DIGITAL ICS
Connecting data across organisations, integrating systems, region-wide pathways – there are lots of ways in which digital can support ICS ways of working. Lantum, InterSystems and CCube Solutions join us to highlight the ways in which their products can help ICSs become digital systems of the modern age.
Building digital-first ICS workforces with flexible staffing solutions
Recent funding for flexible staff pools is a solid foundation for ICSs to build flexible workforces while ensuring adequate staffing and excellent patient care. Leaders at the ICS level can champion new flexible ways of working and ensure their workforces are ready to face any challenges ahead.
Find out how digital flexible staffing solutions can improve organisational resilience and build future-ready workforces.
The impact of flexible working and digital staff pools across ICSs
Flexible working means investing in tools and tech that allow staff to do their jobs well, including digital flexible staff pools that support new models of care and system-wide flexible shifts.
“Staff pools offer opportunities to the workforce, so you always have a clinical safety net at times of high demand,” says Mary Jackson, Head of ICS Partnerships at Lantum.
Flexible staff pools also enable ICSs to implement digital passports and remove friction around competency and training requirements. “It’s a way for clinicians to get more control over where and when they work, which motivates them more,” says Melissa Morris, CEO and founder of Lantum.
Practical steps to supporting flexible working across your organisation
A flexible staff pool is a great way to open up opportunities for more staff across your ICS, support wellbeing and development, and build community and a sense of cohesion.
- Multidisciplinary teams: A comprehensive staff skill mix and continuity of care are just as important as technologies like flexible staff pools.
- Wellbeing support: Access to mental health support from peers or professionals and wellbeing resources through the overall structure of a staff pool helps alleviate burnout and improve team cohesion.
- Leadership support for flexible working: When it comes to flexible working, “ICS leaders need to be seen to genuinely support it, speak about it, and put resources behind making the project work,” says Melissa.
This approach to flexible working comes from the top down, and ICS leaders need to work across organisational boundaries to re-think how staff are recruited, trained and retained.
Best practice for digital flexible staffing solutions
Flexible staffing will never look the same at two different ICSs, but there are some core best practices:
- Leverage your digital flexible staff pool to include all staff types
- Empower staff to work where they want
- Provide opportunities that encourage staff to work with you long-term
- Champion flexible working from the top down
Digital flexible staff pools are an invaluable resource for building a resilient workforce. At Lantum, we’re working in partnership with 19 ICSs across England to help them:
- Organise complex clinical governance requirements and build a digital staff passport
- Efficiently schedule all types of staff where and when they want to work
- Build a solid clinical safety net with access to over 30,000 vetted locums across the country
To find out how Lantum can support your flexible staff pool, email enquiries@lantum.com today.
InterSystems on why long-term relationships and non-disruptive change are the key to ICS transformation
by Chris Norton, Managing Director, UK & Ireland, InterSystems
The 42 Integrated Care Systems (ICSs) created under the Health and Care Act (2022), are founded on the principle of partnership. Embedded in the heart of every ICS is an integrated care partnership (ICP), a statutory committee jointly formed between the NHS integrated care board and all upper-tier local authorities that fall within the ICS area. So, by their very nature, ICSs are a combination of healthcare organisations that come together with the intention of planning and delivering joined-up health and care solutions to improve outcomes for people who live and work in their area.
Given the current challenges that the NHS is wrestling with, achieving this vision will not be easy, however. Integrated Care Systems (ICSs) are tasked with delivering the goal of joined-up care against a backdrop of what feels like ever-greater pressure on resources. These new organisations, with varying levels of maturity, face a wide, and evolving, set of challenges that will require the ability to continually adapt and innovate.
The entire health and social care system is continuing to struggle with treatment backlogs amid budget constraints. Social care vacancies stood at 165,000 in October last year and a House of Commons Health and Social Care Committee report said an extra 475,000 jobs would be needed in the health sector, and another 490,000 in social care by the early 2030s.
ICSs must overcome these intense, short-term challenges while innovating to create fresh pathways and workflows that can drive new and transformational methods of delivering care. Most fully understand these issues but are nevertheless often forced to transform themselves in flight, as the environment in which they operate continuously changes.
For patients, ICSs should be delivering the manifold benefits of cross-collaboration between what have previously been very independent NHS trusts and social care providers. However, volatile economic factors, a lack of resources and ongoing skills shortages resulting from the pandemic, and demographic change, have made the job of joining up healthcare to improve outcomes an extremely difficult one.
ICSs have the potential to deliver multiple benefits to the healthcare system in the UK, allowing cross-collaboration between independent trusts to provide an enhanced and more joined-up patient experience. However, these disparate organisations often find themselves building the future of healthcare on the fly, while still having to deal with multiple immediate challenges.
From patient backlogs to multi-million budget deficits, there are many factors trusts must take into consideration. Transformation is necessary as these trusts determine how best to share information across regions, jurisdictions, and care boundaries, as well as integrating health and social care into them as well.
Building long-term relationships
It is worth highlighting at this juncture though that ICS transformation is about much more than just simply upgrading IT infrastructures, it’s a long term organisational and community relationships change programme. The right technology provides the potential to improve patient outcomes, optimise clinician workflows, and secure cost savings.
However, implementing digital solutions in healthcare is an adaptive change, not just a technical one. It’s not about simply buying software, it’s a cultural and human shift, or transformation. In the case of large transformation projects, the impact of the shift on those at the very heart of healthcare – the practitioners – is particularly pronounced.
So, the NHS needs partners that are simultaneously able to help make quick progress and achieve rapid time to value, and who are also committed to being with them over the long-haul. It is both a marathon, and a series of sprints – and partners should be willing to agree integrated, outcome-based commercial agreements.
After all, it is no longer acceptable for any vendor to turn up, do their bit, drop off their solution, and wish the customer good luck – the challenges are too big and too complex for this kind of culture and these kinds of relationships to survive.
Key role of change management
Consequently, vendors delivering to the healthcare sector can never afford to concentrate exclusively on the systems and solutions they are delivering, even if that is their bread and butter. They need to be focused just as much on change management.
Given this, the cultural and human impact of healthcare transformation must be considered at every turn. That’s why putting a strong change management strategy in place is key. But delivering on it is often easier said than done, especially in the complex healthcare space.
According to the Change Management Institute UK:
“Change management represents a domain of principles and practices that enable stakeholders of change to adopt the mindsets, behaviours, and capabilities required for that change to deliver full business value. It focuses on people.’’
In the context of healthcare, that means stakeholders, including technology providers, working in partnership to achieve common goals.
Working in collaboration
This emphasis on collaborating to achieve common goals is very close to our hearts at InterSystems. We wholeheartedly believe that rather than just focusing on technology delivery, providers should be concentrating instead on delivering accelerated time to value, and more effective, less stressful collaboration throughout every ICS customer’s region.
By taking a coherent and integrated whole system approach to healthcare and social care data, providers should be focused on setting ICSs up for success, first time around. Equally, by ensuring all partnership organisations within the ICS can have accurate administrative and clinical information whenever and wherever they need it, technology companies can streamline collaboration, helping everyone work together more effectively. This in turn frees up ICS capacity and capability, so partner organisations can focus on the more sophisticated, longer-term challenges, and goals for their region.
Technology is key too but must fit with the vision
To fit with this vision of flexible, collaborative working practices, it is important that the solutions that ICSs adopt have a similar level of in-built adaptability, allowing them to readily form a platform that can help create a new ecosystem of seamless, multi-discipline treatment, and care plans. Any solution or system must be capable of maximising outcomes within fluid resource parameters, quickly and without disruption. Otherwise, its useful lifespan will be too short.
In line with this, ICSs will benefit from taking a platform-led approach that sits above, and integrates all their current systems or workflows. This means the data can stay where it is, while providing a single source of truth that massively streamlines the time and energy it takes healthcare staff to find and share the right information. And it also means staff don’t need to be retrained with working patterns changed overnight – it offers almost immediate benefits, while still helping ICSs make more gradual and consistent progress, without interrupting service delivery and patient care.
This kind of non-disruptive change saves time because the process is smoother, and it also saves budget because a flexible interoperability platform can help ICSs integrate and make best use of the tech infrastructure and skills it has already, rather than having to start all over again.
This is especially true in an area such as shared patient records, where we can already see that implementations which lack adaptability are experiencing significant fall-offs in performance – posing a dilemma for senior managers about whether to supplement or replace them. At one time this might not have been viewed as a critical decision, but the successful response to Covid has made this more significant. It has taught everyone what is possible with data if it is managed properly. Expectations are higher around the speed of delivery possible with access to high quality data from fast, interoperable and available systems that meet new demands at short notice.
A focus on data integration and system interoperability will be key in ensuring that the technology delivered by providers is able to support a collaborative approach to change across ICSs. To drive operational efficiencies, it is important that administrative and clinical data can be integrated across systems and platforms, so that, for example, the same waitlist, appointment, and clinical information is shared by administrative and clinical staff.
Coming together to deliver real change
Looking at the current status of healthcare across the UK, it is clear that change is urgently needed to improve patient outcomes, optimise clinician workflows to deal with increased demand, and manage a lack of resource across the sector. But this need brings about a corresponding requirement for collaboration, and a well thought-out and well-implemented strategy to support it.
That entails stakeholders across ICSs and wider healthcare ecosystems working in partnership to achieve common goals. It means focusing on people and how they can form trust-based relationships in order to drive through the changes required. Technology is a key element of this process of course, but focus on working together positively to effect change is equally crucial for ICS transformation to happen, and for UK healthcare to move positively forward into the future.
CCube Solutions’ Vijay Magon on creating a single true source of patient information
CCube Solutions’ managing director Vijay Magon highlights the challenges around unstructured data and how technology can help transform healthcare records management.
The need for digital
The growing adoption of electronic patient record (EPR) systems is an important first step to improving access to health information, but far too many healthcare organisations believe that EPRs are all that’s necessary for digital-enabled clinical transformation.
While the shift from paper to digital has been ongoing for years, but embracing it is no longer an option – it has become an essential strategy.
Productivity, teamwork, and the patient experience are constantly at the top of every healthcare organisation’s priority list, but our research indicates that a high proportion of healthcare organisations believe that in the last 12 months, their hospital has been impacted by incorrect or missing data due to paper processes.
The problem: unstructured data
If we explore the landscape of patient information for context, we see two large groups: unstructured and structured.
As much as 80 percent of the information that exists on a patient is unstructured. It is largely found in paper form and electronic files and lives outside of the electronic patient record in a number of siloed systems and repositories. That means that this data is locked within the documents or files; and it is found in huge volumes, leading to enormous amounts of paper sitting in storage.
This creates additional problems in itself. Storing huge volumes of paper means that huge amounts of storage space is taken up; paper has to be retained, and in some cases, it has to be retained for a long period of time. Alongside taking up premium storage space, there are issues around retrieval and access, with time and costs associated with going into these paper libraries and finding a particular patient record by hand. Filing and refiling also leads to recurring costs, so the costs associated with storing this unstructured paper information will rise over time – this is the cost of doing nothing!
Then there are the risks with holding physical records; it is easier to lose a paper file than it is an electronic one, and it is also more difficult to restrict and audit access.
Ultimately, dependency on paper creates and exacerbates issues within care pathways and workflows. This unstructured information needs to be digitised and transported electronically, rather than relying on trolleys laden with paper.
Having said that, it’s not just about paper. Some 65 to 70 percent of new patient information is actually created electronically through a variety of IT systems in use within an organisation: EPR, clinical portals, primary and acute care systems, specialty systems, laboratory information management systems. In these systems, we might find Word documents, PDF files, photography, electronic forms, emails, spreadsheets.
Although it is electronic and not causing the same physical problems as paper records, the content within these files is still largely unstructured. It is disconnected from other sources of information and difficult and time-consuming for clinicians to find what they need – document silos.
Structured data: the solution
Structured information is data that sits within system databases and can be managed and searched through those databases. As it is accessible and organised, it can be used to deliver patient care in pathways and in patient administration systems, providing clinical decision support.
Structured data is absolutely necessary for digitally-enabled clinical transformation, so we need something that can capture the unstructured information described above and manage it – turning it into structured information that can be more useful.
Electronic document & records management software (EDRMS) technology has been around for nearly 50 years. Originally developed to help manage paper records, the technology has now developed so that it can assist with multimedia electronic files too. Unstructured information can be inputted into the EDRMS where it will be managed and stored. The technology can be configured to manage the files that are captured over a long period of time, supporting work around retention and destruction policies.
Once set up, the EDRMS provides a clinical view of the whole record contained within the platform, supporting clinicians by providing them with access to all the information that is available on a patient.
The model can be easily extended, too. There might be information sitting outside the EDRMS – for example, information contained on file shares. The technology can be integrated with the other systems such as the EPR or clinical portals to provide access to this.
Interfaces can be set up to ensure that the EDRMS provides a multi-document repository that can be accessed through some of the IT systems. The interfacing work has already been done; so a user can sit in a clinical portal or an EPR, select a patient through clicking a button, and instantly view what is held in the EDRMS without having to log in and out of applications.
That’s the goal we should all be aiming for – we need to create a true single source of patient information. It doesn’t mean that everything needs to be contained in one system – it means that information can be held on one system and fed to where it is needed, supporting data flow and staff and patient experience.
For more information on how CCube Solutions can help with EDRMS technology, please click here.
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