24 April 2018
Momentum is fast building behind the use of digital technology to integrate care across whole populations and health economies – from direct care to research, care planning and provision.
As I write this, the NHS and its technology partners are preparing bids to become one of five new NHS England Local Integrated Care Record Exemplars, three of which could develop into full-blown population health management and regional research databases or ‘data lakes’. At the same time, suppliers (including CSUs) have just weeks to apply for a place on the new national procurement framework for ACSs and STPs.
In all this, we are once again looking across the pond for inspiration. Examples are cited of US care providers starting to use AI algorithms and population health management at scale, and unfavourable comparisons made with digital maturity in the NHS.
This has its risks. US healthcare has benefited from massive fiscal stimulus and ‘meaningful use’ incentives, but as Bob Wachter was careful to point out, healthcare digitisation in the US is not the success story UK policy makers would have us believe. Remember too, the mess we got in with previous attempts to import US IT solutions and apply them to the NHS.
If the move to a population-based approach and cross-community working here in the UK is to work, there are three important steps we must take:
1. We need to understand and articulate the very real benefits to clinicians and to patients of sharing data and mobile, clinical and cross-community digital solutions.
2. We need to get on with the task of moving our health economies off paper.
It is all very well talking about rich datasets, predictive modelling and risk stratification but unless we improve our patchy digital performance, the reality will be towering mountains of paper rather than vast Matrix-style data lakes.
Part of the solution is making sure we have the right skills in place - the NHS Digital Academy has made a great start, but we need to go further, faster.
3. While we go along, we must keep testing the impact of technology and keep pushing the boundaries. That means evaluation, documenting use cases, investing in mobile communications, testing apps and wearables for patients, and focusing on delightful solutions, designed with patients and clinical users in mind.
It also means a relentless commitment to getting the deployment right, since a smooth deployment is the key to a successful transformation project. Experience and methodology count for everything here. Finally, we need energy in spades. Transforming workflows and care pathways is hard work.
Like other suppliers, the System C & Graphnet Care Alliance is committed to developing the clinical, mobile technology solutions that will enable health economies to break down organisational barriers. We are right behind the importance of large integrated care records, both for direct care and, once deidentified and with the correct consent for population health and research purposes. Our shared care records hold over 10m citizen records and are used in over 45 CCGs.
We know first-hand the benefits of large pools of clinical data. Our shared record data helps reduce A&E attendances, admissions and length of stay and improve patient safety and clinical outcomes.
This is the prize of these large-scale cross-community integrated care record projects – they transcend organisations and give visibility to the whole care community, no matter where individuals work. And this is all within our reach, providing we all work together and support health economies right now in getting the foundations right.
Beverley Bryant is chief operating officer of the System C & Graphnet Care Alliance