Jonah Aburrow-Jones, Director of Consulting, Strategy and Digital Maturity of Ideal Health, joined us live for the second session of our HTN Now Focus event on the topic of Digital Integrated Care Systems.
Using the slot to look at what can be done practically to help health tech professionals to understand and assess organisational maturity, Jonah also focused on how this can help with prioritising resources for the greatest benefits.
Jonah who previously spoke at our September HTN Now event on the NHS framework ‘What Good Looks Like’, began by providing some background on Ideal. He said: “[We are a] bespoke and specialist digital health consultancy. We work in a practice model…developing strategy and business cases, working with digital maturity, dealing with change – which is very much a golden thread in all the work that we actually do – implementation of those systems to get them up and running, training and the adoption of those systems through go live, and then optimising those systems through time.
“Sitting through all of this, of course, is data – data quality and RTT, and the focus now on elective care recovery being a big part of what we do and what we focus on.”
“We all know that technology doesn’t actually fix problems”
In this session, Jonah explained that he wanted to discuss organisational maturity and “go beyond digital” when considering this. “What I want to look at,” he said, “is where that sits, and some of the other things that will either make digital work, or not work.”
“We all know that digital is an enabler,” Jonah continued, “but it is one element of that digital transformation matrix, [and] much of What Good Looks Like recognises that digital is a core enabler of what they are trying to do – but there’s still a huge dependency, as there is with any other type of transformation, on the process, people and culture. The culture, I think, becomes increasingly important as we get organisations to work together.”
However, despite many digital strategies recognising this, Jonah added that there still isn’t “enough focus on the right sort of resources being allocated and recognising the level of change that’s going to be required…that change needs to be managed across multiple organisations.”
“There’s still that huge drive to ‘level up’, add more technology, be more innovative…those are all good things, but we all know that technology doesn’t actually fix problems.”
Moving onto the topics of navigation and prioritisation, as well as the benefits of finding the balance between mandatory initiatives and citizen and staff expectations, Jonah again picked up the thread on technology not being a fix-all, highlighting that the uptake of digital tools is “not just about buying them and sticking them in place and hoping they actually work”.
“We know that doesn’t work within a siloed environment within an individual trust – adoption requires good change, training and a long-term plan in terms of benefits realisation,” he said, adding that it’s important to also understand whether there is the capacity and capability available.
Focusing on his ‘three steps to great patient experience’, Jonah said: “The experience is sometimes thought of as being a benefit of better joined-up care. Actually, what it should be is about is engagement in terms of designing things together, with the people who are going to be consuming and utilising those systems.
“It’s a really important part in terms of making that transformation matrix work well. What you’ll also see is, by engaging with people in terms of co-design, listening to how they are working together, you’ll also see that that creates a genuinely citizen-centric culture, which is going to be pretty critical moving forward.”
“There are lots of different smaller programmes looking at inclusivity within key areas – cancer, maternity…this is something that needs to be built into the overall culture and the organisational design for ICSs,” he added.
“You must have both a data and an analytics strategy”
Discussing a ‘digital first’ approach, he stated that this could include “everything from individual EPRs [Electronic Patient Records], shared care records, the use of HIEs [Health Information Exchange], PHRs [Personalised Health Records]…and all the other solutions that will make this work and flow together.”
“Looking at things from a one-size-fits-all approach, we know won’t work. So, try and stay away from that as much as possible, even though it’s very tempting,” he stated.
On population health management (PHM), he commented: “You must have both a data and an analytics strategy before running away with PHM. Having robust data quality within the system before connecting multiple data warehouses and EPRs into data lakes will be something that, if we don’t do [it], then you risk having basically a garbage machine in terms of what you’re doing with population health management. You won’t be able to rely on that data. You get into the concept of ‘rubbish in, rubbish out’.”
Jonah also covered governance – emphasising the need for good board attendance and interaction and that not having clinical representation is “a mistake”, with different perspectives “important” to have on board during transformation. He also added that having just one form of staff training does not usually work and that, moving forward, workforce training should be high up on the agenda.
Other advice included that specific infrastructure at a regional level needs to be considered, including use of the cloud, automation and machine learning, alongside network design and accessibility.
Jonah also added that social care has much to offer, in terms of technology for person-enabled health and care and in developing solutions. “They’ve been utilising homecare and telecare solutions for many years,” he said, “in terms of how you can roll those up and expand those, those models can be leveraged, undoubtedly, to create much broader integration of devices in the future…it shouldn’t just be health-led, there’s an area where social care is undoubtedly more advanced than health.”
“An ICS is only as mature as its least mature organisation”
Looking at opportunities to improve maturity, Jonah suggested looking at four key areas – vertical integration, culture, data strategy and the scale of change.
Noting that paper is still widely used despite the prevalence of digital solutions, he reminded the audience “don’t forget that an ICS is only as mature as its least mature organisation” and suggested that more thought should be given to processes and people change when it comes to engaging with digital. While acknowledging that “digital should be first”, Jonah also stated that we need to make it “less frightening, less onerous” and “encourage people to see the art of the possible, rather than residing in the status quo.”
Mentioning that there are now a lot of “COVID-tired staff”, Jonah then moved onto addressing workforce and resources, and factoring that into the thinking. Sabbatical working, digital literacy and up-skilling were all mentioned, and Jonah added that there also needs to be a solution to the “wider population” learning to use systems too, to ensure inclusion.
In conclusion, Jonah also rounded off with his advice on what ICSs can do to improve maturity, recommending that organisations have a vision for a shared care record to understand how to prioritise and best use resources, and also to assess maturity versus the What Good Looks Like guidance, have a roadmap for everything and ensure everything aligns to clear patient flow. “Try not to boil the ocean here – it is just overwhelming otherwise, and spreading ourselves too thin,” he said.
And for his last point, Jonah summed up by stating, “whatever we are doing, we should adopt a patient-centred approach, looking at UX [user experience] in terms of designing all the digital solutions…citizen/patient engagement needs to be a central component in anything that we do in terms of the design and the development of digital services. Thinking that we know best, as either vendors or organisations, without engaging them is just wrong…it should be a mandatory requirement.”
To catch up on the full session, watch the video below:
