Secondary Care

Health Tech Trends Series 2021: Northern Lincolnshire and Goole’s refreshed digital strategy in focus

As part of our latest Health Tech Trends Series, sponsored by InterSystems, our focus on digital strategies set out by NHS trusts continues.

In part one, we picked out the interesting digital and tech initiatives for the next five years, as laid out by the Wirral University Hospital NHS Foundation Trust.

Here, in part two of the series, we turn our attention to Northern Lincolnshire and Goole (NLaG) NHS Foundation Trust and its refreshed digital strategy for 2021-2024, which is intended to “align with the NLaG strategy, Clinical strategy, Integrated Care System (ICS) digital first and the Humber Acute Services Review (HASR) ambitions.”

The four key elements to the renewed strategy, as described by the trust, are:

  • Modernising infrastructure to support interoperability and integration of solutions
  • Integrating solutions, maximising functionality and creating a digital ecosystem
  • Positioning NLaG to integrate with the ICS to enable seamless patient care and flow of information
  • Actively engaging in initiatives that lead to a financially sustainable digital service.

Sharing many wider strategic objectives in common with Wirral University Hospital NHS FT – such as general aims around improving overall care, employee wellbeing and work environment, and collaboration – NLaG also picked out strong leadership and the need to live within its means.

Setting the scene in its foreword, the trust explains that it “provides health services to a population of 450,000” across North and North East Lincolnshire and the East Riding of Yorkshire. But, it says, to “deliver quality care and continue to be responsive” to its communities it must develop “new models of care” and “transform” ways of working to meet growing demands.

To do this, NLaG has highlighted “one crucial change” – to embrace and leverage digital technologies and “maximise the benefits they can bring”. Outlining its plans over the next few years, it hopes to “deploy new technology in numerous ways”, such as using digital innovation from real-time data and analytics and utilising robotic process automation to “take advantage of the delivery of precision medicine in the future”.

Updating existing technology, reducing reliance on paper and introducing an integrated health record to its hospitals and services, as well as aligning its work as part of the Integrated Care System in the Humber Coast and Vale region, finding creative ways to improve digital learning and implementing wearable technologies, are all part of its broad set of ambitions.

Interesting thoughts that the literature shares are that digital strategy is as “equally about business transformation” as it is about implementing new technologies, and that a “mature digital hospital should be where people want to work”. In regard to recruitment and retention, with the “competition for healthcare workers so high”, it says, “those that can offer a digital first experience are able to attract the brightest talent.”

Outside general organisational aims, while developing the strategy, feedback from a wide range of staff led to a recognition of the need to focus on the summarised points below:

  • Digital infrastructure – investment to improve existing digital infrastructure, so that staff have the right tools and equipment for the job, including new hardware and devices that enable working “on the go”, updated networks, improved remote working capabilities, and effective document management systems.
  • Digital health record – secure access to real-time information via a single source, which can be accessed across all healthcare settings.
  • Digital systems and processes – efficient and integrated working to support staff to store information in a paperless digital format in one place, through use of an enterprise information platform that captures and manages documents and connects them to core applications.
  • Data and information – harnessing technology to use data to provide insight-driven information that can be combined with business intelligence tools to provide departments with accurate real-time information and predictability algorithms to support planning and decision making etc.
  • Collaboration and innovation – working more collaboratively across organisations to capitalise on shared funding opportunities, and share successes, innovation, and best practice.
  • Digital as business as usual – developing a ‘digital leadership mindset’ to drive through changes and a digital first culture; encourage staff to develop digital skills and lead innovation, with digital initiatives supported by implementation and change management resources.
  • Digital triage and virtual consultations – utilising AI to support clinical decision making and having virtual consultations where clinically appropriate, so care can be delivered anywhere.
  • Digital communication with care providers – allowing patients to make and track healthcare requests, including appointment bookings, reminders, prescriptions requests, and test results, as well as enabling communication.
  • Empowering patients to manage their own health – creating a two-way relationship in managing healthcare, through access to verified apps and online services, as well as wearable technologies to promote self-monitoring.
  • Supporting patients in the community – ensuring any transformative changes are inclusive and working with the community to better understand the digital literacy and digital readiness of the local population.

Through engagement activities, the main barriers and challenges to achieving digital transformation within NLaG were identified as: current digital infrastructure and estates; resources – funding and staff; need for increased collaborative working; differing priorities and pressures.

Answering the question, ‘what will change look like?’, the trust says that “by adopting a digital first approach, patients, families, and care providers can expect”: better, more connected tools for frontline providers; greater data access for patients – to make more informed choices about their care; digital inclusion; a digital workforce through up-skilled staff, digital leadership and the embedding of digital literacy within the organisation; data integration and predictive analysis; using digital tools to ‘broaden the circle of care’ and join-up patient lifecycles; more virtual care options, such as remote monitoring, video consultations and tools such as messaging and reminders; and introducing innovation, such as AI, robotic automation and apps.

Within the trust’s full roadmap of recommendations for how to reach digital maturity as an organisation, level one included steps such as consistent devices and hardware across all sites, single sign-on for care providers, and maximising N365 functionality. While, moving up to level two involved steps like integration/ interoperability with other providers (HIMSS Community Continuity of Care Adoption Model), conducting 50 per cent of outpatient visits virtually, trialling remote monitoring devices, and adopting robotic automation for some administration functions and AI to support clinical and administrative processes.

Placed into year-by-year ‘strategic horizons’, the trust sets out aims up until 2024, but also goes beyond that with a map looking ahead at years five to 10. Years one to two are envisaged as including goals around devices that allow mobile working, single sign-on, virtual consultations and data warehouse capabilities, before years two to five move on to areas such as remote monitoring and population health management. Years five and beyond are expected to tackle AI, precision medicine and assistive robots.

To conclude, NLaG’s ‘next steps’ look at:

  • Financing the strategy, developing a four-year capital and revenue plan.
  • Improving infrastructure, through modernising devices and processes, migrating to the cloud, working with partners and conducting HIMSS, INFRAM and EMRAM assessments.
  • Digital literacy, engagement and digital quality oversight aims, such as recruiting, building digital resources, literacy support for use of digital tools and implementing a Digital Operations Group.
  • Eliminating paper documentation and consensus on an EHR/PAS approach, mapping patient pathways in the EHR.
  • Enhancing data quality and reporting, including a central oversight team that validates accuracy and improving the reporting dashboard.
  • Patient flow – conducting a market assessment to procure a command centre and use AI to assist with system level management of patients.

The full digital strategy from NLaG can be found here.

Take a look at other digital strategies featured in our Trends Series to contrast, compare and learn. Or visit our leadership channel to find other similar content.