Here at HTN we sent out a call for comment to understand some of the current market challenges, which proved to be a popular topic.
Outlining what those challenges are and how they can be solved – many of you sent in your views and perspectives. Below is a focused selection of some of the replies we received from healthcare professionals and tech experts across the industry and the NHS. We hope everyone enjoys reading each others’ thoughts…
“It’s never been more important”
For Dr Anas Nader, co-founder and CEO of Patchwork Health, he focused on staff burnout rates, writing: “From my perspective and experience as an NHS doctor, it’s clear that – in order to fuel continued progress – healthtech innovators need to collectively double-down on technologies and services that support the most important pillar of care delivery: health and care staff.
“With rising burnout rates and an ever-growing list of NHS vacancies, it’s never been more important for innovators and decision makers to put people at the top of their agenda. This means exploring ways that we can better support healthcare staff to work safely, healthily and sustainably, whilst continuing to deliver exceptional patient care.”
Continuing with staff presented challenges, Andy Wilcox, Senior Solutions Marketing Manager, Imprivata, explained: “Continuing staff shortages mean that healthcare organisations are relying on a more transient workforce to deliver services, utilising bank nurses, students, locums and agency staff. There is a huge challenge in managing joiners, leavers, those working across different departments and remotely, to provide access to patient data and clinical systems securely.”
Richard Wyatt-Haines, Chairman at HCI expressed that because there is a shortage of staff, there is a lack of capacity and energy. “This means that whilst everybody knows they need to get on and make change by re-designing pathways and using digital first whenever they can, on the ground they just don’t have the mental space to make it happen.
“Longer term, the potential is enormous but it means people need to find a way to lift up their heads, paint a picture of what is possible and bring people along with them to make it happen. This demands strong leadership skills at all levels and in all places.”
“Digital tools must rise to the challenge”
Liz Ashall-Payne, founding CEO of ORCHA, felt the care waiting list is the biggest challenge: “The harsh reality NHS leaders are faced with every day is a 6m elective care wait list. Digital tools must rise to the challenge. Those which help with high volume and low-tech support can really come into their own now. For example, one app on our ORCHA libraries helps reduce the need for pre-operative assessment appointments in MSK by 60%. The savings in staff time could be massive.
“But if I could solve one thing, it would be digital health education. Our fantastic doctors and nurses must have not only the best digital tools, but also the confidence to embed them in care pathways.”
Dr Owain Rhys Hughes, founder and CEO of Cinapsis, followed on the theme: “As a doctor, it’s been incredible to see the roll out of some really powerful solutions to tackle elective care backlogs, streamline clinical communications, support remote care delivery and much more. However, as tech capability progresses and our dependence on digital tools increases, it’s vital that platform interoperability and data security are not left by the wayside.
“At this moment, my colleagues and I want to see even more robust regulation and stringent standards introduced across the healthtech sector. Cooperation and trust needs to be nurtured between suppliers and customers, so that clinicians and patients can embrace new technologies safely and confidently.”
Sam McMaster Director of Telehealth HSL highlighted the limited interoperability between different parts of the healthcare tech spectrum: “Without a standard that covers the scope from devices to big health systems and everything in between then it is left to the vendors to develop systems in islands of connectivity and interworking ability. This is a challenge that will limit the adoption and use of new systems and practices within the hospital, in homes/care homes and in hybrid care.”
Melissa Morris, CEO at Lantum, focused on the challenges of procurement: “An important area where the healthcare industry should modernise in order to gain access to the best technologies is its NHS tendering process. The current system is time-consuming, convoluted, favours larger companies, who can often dedicate entire departments to submit tenders. Each individual tender is a lengthy written process requiring weeks to complete. Whilst smaller agile companies often have more innovative products based on more modern tech stacks, they often struggle to navigate these hurdles and sometimes are unable to engage in it at all due to resource constraints.”
“This is both the biggest challenge and the greatest opportunity”
Simon Tobias, sales director at OLM, explained his challenges: “One would be hard pushed to find a health or social care practitioner recording a person’s data on a machine which doesn’t have access to the internet. That said, one would be equally hard pushed to find organisations using those capabilities to the full. This is both the biggest challenge and the greatest opportunity currently facing OLM. With the burdens of data capture so often cited as a barrier to efficiency; cloud-based software offers the solution. Data captured incidentally as a part of human interactions with citizens, shared securely between systems is key.
“Moving forward, building the connections and confidence to use this data to its fullest will reduce administrative burden and can put citizens in control of their own information.”
Peter Corscadden of Hyland Healthcare, said: “There’s a real risk of change fatigue, with both the NHS and independent healthcare providers being told that they must transform everything, right now. As a result, some projects may not be getting the resource and planning they deserve.
“If I could change one thing right now, it would be to give healthcare organisations the time, resources – especially trained personnel, and leadership to allow them to focus on the transformation projects that matters most to them.”
Markus Bolton, joint CEO of System C and director of Graphnet explained that there are still challenges from the COVID-19 pandemic: “One of our immediate priorities is doing what we can to help the NHS and other care providers to recover from COVID-19 and the increased pressure on bed availability and workloads.
“In response, the System & Graphnet Care Alliance is focused on supporting the major drive to bolster remote monitoring and virtual beds outlined in NHS England’s 2022/23 priorities and operational planning guidance. The document has asked for the equivalent of 5,000 additional hospital beds and Graphnet/Docobo are targeting over 250,000 remotely monitored patients to help our customers meet this demand.”
Lisa Riley, Vice President of Strategic Product & Partnership Development at VitalHub UK stated: “The COVID-19 pandemic forced the adoption of digital technology at a speed not seen before in the NHS and saw an astronomical growth in the use of health technology to efficiently manage patient flow. However, a disparity in digital maturity within and across different sectors of care, along with human, cultural and political barriers, has made digital transformation an even greater challenge. Identifying gaps and prioritising areas for improvement are essential, if we are to implement and drive digital change in the short and the long term.”
Dr Raza Toosy, GP Principal, and creator of PatientChase and PatientLeaf, said: “As a GP, the current challenges we face is managing the overwhelming volume of work coming through on both the reactive side as patients are coming out of COVID with held back complaints and on the proactive side as QoF starts again.
“One thing I would use tech to try and solve would be a digitally inclusive way of prioritising patients so the right patient sees the right type of health care professional with the right experience in a timely manner which doesn’t need to be a GP. The focus should be on time to a decision-maker, ie how long between patient contact to when they have a decision on their care. Currently, it sometimes feels that patients have to jump through hoops before they reach someone who can help them.”
“There are too many conflicting forces at work”
Chris Robson, CEO of Living With Limited stated his challenges around interoperability and EPR systems, saying: “If we could solve one thing in the next 6 months, it would be clarifying and resolving the confusion that is “interoperability” in the NHS, so that we could deliver what our NHS customers want.”
Touching on the same topic, Vijay Magon, managing director of CCube Solutions stated: “The growing adoption of EPR systems is an important first step to improving access to health information, but far too many healthcare organisations believe that EPRs are all that’s necessary for digital-enabled clinical transformation.
“The fact is, as much as 80 percent of the information that exists on a patient is unstructured (e.g. in clinical documents and medical images) and lives outside of the EPR in a number of systems and repositories. Creating a true single source of patient information means capturing and consolidating this unstructured information and linking it to the EPR. Embracing digital transformation is no longer an option – it has become an essential strategy.”
Dr Owen O’Sullivan, Specialty Registrar in Forensic Psychiatry at West London NHS Trust explained another reason on why EPR’s are tough: “A challenge facing clinicians within the NHS relates to the mushrooming of administrative tasks that must be undertaken on electronic patient records. Many of these relate to logging clinical interactions, outcome measures and charting other organisational metrics. Whilst some of these may be important on an organisational level, on a user level there is neither marshalling of any boundaries to this with respect to clinicians’ workloads nor is there consideration given to cohesive and intelligent user interface design to support these tasks’ completion in an optimal manner.”
“So what are the alternatives?”
Marcus Baw, a GP and software developer, said his biggest challenge is funding. “My biggest concern about the future of health tech is that we simply won’t be able to afford all the technology that’s being developed, while still paying full whack for simple, commoditisable software such as for PASs, OrderComms, EPRs, and suchlike. In other industries there is a ‘trickle-down’ effect produced by the commoditisation and simplification of core technologies, which become cheaper, enabling that spend to be diverted to newer value-adding technologies.
“However, this isn’t happening in health tech. We’re paying ever more for our EPRs and yet in the future we’re going to need systems that can handle Precision Medicine, Genomics, Proteomics, and other forms of individualised care. We simply can’t afford it. So what are the alternatives? At the moment, very few. But open source could be a way to reduce this cost and commoditise simpler systems, while broadening the reach of open standards and making it easier to develop future systems.”
Explaining his implications and recommendations, Stephen Sutcliffe at NHS Shared Business Services said: “I would suggest that it is both a financial constraint (naturally), an ability to prioritise which will bring value and then also the change management required to implement the technology. If I take ERP SaaS and the move to evergreen and standardisation, the need for NHS bodies to coordinate and move towards an operating model that supports an optimal solution is a large scale change.”
Iain O’Neil, Director of Health said: “If I could fix one thing it would be to get all digital and transformation funding agreed for at least three years to allow people to bring their situational awareness to the challenges we’re facing. This would lead to better planning and better strategy as well as bringing stakeholders more fully in on the journey. It also gets out of the ‘boom and bust’ cycle of annual planning that is so very prevalent in our ways of working.”
Peter Snuggs, COO at Definition Health commented on the impact of the Elective Recovery Technology Funds acting as a ‘catalyst’ for many NHS trusts to accelerate their digital transformation programmes, and noted the next challenge. “The next step is to achieve true interoperability across the digital ecosystem. Whilst a great aspiration and something we have made significant progress towards with the major EPR providers, there is an ever-present danger customers allow perfection to block progress.”
Thank you for your comments!
We received so many amazing comments and it was a great struggle to fit them all on one page. The HTN team says a big ‘thank you’ to everyone who shared their thoughts with us.