolation. We all need to “recover” from social isolation, beat the invisible loneliness many of us have felt at times.”
While Dr Ian Denley, joint CEO for System C & Graphnet Care Alliance, contemplated on how the industry can support health and social care services as a whole. He said: “Technology providers need to support health and social care services as they move from a provider-based service to Integrated Care Systems to manage the needs of their population and transform services. There is also a big emphasis on supporting health and social care providers to address health inequalities whilst they meet demands with waiting lists at unprecedented levels.
To do this, Ian suggested, “clearly, the government’s new strategy will require a major shift in approach and the expectation is that technology and data sharing will be central to success.”
We’ll be collating more industry views throughout the year. Catch up on our previous pieces, which focus on a variety of areas, from clinical communications tools to digital health technology standards.