Interview

Interview: “Learn to be their partner, not their supplier” – Vijay Magon on his experience over decades of working on digital health solutions

We recently sat down with Vijay Magon from CCube Solutions for a chat about his career in the health tech industry, which began around 30 years ago when he and his team identified an opportunity to offer document management solutions in the UK.

Vijay talked to us about his early experiences and his involvement with helping different NHS sites move away from paper-based systems. He shared that the first site he worked with was Tameside and Glossop Hospital, who have remained a customer for over 24 years.

Vijay stated that he realised that the problems within the health service were the same as with other commercial and council clients – they were all struggling with paper documents, but the difference within health was that these paper records had “more value”, given that they contained important and sensitive patient data past and present, and would need to be held for a longer period of time.

Initially, according to Vijay, the objective was simply to scan the paperwork, to eliminate the need to keep adding to the patient’s paper record. The best way to describe this, he said, was that they were archiving systems; documents were digitised but “the digital document was not delivered at the point of need”.

Vijay went on to talk about his work at St Helens and Knowsley Teaching Hospitals NHS Trust. Over the course of several meetings with the trust, discussions were had about how they could come up with a solution that “actually delivers digital content to users, clinicians, at the point of need”.

In this way, they came up with the concept of “scan on demand”. Vijay described it from the patient’s perspective: “The hospital knows that I have an appointment in three weeks’ time, so they can pull my record, prepare it, scan it, check it, make sure that it’s available for the clinician when I turn up on the Monday morning for my appointment.”

As the first hospital to do this, St Helens and Knowsley had, within a year, stopped delivering paper records across every outpatient clinic in the hospital, before continuing to extend the system to different wards and specialties.

Now, Vijay noted, CCube helps some 30 trusts up and down the country with their electronic document and records management solution, providing support as required. He described how the foundation that has been in place since 2009 allows suppliers and trusts to add and incorporate new technologies to their systems.

“Within the health sector, this huge volume of locked information is ripe for machine learning, with limited scope for artificial intelligence too,” he added.

The biggest changes across Vijay’s career

We asked Vijay about the biggest changes that he has witnessed throughout his career, in terms of technology and healthcare.

Vijay answered: “I think one of the biggest changes is the progress of technology itself, and the consumerisation of it – meaning that ‘Joe Public’ is now used to doing things online like bank statements and online utilities. That has driven down the cost of customised and bespoke technologies. Gone are the days of the nineties, where this stuff was quite expensive. They’re still not cheap, but the technology in our systems is now much more advanced and affordable because of the consumerism of technology in the wider world.”

He noted that things like tablets and mobile phones have also helped to advance digitisation, giving individuals a means of accessing the internet, and giving suppliers a new way of reaching them.

On his biggest learning to date, Vijay highlighted the importance of working closely with users. “There needs to be a healthy partnership between a supplier and a user, and not a case of forcing down a particular solution because somebody who is not actually going to use that tech is making a decision based on cost, affordability or whatever else it might be. How to work in partnership with the user has been a massive learning curve for us, but one that we have derived a lot of pleasure from.”

He added: “At the end of the day, we develop software, but the expert is the user of the systems that we deploy. They are the ones who need to shape what should go into the software. We can sit in an ivory tower and build the best suite out there, but if the user doesn’t like it, it’s not going to work. I think you always know this in some way, but it is true that the customer is always right.”

Vijay commented that a couple of decades ago, CCube would mainly have dealings with IT departments. Nowadays, he said, “it’s the nurses, the clinicians, the admin staff. We have to listen to them.” He highlighted the importance of delivering solutions that meet their needs and that are usable to them, rather than getting “bogged down” in the costs and other factors.

Differences between the US and UK

We moved on to ask Vijay about his view on the differences in digital health between the UK and US.

He considered the difference in nature when it comes to the health system between the two, highlighting how the NHS is “unique in the world because it’s a single organisation – you’ve got your foundation trusts, but they’re all within the envelope of the NHS. The NHS has overall rules, guidance and regulation. There are good and bad sides to that. The good side is that within that envelope, there’s plenty of room for innovation and plenty of room for improving things.”

There are challenges too, such as the public procurement processes, which Vijay noted can be a “handicap, particularly for some companies”. However, he said, being able to build a good footprint within the NHS with CCube has been “an enormous help”.

Vijay said that he likes the NHS model with the overarching authority in place, because “it will make sure that rules are followed. I don’t think that always happens in the States, where money drives innovation and technology.”

The US model is still exciting, Vijay acknowledged, because of how vast that space is.

In terms of CCube’s roadmap for the future, Vijay said, “Going forward we’re definitely keeping the UK as our focus and improving the foundation we have built, before we take a wider view after that”.

Advice for up-and-coming health tech innovators

We asked Vijay a final question: what advice would he give to somebody who was taking their first step in a digital health career?

“Work hard and learn to be their partner, not their supplier,” Vijay said. “I think that’s the biggest lesson I learned, and I think that’s the biggest message I would give to anybody else.”