For our latest industry view piece, we posed three questions to our health tech audience: where in healthcare do you expect the most digital progress to be made? Does your expectation match your hope – do you think the focus will be on the areas that need it the most? If you could solve one challenge in health tech this year, what would it be?
To start the industry view, in a poll, we asked our audience to predict where they think the most progress will be made in health tech during 2023. 89 people took part with participants from a range of backgrounds including managing director, consulting director, chief clinical information officers, chief medical officers, chief information officers, clinical safety officers and others.
The majority – 33 percent – predicted that patient access and engagement will see the most progress. Participants selecting this option included partnership lead, senior programme manager, group chief information officer and regional director.
29 percent chose pathways and cross organisation workflows, with roles including research delivery manager, chief commercial officer, clinical lead and diagnostics lead.
Behind that, 22 percent said scaling remote monitoring. Participants for this answer included chief clinical information officers, chief medical officers, chief information officers, marketing communications manager and GP.
With 16 percent of the votes, the final selection was digital mental health. Participants varied from business development analysis, chief digital information officer, head of digital and global CCO.
On progress, expectations and challenges, here’s what the health tech community had to say…
Andy Webster, CCIO at Leeds Teaching Hospitals said it depends on where you work and what level of digital maturity your organisation is at. “For us we are continuing to build our foundations, improving systems resilience, modernising clinical systems, improving clinical engagement and adoption, and improving the experience of clinical users.” He noted an aim to focus on supporting their workforce: “for our digital teams, we want to ensure we can better meet the requirements of our clinical and non-clinical teams to better meet their digital requirements.”
Mike Fuller, Regional Director of Marketing, InterSystems, said that ICSs must make use of digital transformation to create more value from their disparate data, and to close gaps in services to provide better visibility, accessibility, customer experiences and outcomes. “Digital can improve the quality and cost efficiency of their services when used to reimagine and integrate services, providing more self-service options for services and users and also the provider’s staff,” Mike said. This will necessitate a new generation of shared care records because “many of the first generation are being patched beyond their serviceable limits, and the house of cards will fall.”
Mike would like to see “a boom in robotics and the mass adoption of 3D printing using plastics, ceramics, metals and now live tissue for customised prosthetics, reconstruction, orthotics, and organ grafts as the ability, affordability, and practicality eases.”
He also emphasised the importance of cyber security. “Clinical safety compliance remains I think too fast and loose a game. Tough conversations are needed and reality faced when employing personalisation and localisation using configurability vs. customisations and local application development.”
“The digital focus needs to be on finding solutions to some of the exceptionally difficult challenges currently faced within health and social care,” said Richard Jarvis, Chief Technology Officer for EMIS. “While we’ve seen lots of exciting innovation in terms of artificial intelligence and machine learning, this year the focus of the NHS and health tech industries needs to be on working in close collaboration to innovate operational level tasks to ease pressure points. Integration of systems and confidence that data can flow both freely and safely across the whole health service are key.”
He added: “The use of systems that deliver data insight to enable greater control over problem areas such as the management of hospital beds, primary care access and surgical waiting lists will be key. And we’re already seeing this become a reality as the NHS invests in and collaborates with health tech innovators.” In terms of the challenges, one of the largest hurdles is overcoming “the issue of mobilising patient data across health and social care. This is for both point-of-care access and wider scale analysis to spot trends for prevention and improved access to healthcare services.”
Dr. Rishi Das-Gupta, Chief Executive, Health Innovation Network commented that his digital expectations lie within digital tools to support patients waiting for care with long-term conditions or awaiting a procedure; tools to support staff training; and workforce scheduling tools. He explained how the “market has several new functionalities and this could be the year that competitors to HealthRoster gain traction.”
“Greater collaboration from health technology providers will be important in 2023 to ensure genuine solutions are provided to urgent challenges faced by healthcare organisations,” said Dr Mark Ratnarajah, practising NHS paediatrician and UK managing director for C2-Ai. This means “being agile, federated data platform ready, and interoperable now and for the future. The notion of competition is good – but a more co-operative approach from suppliers, in order to avoid draconian definitions of what technology can achieve, might be more helpful.”
Risk stratification will also be “fundamentally important in the year ahead as the NHS works to mitigate demand through anticipatory pathways.” Mark stated that these pathways will target interventions and support, and identify the patients who need help the most as they wait for hospital treatment. “But that works most effectively when the underpinning risk stratification tool can interoperate with other systems across an integrated care system, to enable a joined-up approach – for example with systems that understand capacity so that the most appropriate resources are put into action for the right patients. This might be equally useful to enhance current approaches to virtual wards, to help ensure the right people are given access.”
Jeremy Nettle, Chair of the Highland Marketing advisory board, expects the NHS England Transformation Directorate to launch the frontline digitisation programme to “level up digital capability at acute trusts and integrated care systems to push ahead with their digital plans. I hope that both things happen, because one of the things that we hear from the chief information officers on the board is that they need consistency when it comes to strategy and funding. We need to complete what we are doing, instead of trying to do more things.”
As procurements and deployments start to come through, Jeremy hoped that “NHS organisations maintain a focus on interoperability and usability as they do have the ability to improve this.” He also noted a hope that “we will see a faster roll-out of the kind of self-serve and remote technology that is common in banking, shopping, and other areas of the public sector. The NHS needs to use IT to address the challenges it is facing, while creating a better offer for citizens. Polling has shown that satisfaction with the NHS is declining, but if we could start to do that in 2023, I think we would regain a lot of trust.”
James Morriss, Director of Business Development at WiFi SPARK, said: “I think we could make real progress in 2023, if we see the development of two trends. The first is for health tech providers to form new partnerships, and the second is for the NHS to make better use of its existing infrastructure to get their solutions to the bedside. Why do we need partnerships?”
We need them, James continued, because “nobody has all the answers to the challenges that the NHS faces. Why do we need new thinking on delivery? Because we know the NHS lacks the resources to deploy all the technology it needs from scratch; and it needs to make better use of its existing infrastructure. Wouldn’t it be great if 2023 was the year we finally started to deliver on the promise of those IT strategies; and it to address some of the big challenges that the NHS is facing right now?”
Dr Richard Pratt, NHS General Practitioner & Eva Health Technologies Clinical Director said: “For 2023, our wish is to see the focus shift from the hospital to the wider health ecosystem, with support and engagement within the wider tech space to create flexible, agile, clinically and cyber-safe, and interoperable solutions that work across the patch for patients and for clinicians.”
Suvir Venkataraman, General Manager at Harley Street Fertility Clinic said he expects the digital focus to lie with connected self-monitoring for 2023. He hoped “for focus on missing pieces of puzzle: e.g. gap in IVF outcomes, increased pace of development for personalised medicine, in oncology and women’s health.” As for solving one challenge this year, it would be “wearable monitor for hormone levels.”
Zofia Bolisęga, Business Development Executive at Generated Health reflected on the previous year and highlighted the “ongoing need for collaboration and sustainable policies to support digital health” and stated that this year will be another challenging year. “We will see the continued uptake of remote and home-based care innovations that improve outcomes and facilitate earlier interventions. This tech will have far reaching implications in terms of care costs, and human health and wellbeing.
Interoperability will remain at the forefront of industry and “health system agendas as it offers opportunities to provide better, more joined up care. Finally, we will see increasing focus on health inequalities and how to serve more diverse populations where digital health tech will be pivotal.”
Ewa Truchanowicz, Managing Director, Dignio, said: “Virtual wards have not had the take-up that NHS England was expecting, and one reason is that providers have been trying to create virtual beds by using pen and paper, and phone calls. The penny has dropped that you need technology to engage patients and make it easy for clinicians to monitor and communicate with them. Plus, you don’t want to be using different technologies for different pathways; you want a platform that can scale.”
The market is maturing, she said, and there are lots of new entrants, but “tenders and market engagements suggest buyers are increasingly confident about what they should be looking for in a technology partner. The policy has matured, the buyers have matured, and the procurement process has matured. Virtual wards and virtual care are much more of a done deal. I expect a lot of activity in this domain in the spring, and interest will only grow if the funding is there.”
Digital investment has also been advancing at pace for regional imaging and pathology networks across the NHS. “2023 will be about more than realising the benefits from these investments,” said Jane Rendall, UK and Ireland Managing Director for Sectra. “It will be about the opportunity to make use of this new consolidated diagnostic data, and to surface that data along with genomic information.” The next year will see a new discussion “for the potential of this powerful data source, how it can be served up to those who can make a difference with it for patients, and the impact on tailored and targeted medicine that precision diagnostics might enable.”
“Winter and spring are going to be taken-up with escalating demand on general practice,” noted Paul Bensley, Managing Director of X-on. “Setting up a system so patients have options if they want a prescription, or a test result, or another service can also reduce pressure on appointment lines. In the longer term, primary care will need to take some tough decisions on how to allocate scarce resources, and then use practice systems to make sure the most urgent cases get the care they need, while other patients receive a satisfactory offer.”
Integrated care systems and primary care networks need to “get the necessary systems in place, consistently and at scale, next summer,” Paul added. If they can do this, “primary care should be in a better place next winter. If not, there’s a danger that patient access will revert to being a lottery, with even more pressure falling on NHS 111 and 999 as a result.”
“Reducing the data burden, and simultaneously making data more useable for nurses and other frontline teams is a priority for the year ahead,” commented Su Lei, General Manager of Mindray UK. “In 2023, healthcare providers are likely to play close attention to where medical devices fit into this mix. Given the workforce challenges facing healthcare, and rising demands, nurses cannot be expected to spend their time examining data on a multitude of devices, in order to arrive at a conclusion on the wellness of a patient in their care.”
The hospitals he speaks to are “exploring an interconnected device approach, where data from ventilators, infusion pumps, patient monitors, ECGs, ultrasound and other devices can be presented into the electronic patient record as a single set of information. People are making vital decisions – and medical technology, both software and hardware, must interoperate to help make that decision making as efficient as possible.”
Lynette Ousby, UK Managing Director, Alcidion, said: “The pressures on the NHS around demand, workforce, waiting lists, flu and COVID-19, to name just a few, will focus organisations on their capability to flow patients throughout the system during 2023.” She explains how we will see an increased focus on patient flow at an organisational level, but “I hope this will also happen at integrated care system level. Flow isn’t just about getting patients in and out of hospital. It is about effective transfer of patients into the community and social care, and looking after them remotely when hospital isn’t the right place and capacity is strained.”
She noted how the health technology industry has an opportunity to break-down organisational barriers and “enable flow across regions, in support of the ICS agenda. This means joining up data at a regional level to the benefit of capacity, patient and pathway. Doing this must be a collaborative effort – across acute, GP, community, and shared care – where orchestrating data across the technological ecosystem supports flow and virtual care. This will require technological investment in a coordinated approach, rather than organisational silos.”
“One of healthcare’s biggest challenges this year is improving access to primary care,” stated Antoine Lever, Commercial Director at babblevoice. “Digital solutions to this have to be part of the answer. The switch from legacy systems to cloud-based telephony can significantly assist reception teams deal with high volumes of calls. Exploring digital solutions like this will help increase patients’ healthcare access.”
Melissa Morris, Lantum’s founder and CEO, emphasised the need to better match workforce with demand. “One thing is for certain that organisations are in desperate need to find backfill throughout the year,” she said. She has seen investments in digital flexible staff pools and “improved scheduling over the past year, and the prediction is this will continue. Front line digitisation is the biggest budget line item in the NHS when it comes to digital this year.”
In terms of solving one challenge in health teach this year, Melissa said: “It would be on digital literacy, giving everyone in the NHS the skills to be able to spot the best software out there and the capabilities to implement them. More often than not, literacy levels are not there, which means people just roll over legacy technology contracts rather than finding the best solutions.”
“The focus of digital in healthcare during 2023 will be much as it was in 2022,” stated Martin Bell, Director at The Martin Bell Partnership. “Extending and supporting the creation of virtual wards, and so increased use of TECS and supporting patient platforms; a focus on managing waiting lists, efficiency; solutions that can improve the interface between the NHS and Social Care, and so on.”
He noted how funding is important, especially in social care; in developing workforce plan, and with regards to pension challenge and pay rises. He also highlighted the need to fund more beds and more diagnostic facilities, “so that the UK is no longer near the bottom of the league table for these things versus other developed nations in ratio to population.”
Charles Frost, Director at Prescribe Digital, said: “Clinical functionality, AI, and other exciting technologies often capture the headlines in the health tech space. But sometimes, it is technology working to support healthcare behind the scenes that can be just as important in helping to drive forward patient care.” Alongside the efforts to digitise the frontline, “2023 could be a year when the administrative workforce receives greater support from technology providers.”
Charles added that the “provision of timely clinical letters, for example, is a key area for ensuring patients receive medications, diagnoses and efficient progression in their pathway, when they need it. This is also an area where healthcare organisations often need additional support, with correspondence turnaround breaches and backlogs still a reality for many. Technology, applied well, can help to enable workflow efficiencies, by providing tools to help staff more efficiently extract and manage actions contained in letters, or to focus their time on priority documents, for example. As EPR programmes progress at pace, this could be an additional helpful part of the discussion for healthcare organisations, in delivering a rapid and meaningful impact for timely patient care.”
“NHS doctors and nurses have never been so busy,” commented Mark Pridmore, Head of Strategy at Net Solving. “2023 might become the year when healthcare professionals, faced with so many pressures, no longer need to spend any of that time filling out spreadsheets on a computer, in order to complete important clinical audits.”
It could be both a quick and significant win in the year ahead in “making the most of the valuable time of clinical teams,” Mark added. “Clinical audit is an important part of understanding the quality and safety of service provision in healthcare, but in many organisations it still requires manually intensive activity from healthcare professionals to gather required data. And to extract value from that data, further intensive work can be required.”
