For our latest industry view piece, we posted two questions to our health tech audience. We’ll be sharing the responses we received in a two-part feature, the first of which focuses on the following question: what is the biggest benefit that an ICS will derive from deploying technology?
Here’s what the health tech community had to say…
Simon Jay, Commercial Director of TellMi, said: “Technology provides the ability to scale, fast. Knowing there is a shortage of qualified counsellors and psychologists in the UK, there are many opportunities for ICS teams to employ evidence-based, high quality solutions that are proven to reduce waiting lists and provide instant access to services. By doing so, waiting lists will reduce, crisis situations will be lowered, and people of all ages can be supported much sooner in their journey.”
For Dr Kit Latham, co-founder and CEO of Credentially, there is “huge potential for new tech to streamline the operations of new ICS organisations, most notably by enabling a more efficient, more connected, and safer way of working. When the right digital tools are deployed, manual and paper-based processes can finally be phased out and replaced with automated systems powered by AI, computer vision and machine learning. This will significantly reduce the workload on staff, increasing capacity across the ICS, conserving resources and helping to tackle burnout.”
Getting collaborative working right is essential for success at ICS level, Kit noted. “But this will be impossible to achieve without the right communication systems and the deployment of technologies that are properly integrated with one another. When the right tools are embraced to facilitate cross-border, joined-up working, organisation-wide efficiency will be transformed and the impact on patient care delivery will be significant.”
“Technology can drive efficiencies and reduce operational and resource costs as well as freeing up time”
Chris Norton, Managing Director in UK & Ireland for InterSystems, commented: “It’s hard to pick just one benefit of deploying technology for ICSs, because if the correct technology is implemented – one that supports a collaborative way of working and data sharing among trusts in the ICS – it can bring about a series of long-lasting benefits that will support them on their digital transformation and innovation journeys.”
Some of InterSystems’ recent research found that 81 percent of healthcare organisations cited that keeping pace with patient requirements was mostly driving innovation within the organisation, Chris shared. “To help support them to achieve this goal and drive these initiatives forward, implementing technology that can facilitate electronic data flows to bring data together can allow ICSs to boost collaboration across health and care settings, allowing for better use of resources, easier sharing of data, and ultimately, will provide that much desired improved patient experience.”
He added: “By supporting a single integration environment across the ICS, data technology can also drive efficiencies and reduce operational, and resource costs, as well as freeing up healthcare workers’ time. The cross-organisational information flow supported by technology will, in turn, be able to help ICS partnerships to deliver on the NHS Long Term Plan, which aims to remove traditional divisions between the different organisations responsible for health and social care in England.”
“An ICS is built on communication,” said Brian Boys, Managing Director of Kingsfield. “When organisations work together in such a way, it is imperative that they have the tools at hand to connect and collaborate as quickly and easily as possible. Relying on outdated means of communication can lead to delays and even information being lost altogether. Having up-to-date devices within an organisation means that information can be passed on without the need for repeated notes, travelling back and forth to relay relevant info or needing patients to attend in-person appointments in order to record up-to-date medical info. The results of a streamlined workplace mean improved outcomes for patients and staff alike.”
Mark Burton, Health & Social Lead at Virgin Media O2 Business, noted that the NHS Long Term Plan and the Department of Health and Social Care’s Digital Plan both set out “bold ambitions to digitise, connect and transform health and social care. The formation of the ICS structure is also providing an enablement pathway towards true transformation.”
Success in achieving these plans is “dependent on the development and enablement of technology,” Mark said, “the foundation of which is a digitally enabled infrastructure across the system that is scalable, dependent on the digital needs of healthcare eco-system. Technology touches every aspect of the healthcare eco-system… The biggest benefit in deploying technology will be the efficiencies that technology enable.
“Solutions already exist for a future digitally-enabled healthcare system which will provide round-the-clock monitored care in the community. This will allow individuals to remain in their own homes with the security and peace of mind of continued monitoring of their physical and mental health care needs. Preventative care pathways can significantly alleviate pressure faced in physical hospital environments, with fewer people requiring in-patient treatment. For this to happen at pace, digital technology will have to play a central role – connecting people and care providers across the healthcare eco-system taking a true ‘population health’ approach.”
For Matthew Riley, Head of Informatics at Here, the biggest benefit is the “cultural change that ICS thinking can introduce; discovering the ‘art of the possible’ as we think across organisational boundaries. Where is care happening? How do we enable exceptional care through technology? This means being much more open to working with the wider health and social care community. It also means being prepared to use technology to shift the point of delivery so that patients have more control over where, how and when they receive care. So, we need to move beyond the view that technology is there to just make the things that already exist more efficient.”
“Technology projects offer the chance for an ICS to totally reset the clinical user experience”
Andy Kinnear, Partnerships Director, Ethical Healthcare Consulting, agreed: “In my experience, the biggest benefit will be cultural. Technology projects offer the chance for an ICS to totally reset the frontline clinical user experience and create a far more joined up system. The NHS has repeatedly failed to get the full benefit of its technology investment because organisational boundaries, clinical fiefdoms, and disparate budgets, none of which have focussed on the best technology design for a single geography. By removing that barrier in time, then the benefits should include faster access to key data through even more record sharing, more efficient procurement servicing a combined ICS architectural vision, financial savings through combined back-office services, happier clinicians. My view is that it will be the technology programmes that will drive the creation of a new ICS culture.”
Commenting on how their product is being used in the NHS in North East London, NEC Rego’s Managing Director David Ezra noted that a “major proven benefit” of switching to digital referrals for secondary care has been “significantly reduced waiting times”. He shared how a project to switch to a digital referral management tool led by Barking, Havering and Redbridge University Hospitals Trust has “improved the number of patient referrals that are right first time by 70 percent in three months. The technology by NEC Rego will help them reduce the MSK waiting list by over a month, increase the number of available appointments, and provide earlier support to patients, by reducing the time between referral and treatment.”
Dr Noel O’Kelly, Medical Director at Spirit Health, said: “Technology’s biggest potential for long-term impact is to counter a perennial issue ICSs have experienced collectively and within their individual settings; working to improve patient flow.
“The benefits for an ICS are interconnected, as successfully hitting the first benefit leads to others further along the chain and maximises its impact. We know that technology can reduce an ICS’s hospital admissions, which in turn means ICSs are getting patients safely out of hospital and doing so more quickly. The broader impact is that it leads to patients getting improved access to the health services they need more quickly, their ability to do so is the currency on which patient flow is measured.”
Using technology as a “wraparound to increase clinical capacity” is a “huge talking point at the moment, and something that needs to happen to reduce the strain on the NHS,” noted Clare Morris, CEO of Rethink Partners. “This could include staff and clinicians using technology as part of their clinical work, using technology to create a really smooth and efficient admin environment (HR, clinical notes, RPA) and it’s a big untapped opportunity to use technology to get people and patients to self-serve, self-care, self-monitor and self-report. This could deliver a much improved service experience for patients, less-stressed staff, and more capacity for clinical care. Win, win, win.”
For Robert Miller, CEO of Wellbeing Software, the biggest benefit is “the improvement of patient experience, through better connected services and specialties spanning primary, secondary and tertiary care.”
Robert added: “But this is by no means guaranteed: the switchover to ICSs brings commissioning and planning of service delivery closer, yet ICS organisations have inherited a web of overlapping legacy systems, alongside existing organisational challenges that extend beyond technology.”
Truly integrated care would see clinicians with “easy access to all relevant information on patients’ health,” he noted, “with an effortless, two-way interface between primary care and secondary care, pathology and radiology, and other specialties. Used effectively, new technology provides patients with seamless care, spurred on by easy-to-use, interoperable systems that allow data to flow smoothly and swiftly.”
Vaish Khullar, Founding Data Scientist for Monitor Analytics, noted that “the primary aim of an ICS is to deliver joined-up care.” In Vaish’s opinion, “technology is the engine that powers that vision. The use of technology will enable us to increase capacity, reduce backlogs and be more effective in supporting both patients and clinicians. By reinvigorating the current technology ecosystem, we can evolve the culture and reduce the operational boundaries that have restricted us in the past.”
“The biggest single benefit any ICS can derive from deploying new technology is unlocking huge sets of rich, but previously siloed data”
“ICSs that deploy tech at scale across their different services will be far more likely to be able to deliver integrated care for their populations than those who take a siloed approach,” commented Dr Satya Raghuvanshi, Head of Clinical at Accurx. “For example, tech can be used to support DNA reduction across an entire ICS, not just individual services, through giving patients easier ways to get in touch with their care teams via online consultations and PIFU, as well as automated tech like appointment reminders.”
Satya added: “Communication tech implemented across an ICS will enable ICS leaders to deliver system wide efficiencies through improved optimisation and utilisation of services. For example, to reduce waiting times for services, simple patient messaging via SMS can be used to validate patients on waiting lists, or triage them to other services.
“For frontline staff, being able to more easily communicate and collaborate on patient care will deliver significant time savings, better connected services, and ultimately higher workforce morale. And for patients, these system efficiencies will translate into shorter waiting times and a more consistent experience of care, leading to improved patient satisfaction.”
Matt Cox, Managing Director UK and Ireland at Better, picked up on the point around the siloed approach. “The biggest single benefit any ICS can derive from deploying new technology is unlocking huge sets of rich, but previously siloed data,” he said. “However, this only becomes a benefit if the technology enables the data to be accessed by the person who needs it, when they need it, irrespective of the care setting. As many programmes focused on convergence take shape, they have the ability to embrace new technologies at a whole system level. These technologies have the potential to provide huge patient-centred data sets which can help our care services be more efficient and evolve more quickly.”
It is a viewpoint reiterated by Kenny Bloxham, Managing Director at Healthcare Communications. “Technology, alongside centralised data and a digital first approach should break down silos and open up the economies of scale needed across an ICS region,” said Kenny. “The combined transformation approach would allow an ICS to put the patient at the centre of its strategy, regardless of the setting or pathway, giving the patient a personalised care experience.
“Communication Platform as a Service (CPaaS) is not a new concept, but one relatively underutilised in healthcare… Deploying CPaaS technology would build on already successful examples of digital driving more efficient processes, such as automated scheduling and appointment reminders, IVR deflection, self-serve chatbots, waiting list validation, and patient initiated follow up. CPaaS uses cloud technology to simplify interoperability, and can be deployed rapidly across multiple communication channels. Using AI and NLP to drive and automate conversations will deliver productivity and efficiencies needed across the sector.”
Unlocking data silos in long-term condition management a key benefit for Paul McGinness, Founder and Chief Executive for Lenus Health. “The issue isn’t around a lack of data, but in fact a lack of structured data that is accessible across care settings,” he said.
“It’s estimated that chronic disease accounts for 70 percent of cost of care in the NHS. Technology will be the key to reducing variability and improving outcomes. Patients can be treated from home on digital pathways that move structured datasets between care settings and specialties. Better care coordination will reduce system wide pressures on the ICS’ by shifting care out of acute settings through proactive management.”
Alan Payne, Director for The Access Group, noted that “with ICSs expected to deliver whole-person care, they’re going to derive medium & long-term benefits from technology that works across the care continuum, from cradle to grave. And with interoperability ever-evolving, digital tools from a single ecosystem that connects across primary, secondary, tertiary, and community care, will unlock the benefits of fully integrated, and reduced friction services more effectively.”
From the Health Innovation Network South London, Director of Digital Transformation Amanda Begley and Head of Digital Transformation and Technology Darragh Twomey said that for the south London ICSs they work most closely with, the opportunities for technology to bring significant benefit are split by timeframe.
Amanda and Darragh said: “The main focus currently is on the infrastructure – achieving consistent levels of digital maturity across the region, information exchange programmes, and of course establishing a safe shared data environment such as the sub national secure data environments, which will all unlock widespread improvements for services and systems. There are also some relatively quick wins out there to support more efficient administrative processes through the use of automation and improvements in primary care telephony.
“Looking at the longer term, digital technology offers huge opportunities to improve care through integration into pathways and through population-level applications. Covid-19 gave us a glimpse of what anticipatory care and remote monitoring approaches such as virtual wards could offer. Now, the challenge is moving from local experiments to widespread adoption and integration, and broadening the scope to see what can be achieved looking at different levels of acuity and in mental health as well as physical health. There’s still a lot of work to be done in this space in terms of establishing new tech-enabled care models and working with industry to shape what procurement of these technologies at scale could look like.”
For Dr Richard Pratt, Clinical Director for Eva Health Technologies, “better coordinated, collaborative care with fewer siloes in budget and thinking” is a major benefit of deploying tech within an ICS.
“ICSs aim to wrap health and social care around the populations they support,” said Richard. “Rather than siloed thinking and budgets, we look for a more collaborative, harmonised approach as providers. As people accessing health and social care, we hope for better coordination of support, with varied needs more creatively met. Just like the care we aim to provide, the software systems that underpin delivery must offer seamless collaboration.
“There are two broad approaches to electronic health records (EHRs); a single, vast solution that covers the entirety of primary, secondary and social care. The other embraces an ecosystem of providers, with well executed interoperability. The merits of both approaches will continue to be hotly debated globally but in reality a comprehensive strategy will interweave elements of both.”
ICSs “will see a huge benefit from implementing health tech platforms which help people living and dealing with cancer,” said Paul Landau, CEO of Careology. “Digital cancer care solutions can be integrated into routine supportive care in oncology and provide more patient-centered care. This joined up approach has the potential to improve the millions of lives of people living with cancer by helping them to better navigate their treatment and be more in control of it. Digital cancer solutions can also provide better triaging and remote monitoring capabilities which prioritises those in need and allows clinicians to spot when symptoms need to be treated earlier to prevent the need for more acute care. We are already beginning to see how effective and efficient this is for oncology care teams who are able to be proactive rather than reactive.”
Paul Christie, CEO at Tachmed, highlighted the need for diagnostics technology to improve speed and ease of diagnosis and added: “Medical professionals will have access to devices that can provide faster results without having to wait days or weeks for confirmation and patients can get started on treatments much quicker. It can also be much more cost-effective making primary health services more affordable, accessible and effective at treating communities.
“We believe that by empowering people to take charge of their own health, it will take the pressures away from the hospitals and GPs who are currently battling to find efficiency savings across all departments. It will also free them up to provide emergency care more immediately, as well as prioritising surgical procedures and hopefully reduce waiting times for test results and treatments.”
Dr Rachael Grimaldi, Chief Executive at CardMedic, raised the point of digital exclusion. “Technology will play a huge part in reducing health inequality in an ICS context,” she said. “Results that are being achieved at trust level will be able to be scaled to have an impact across the ICS, supporting patients in hospital and in their communities. At Suffolk and North East Essex, patient engagement has been a core focus and they’re working hard to encourage technology adoption at every touchpoint in the patient journey. This will help to reduce health inequalities in hospitals, and in the community too.
“When it comes to commissioning technology, it will be important to consider how it will be deployed across an ICS, rather than focusing on individual settings. If we think about technology and innovation through this lens, we will be in a better position to improve population health and reduce health inequalities – two of the key ambitions for ICSs.”
“The priority myst be greater productivity in ICSs”
Technology gains can be found everywhere in the opinion of Tom Whicher, CEO of DrDoctor. “Given the pressure on health and care providers at the moment to find capacity, exacerbated by the ongoing acute elective recovery challenge, the priority must be greater productivity in ICSs,” he said. He shared how DrDoctor has been working with trusts in the Birmingham and Solihull ICS to free up capacity with digital waiting list validation and patient-initiated follow ups. “It has helped to identify at least 3,000 patients who aren’t in need of a follow-up appointment. And by ensuring patients receive the most appropriate elective care in a shorter period of time, means they are less likely to need other services, such as urgent and emergency care, primary care or social care, should their condition change or deteriorate while they wait – hence minimising the domino effect across providers in an ICS footprint and enabling better patient outcomes.”
Mark England, CEO for HN, commented on how he hoped to see machine learning to predict high intensity users of primary, urgent and emergency care implemented at ICS level across the country, with the benefit of reducing referrals to hospital and unplanned demand. “If more ICSs deployed machine-learning driven case-finding it would allow them to make predictions about which people are more likely to need care and intervene early. This would support the delivery of preventative, anticipatory and personalised care.”
If deployed correctly within an ICS, technology has “the capability to provide more joined-up delivery of services, improve patient safety and experience, while ultimately delivering better outcomes,” said Andy Meiner, Chief Revenue Officer for ReStart. “Furthermore, the biggest benefit for an ICS will be that it can use data to gain insights into diverting resources to where they are needed most which will improve services.”
David Kwo, former CIO and healthcare consultant, commented that the greatest benefit will come from “enabling truly patient-centred integrated care, designed around the patient, seamlessly across care-settings” and added that “integrated care can only really happen with truly integrated, single, shared, converged EPR systems within each ICS.”
Many thanks to all respondents for taking the time to share their thoughts and don’t forget to keep an eye out on HTN for the second part of our industry view feature, which will explore respondents’ thoughts on where technology can have the biggest impact within an ICS.