Welcome back to our podcast HTN Let’s Talk!
For this episode, we interviewed Chris Mason, chief information officer at Wirral University Teaching Hospital NHS Foundation Trust. We discussed what digital projects Chris has worked on throughout his career, the key factors needed for innovation in healthcare, the current challenges in digital health and more.
To start off, Chris spoke about his current role and career background.
Chris has been with Wirral for around 15 years and started as a project manager, joining at a time when the trust had just started its EPR journey.
His first implementation was the outpatients PAS (patient administration system) and following that he moved on to become programme manager which involved taking care of the team of project managers. In this role, Chris continued the trust’s journey with migration to Cerner.
From there, Chris moved into the service improvement team within Wirral. “I built up a lot of operational contacts, but also it gave me a chance to see the impact our digital systems were having on clinical and operational workforce,” he said.
When he moved back into the digital healthcare team, Chris was benefit lead for the GDE programme before progressing to deputy CIO, interim CIO and then onto the substantial post in December 2021.
Chris looks after all of the trust’s IT functions and staff, including technical development and clinical analysts, projects, integration information and business intelligence. “Under my remit I’ve also got medical records, information governance and clinical coding. So it’s really widespread, with great teams across the board. We’ve got a lot of great people in the organisation and particularly in individual healthcare teams. You’re only as good as your team and my team are fantastic, so I’m very lucky to have them.”
Key digital projects
When Chris first started, his work focused on decommissioning their legacy system. The trust’s first intention was to move what they already had within their legacy system and build upon that. “We already had some sort of digital care pathways, the inpatients PAS, an element of e-prescribing,” said Chris. “We’ve now got the vast majority of our medical devices integrated into our EPR with all of that data flowing in from our medical devices. Where we have specialist systems, again the vast majority are integrated with a small amount of specialisms still to go. Most of our clinicians probably only log into one system, which is great. It’s a one-stop shop for everything.”
On a wider scale, the trust led initially on the implementation of Health Information Exchange, a shared care record for Wirral Place, and also on the population health solution for the Healthy Wirral Partners.
Chris described Wirral’s portfolio as fast-paced and said: “Nothing ever stands still – there’s still an awful lot to do. At the moment we’re planning for the next financial year, so we ensure that everything is prioritised so that we can keep our work in line with clinical strategies on a yearly basis.”
Whilst the trust has operational plans in place to ensure that they are meeting all of their clinical and operational requirements, Chris acknowledged that “things obviously do change throughout the year and we have change control in place to re-organise and be flexible around the up and coming requirements. But on the whole, those plans form a really important part of the year for us.”
As part of that, the trust is moving to a new PACS (picture archiving and communication system) which is aligning with the wider region. They are also working on their patient portal which will be coming up in the next financial year and which aims to get far greater coverage of their patients. This will offer patients the ability to book their own appointments and view elements of their record.
Chris continued: “We’ve also got outpatient transformation work which will focus on our self-checking kiosks, room management, dashboards for clinicians, virtual appointments, telephone appointments – it will really transform the offering to the patients of Wirral and provide a better patient experience when visiting the hospital.”
In terms of training, the trust has a learning management system that they are bringing in across the organisation. “We have tended to do traditional face-to-face training methods, but we realised that we need far bigger, far greater coverage and we need to allow people to do the training when they can fit it into their busy schedules.”
As part of elective recovery, Chris explained that there is a major piece of work “that we’re going to be embarking on with Cheshire Merseyside around the data provision for the Cheshire Merseyside Surgical Centres. Where I’m based at the Clatterbridge site, there are two new theatres that have opened up recently. We’re currently taking patients from Chester, but it’s envisaged that we will take patients from other secondary care settings too.”
Key factors needed for innovation in healthcare
Chris said that the technology for innovation is there and has moved on in leaps and bounds.
“From an innovation perspective, I think the scope is massive, but the key factors for innovation in healthcare are around that engagement and embedding. Sometimes there is technology, but it doesn’t necessarily fulfil the use case.”
He highlighted that it is also key to make sure that systems are intuitive, as most clinicians and operational staff do not have time for extended learning. “When you pick up your phone and use an app and you’ve not had training in it, it works because it’s intuitive,” he said. “That’s what we need to make sure we achieve with clinical apps. We don’t want to have to set a clinician down for hours of training. They need to be able to work with it with a minimal amount of education. We also need to allow time for subject matter experts to be engaged and feed into requirements.”
Chris commented that there needs to be time to focus on “preventative measures and working as a system to make population healthier as a whole. The aim needs to be that we don’t need to treat these people in the first place, because they are well, better and healthier.”
Challenges
For Chris, one of the challenges is demands on time. He noted that some projects had to stop during COVID but have taken off again now, and there are new projects coming into the frame. “The governance that we’ve put in place to help the organisation to prioritise this work has been invaluable,” he said. “We’ve got a really supportive exec board and they’re all signed up to our governance processes – it’s very transparent.”
Workforce can be another challenge. “I would imagine that if you ask any CIO, they would say that this is one of the major challenges. It’s a competitive market, not a shortage in professionals, but the A4C framework and the restrictions around that do pose some problems. We are really close across Cheshire and Merseyside, so we’re looking at ways in which we can work together to try and combat that issue.”
Chris noted that it is getting increasingly harder to recruit in digital. In Wirral, they are looking to grow their own staff. “We may get staff in entry level posts who also have an interest in this area. If we recruit and grow people from there, that helps us and it helps them as they have a good career path too.”
Another particular issue is around operational and clinical staff availability. “They’re extremely busy, and it has to be the priority to care for the patients that we have,” Chris said. “But of course time is also required from clinicians and from operational staff to help with these projects. It’s key that we get their engagement and that they lead on it.”
Due to pressurised environments, he noted, some projects remain IT-led. “That’s inevitable with the situation as it is, and how busy healthcare is,” he commented. However, he added, “there’s always a risk when you take those clinical subject matter experts out, or their time on the project is at a minimum. You’re going to get a product that doesn’t fit the bill 100 percent.”
The best way to fix this at Cheshire and Merseyside level is to work together, Chris said. “We need to come up with a strategic, collaborative way of working to enable us to help each other. There might be a bit of short-term pain, but there’s certainly long-term gain from the potential efficiencies and productivity enhancements.”
Ultimately, Chris pointed out, “There is one reason why we are all here and and that is for patient care. The technology side is fantastic and the work that the teams do is fantastic and but it’s got to contribute towards patient care and productivity and efficiencies.”
What ‘good’ looks like in the future of digital health
‘Good’ to Chris would be an environment where digital is embedded within thinking around clinical and operational strategy. “If you look at my organisation at the moment, we’ve got a clinical strategy and we’ve got a digital strategy,” he said. In the future, he would like to see no separate digital strategy because it is “part of those clinical elements instead, and that our awareness around the opportunities for digital are far wider understood.”
Chris added: “We need to step back and ask how we can do things differently. That would be ideal for me – to create that headspace so that we can forge our way forwards.”
He also raised the need for collaboration and standardisation. “If you’re going to one organisation or another as a patient, why should that make any difference? You should always be treated in the same way. The more we can collaborate to make the patient experience consistent, the better.”
On population health, Chris highlighted the importance of preventative measures and said: “Levelling up is a buzzword at the moment, but we need an environment where patients, no matter their postcode and no matter the organisation, are dealt with in an efficient and expert manner. This shouldn’t be impacted by digital ability.”
As a final note, Chris remarked: “We should give everybody the opportunity for that digital involvement and digital progression. We may not fix all the problems in the world, but we will give it our best go.”
