As part of our Health Tech Trends series, we put forward a survey to gather the thoughts and opinions of health and care professionals and industry on a variety of topics. Here’s what our respondents had to say on what digital success could look like for integrated care systems in the next two years, and some practical ideas for achieving that success.
To begin, a major theme apparent from the survey was that of working together; 24% of respondents brought this up as a key measure of success, from noting a need for “interoperability between systems” on a site level, to “co-ordination with local, central and national” systems throughout the UK.
The need for collaboration with partner organisations was a recurring topic; “we want to create a culture of collaboration and integration, rather than competition and division. We all have the same goal of creating an open, connected ecosystem of health, and the way we do it is by working together.”
On a similar note, many respondents viewed the need for electronic patient records (EPR) as a priority in order to help ICSs operate successfully in the digital world. The need for user-friendly, smoothly-running and efficient systems was highlighted, with an NHS Lead Pharmacist emphasising the need to be able to share data with GPs, pharmacies and other partners “without any printing/scanning or PDF… all data transferred as structured items within the new standards.”
Ensuring that staff have access to technology that can support them in fulfilling their roles was raised as a practical way to support digitisation. One respondent suggested that having an onsite IT Manager role in place at each site would be of benefit to many staff, whilst at a GP practice level said that “free access to systems funded by our CCG” would be useful.
In our last Health Tech Trends feature, culture was highlighted as a major barrier in digitisation; here, it was brought up as vital for success. To a Digital Lead Nurse from an NHS Trust, success would take the form of “having great leadership [with] a clear vision of where the trust needs to be.” An NHS Consultant Clinical Psychologist and Digital Lead agreed, stating a need for “senior managers who are willing to say, ‘Yes, let’s try doing X’, rather than ‘hmm, no, we don’t think X will work so we’re not going to do it’.”
A Lead Pharmacist ICT from an NHS Trust concluded that “persistence in the face of apathy” is needed, both in order to ensure that a digitised ICS is successful, and in order to help it get there.
It’s clear that for many, getting the right culture balance – and often culture change – is vital. “Again, it’s acceptance,” said the CEO of a company working on artificial intelligence solutions within healthcare, when asked what is needed to make success happen. Another respondent added that “communication, breaking down silos, agreeing to a direction, regular reviews and alignment of strategy” are all important for success, whilst another suggested that “improved governance and ways of working” are key, along with “cultural and leadership support.” The same respondent also placed some emphasis on communication with patients, adding that “better sharing of how to tackle self care” would be a practical way to support ICS success and healthcare overall.
On the topic of patients, some respondents were firm in their belief that any success has to begin and end with them. When looking to measure success, an NHS Pharmacist stated that, “reduced readmissions is the end point test of improved discharge quality”, whilst the director of a digital healthcare company added that ICSs need to “make space in the system [for] meaningful change… understanding patient need should be their starting point. What can be done to support patients at home, whilst they’re waiting, and whilst they are not getting the treatment they need. So practically, they should listen more to patients and allow that to focus their energies.”
Population health management was viewed as a route to success; “pollution data, housing data, traffic data, real estate data on where fast food shops are, education data, health and care data – this is true population management,” stated the director of a digital consultation company, emphasising the need for the NHS to work with councils “to change social policy” and identify and work on “the social determinants of health.”
In line with recognising and seeking to improve health inequalities, the managing director of an online platform for mental health services discussed how digital can help to solve the problem of geographic hierarchy via its ability to “give instant access to the specialist for your condition, no matter how rare it is.” They shared their view that “ICS success will depend heavily on how digital opportunity to remove geographic hierarchy of access is implemented across ICSs.”
Funding was repeatedly mentioned as an important practical way to support ICS digitisation, with one respondent voicing the need for government funding to allow the recruitment of staff with specific skillsets for these projects. “NHS organisation and funding structures need to align with the digital opportunity for accessibility and specialism,” agreed the director of the online mental health service. “This can only increase beneficial outcomes as more people get to see the right expert sooner. It will also cut out huge costs. The challenge will be to not lose the duty of care of the individual patient across the whole NHS. But this is where digital shines.”
Alongside funding, time was a key point. “Clinical staff [need to be] freed from clinical duties to be involved with implementing change,” said a respondent from a Northern Irish trust.
Finally, mention of the COVID-19 pandemic recurred throughout survey responses; interestingly, four separate respondents said that success for digital in an ICS looks like the work that happened in the pandemic, noting that, “the pandemic has forced everyone to consider new and better methods of work at all levels” and brought out a “can-go approach”, sharing their belief that momentum to build on all that has happened since March 2020 is an important factor in digital success.
Next up in the Health Tech Trends series, we’ll be looking into what organisations and individuals need to support them in their digital work – keep an eye out on HTN in the coming days for the next part of the series.
