NEW LAWYERS. TRANSFORMATION OF A PROFESSION

The subtle movement and shift of emphasis from today’s lawyers into Business Partners and strategic advisers – has changed the view that we have of them – and them of us. The question is; is this a difficult sell?

Nora Teuwsen is looking at me across the screen. She is dressed in Swiss minimalist chic, dark grey modern clothes, long auburn hair. As former General Counsel for Swiss Railways, and surrounded by the financial areas of Zurich, she is well placed to make a perceptive judgement.

“It used to be”, she says. “But now, Corporates are waking up to the fact that their in-house Lawyer is also a modern facilitator”.

Like so many young lawyers starting out, Nora had little clue of what a legal profession entailed. Her motivation had been more a belief in justice, integrity, that she still regards as valuable of all skills to have. What she was not prepared for in those early days – was the lack of client contact, and to work out and discover an understanding, that her preferred role was one of explanation, to explain the “why” things need to be so.

She is calm but animated in her delivery, you can see the entrepreneurial spirit that is driving her responsibility to take her client on a journey. The legal background has no longer become the prime reason for being retained, it is the structure of thought that can open other commercial discussions.

It is no surprise that after 15 years with Swiss Railways, it was obvious that the next step was to create a vehicle that could embrace all of these attributes and competences, into one, that could be offered as a package so to say.

What she says is; “companies are underestimating the value of their legal department”, and in many ways that department needs to be courageous in pushing for creative and pragmatic solutions which are taking into account the company’s strategy and focussing on longterm value.

Nora continues: “The role of the legal department is expanding. Areas of sustainability, social responsibility, are becoming the go to areas of importance for corporates of all sizes, and the legal department can assist in handling that interest.”

It is also a focus on use of Data. Surprisingly, Nora is not convinced by use cases in Artificial Intelligence in the legal industry. There is a great transformation going on, but so far, results are limited. So far, it has not come up on her radar as a priority.

The “BeyondLegal” Boutique Firm, Nora’s brainchild – from a single Zurich base – is already international clients. “What we are trying to do, is build a network of like-minded legal professionals. We live in an international world”.

I turn off my screen and take a moment of reflection. In a technology driven marketplace, human values are still the bedrock of our corporate growth, which we always had but somehow had been forgotten. Some things remain the same.

IS DIGITALISATION THE SUICIDE NOTE OF BUSINESS?

We look at SEO and the epidemic of digital solutions in Biz Dev, and ask; are we missing the point here?

I have a colleague, who is Head of Procurement for some large areas of Scandinavia. And what he says is this; “Richard” – he says – “ I have deliberately stopped answering any emails, or any calls, from anybody I do not recognise. If you want me to talk to any of your people, just let me know in advance and I will put their number in my personal contacts.”

In the same way that the freedom of the internet has given us multiple information choices that should have given us a broader outlook – and the reverse has been true – that we only focus on those news feeds that say the things we already believe, – and made worse by algorithms that proactively feed us those restrictive views. So – the same is with SEO and all things digital.

We can now reach out to anybody on this planet. But so can everybody else. Which means that the people that we need and want to talk to – for our business growth, our customer service, etc – have long since made the decision not to be available, at all.

What that means is that, far from being simple to grow a business by finding a person who we do not know, and just giving them a call, has now become more than four times as long and four times as expensive, and now involves, pre-sales people, post-sales people, all manner of IT support and analysis, to do what used to be the straightforward and simple task of just phoning a friend of a friend.

But what is worse, is that this has given acceptance and justification, to being proactive in not making human contact possible at all. Woe betide any receptionist who passes on yours or mine contact details!

This means that both sides are the losers. Vendors of great solutions give up, because they cannot support the increasing drain open their marketing spend. And Corporates or our Public Services continue with their outdated practices because nobody has been able to show them otherwise.

If COVID restrictions have taught us anything, it is that human nature needs human involvement, and yet we seem to be travelling at warp speed in the opposite direction. It is as if we are scared about the whole process of actually talking together in a business environment, or being”sold to”. How terrible.

In our own business here at Profomedia, we research a lot and are continually building personal relationships. Whenever we want to find out something, we reach out and phone someone we already know, – who then introduces us to someone who we don’t.

There. It wasn’t so difficult, was it.

DIABETES MANAGEMENT FOR ALL PEOPLE WITH DIABETES

As part of our series of Case Studies for The HETT Show (www.hettshow.co.Uk) – we look at the rise of the Nipro Diagnostics company in Diabetes healthcare and ask, – from a standing start (with the new 4SURE portfolio), in just a few years, has their time come to be a major UK player?

For many people like you and I, the realisation that many people with diabetes do not have their condition out of choice, is a hard one to accept.  And yet its management requires a complex understanding.  

Let’s try and set the scene. In the last 10 years, the cost of treating Diabetes in the UK, has almost doubled. Looking at it another way – some 13% of all the NHS spending, is diabetes related. It is the largest slice of spending in the NHS cake.  And for type 2 diabetes there is no shortage of blame. Everything from the UK government’s lack of practical steps – through to you and I for eating the wrong food and an ever increasing sedentary lifestyle . 

Or maybe, there is no blame? Maybe, despite the fact that 10 years is a long time, and long enough to change both personal and NHS day-to-day processes, is it only now that we need to take a deeper look?

Is it therefore time? Time to reassess, and look again at what do we really need, now, to bring the diabetes epidemic under control and into the 21st century with technological advancements?

10 years ago, and with a Nipro global headcount of some 29,000 people – the NiproDIAGNOSTICS company was not a known player in the UK. Two years ago, they set out to furtherfocus their attention to help people living with Type 1 diabetes, by launching the 4SURE range of glucose meters and partnered with the revolutionary Diabetes:M App. With the aim of being the single one stop shop for every person requiring blood glucose monitoring, Nipro set about bringing into a needy market, a combined process that was affordable for the NHS, and easy to understand for you and I.

Tom Atkinson, Country Manager of Nipro Diagnostics UK, looks corporate cool – with a fashionable soft northern accent, dressed in an open white shirt, he leans into his screen and talks fluidly about his Insulin Pharma background, and the wish to be part of a complete solution. 

“What we understood from day one, was that we have to work the same way as our patients. They don’t want a meter that the NHS cannot afford; they want one with Bluetooth connectivity.And they want an App, which has got to be their Dashboard – everybody wants an App. Our big plus is that access to our new innovative technology, is obviously free, along with the Starter Pack from their diabetes clinic – which includes their initial consumables.”

We talk about the pandemic. It is an irony that, at a time when the NHS and health service provision has been desperate for so many – the essential acceptance overnight of remote diagnostics and monitoring by NHS nurses, has been a game changer for the better, for Nipro. 

“Clearly, we had not forecast a pandemic”, continues Tom, “but it was obvious that it was only a matter of time before common acceptance and a desire for remote diabetes monitoring. What has helped, is that our meters have an accuracy rate of 99.3%, and we are the fastest growing provider of diabetes solutions”.

The corporate ethos of a sales pitch is creeping into the discussion, and I don’t have a problem with that. What is equally evident is the pride of helping the ordinary person with diabetes, just being available, at the end of a phone line if a patient needs help or advice.  But that does not address the basic issue of human behavior. A diabetes meter can only be reactive to a patient’s condition.

Not necessarily. By giving the patient an affordable, information-driven, platform to manage their condition, patients themselves can change their lifestyles armed with the facts and see the benefits of their condition improving by relating to their life choices.

Tom interrupts; “yes, this is true – we are “part” of the solution – but for the patient, we are the major part – as it’s our technology they are using every day and we are the link between them and their own clinic or doctor, as we are providing the vital remote monitoring bridge to keep a patient in touch with their HCP so they can monitor their glucose levels remotely in real time and change their medication and other variables, there and then, if needs be”.

The focus of the discussion goes back to that of patient-provider relationship. “We don’t want diabetes to be the affliction for everyone – but we do want to provide the all-embracing solution for those that need it”. Tom looks at his watch. We have been engaged in academic discussion for nearly an hour, and it is Friday afternoon, end of July. He is taking his family on holiday. 

I closed my screen and take a moment of reflection. Innovation is not necessarily about technology. The patient also has a role to play. The Innovation at Nipro is the approach, taking the fear-factor, the newness, and combining it to tech that simply delivers, and communicating that to the person in the street.

INNOVATION AND THE COMMON MAN! YES, WE CAN NOW TALK FACE/FACE WITH THE PEOPLE WHO PLAY AN IMPORTANT ROLE IN THE DELIVERY DIGITAL INNOVATION.

We give a long overdue and welcome to the upcoming HETT Show, taking place on 28-29 September, at the Excel London, as an essential platform for our UK digital healthcare providers. 

The HETT Show (www.hettshow.co.uk) – as the Uk’s leading health event, opens its doors in a couple of months. The HETT Show is one of the first serious events to greet us all, in person, and it is like when you have to hand your courtesy car back at the end of the day when your usual vehicle is being serviced. “No, I don’t want to go back to my old car, thanks! I prefer the new shiny one you lent me instead.” 

Because – let’s face it – face-to-face events are the perfect place to gain insights and network. We miss the being there. And now we are back. Yes, we can indeed keep the courtesy car with the new number plates, after all. We can now justifiably drive off, and talk about Innovation.

HETT believes that innovation is the sauce that will empower the workforce in our hospitals and surgeries. The Show promises to herald a “new era of transformation”. And indeed it may well do so, for two surprising reasons. First, we are indeed, so fed up with the isolation of the past 15 months, it was fun in the beginning, true – but not now. And second, the success of any Innovation roll out, depends on precisely this, the motivation of the individual, to get up and actually “do something”.  

It is a realisation that if Innovation is to deliver for the common man, the patient, then this is not a technology process, but a human experience process, that involves all of us, at each individual level in the workplace. And for that single reason, HETT has a unique advantage, it is first, in bringing us all together. 

Over the past year and more, there have been significant differences in quality of care and even interest in delivering quality care, geographically throughout the UK. We see HETTshow (www.hettshow.co.uk) as an opportunity to re-examine where we are, and to meet people who can help this journey. 

We will be publishing a Series of Case Studies of those Hospitals and Surgeries who have made Innovation work for them in the past year, despite all the odds. At a time when queues and delays for procedures are at an all-time high, this is a clear moment to get back on track.

————————— 

DIGITALISATION; HERE’S AN IDEA YOU MIGHT LIKE!

Does success in “becoming digital in our workplace” mean we are all techies?”  We interview Katie Trott, Chief Nursing Information Officer at the Royal Free Hospital, Uk, fresh before her HIMSS Discussion on 8th June, to see how they do it at her Hospital.

I am sitting in my office – I pick up the phone, and I call Katie’s Hospital, and the Reception immediately connects me, there is a sound of some children in the background, and then I realise – Katie is at home, this is her mobile line. 

“I’m sorry”, she says, there is a hint of amusement in her voice “I have the kids at home”.  No matter. And so I get straight to the point – you have been responsible for some major large clinical tech initiatives in your past – does this mean you have a technical background?

“No, “ she says immediately. “But I do know how to wire a plug”.

This is all going well.

So we start again, and you could say it gets worse. When Katie started in the NHS as what  was then a Nurse Auxiliary, at 16yrs old – there was no discussion of technology per se for people at the front line. Patients were patients and treatments were treatments. Katie’s background is clinical. It just so happened, like so many chance encounters in life, that she was rather good at explaining to patients and colleagues “what was going on”.

This facility to communicate, to bring things back to their essential levels, has been the secret sauce of what – looking back – has been a step by step process over the years, ie, the innate ability to communicate benefits and to lead others into new pastures. As clinical care has inevitably needed more and more clever toys  and cool IT, so somebody has to engage with the people who have to make it all work. At the Royal Free, under her direction, they delivered a new EHR in just 11 months.

Katie is self-deprecating; “I was just in the  right place at the right time” she says. “We sort of made a decision that we need to do this or that, and then sort of figured it out as we went along”. Clearly this is not true – but what is standout is the motivation to go forward – even though at the time, you might not be sure of what that “forward” can actually deliver.

And it has created some changes in attitudes.

“When I first got into delivering digital or clinical solutions, the mindset was definitely that “big is better”. If we want to do something else, we just got some velcro and stuck on a new module”. But our view now has changed to  scaling down, and adopting “best of breed”, a sort of FHIR approach, for the specialist areas that have specific needs.”

Katie continues; “Perhaps I was naive, but I remember when I first started, I thought that fast means better, that you just plug new solutions in. But over time, I discovered the benefit of taking it step by step. That testing and safe empowerment is a process. Sure, we can plug it in, – but everyone needs to be involved before we go play”.

What it seems is that there is a shift in areas of influence. The clinical demands of patient delivery , are becoming the driver of the IT requirement, as opposed to the other way round, And that IT per se, may not understand the clinical needs it is trying to address.

Two things are  becoming clear – and that tie in with what we have seen from other NHS Leaders that we have talked to.  That success in digital delivery, depends on the individual, and not being scared of appearing to be the idiot. It is a phrase that Katie uses a lot in our discussion – and  also the recognition that we are every day in a brave new world, and we have to sort it out.

It is time to end our discussion. We could talk for much longer, but Katie is at home, and there are noises in the background.

THE PURSUIT OF EXCELLENCE

We talk with Dr Minesh Patel, Partner at the Moatfield Surgey in the UK, and ask – how come they are so good at delivering healthcare for the common man?

Why is it in the UK NHS, that there are good surgeries, and not so good ones, and well, rank awful ones? Why are some standout – and others not so? If human nature is a common denominator, why are there not a set of standard rules, a sort of “go to guide for repairing a surgery”, a recipe book for getting it right, that we all can apply, and that’s job done? And if human nature is indeed the common linking factor, – does this explain why some surgeries are so terrified of change? And others embrace it.

At a time when “innovation”, and “digitalisation” are this year’s buzzwords, can these be imposed by some higher authority – “look, here’s some money, go and start this or that process?” – And if that is the case, then why do we not all have standout surgeries?

The answer is that my human nature, is not your human nature. In short, the success of a surgery, depends on the individual, and the mix of individuals, in each case. You’ve got to “want” to be innovative, to deliver excellence. The only question is whether this is nature at all – or nurture, can we “learn” to be innovative?

Minesh Patel hesitates as he answers this one. In his case, there was never much choice. His father was a doctor, his own daughter is a student doctor, so this is a family tradition so to say, The choice of working in a hospital, or running a surgery, was the freedom to improve and innovate given within a surgery, but it was a journey, taking in improving PCT performance, being Chair of a CCG, leading the clinical strategy development of a developing iCS, before settling and developing the Team at Moatfield, in East Grinstead.

Minesh readily admits that he cannot change or improve everything. Sometimes, the structures themselves do not lend themselves to change. And health inequality from one region to another, one person to another, is a life reality. Having said all that – is there a “process”, an attitude of mind, that is the difference , and what would be the roadmap for other surgeries to follow?

“The answer is little steps, all the time”, answers Minesh.

“At Moatfield, we have a daily huddle, we analyse all of our processes, and we act quickly. Our new website took just 4 days of re-tooling. We are not afraid to act if we believe in something” Minesh uses the word “innovative” a lot. 3 years ago, he became Chair of the National Association of Primary Care (NAPC), which he says has brought him into contact with a lot of like minded and talented people around the country, both within other surgeries and other providers, who are beacons of excellence, and who are learning from each other. It’s a case of seeing “what are the neighbours doing”. so to say. But it is also visionary.

Although we are talking about the daily routine, there is a focus also on the wider picture, why can’t we do things in a different way.

We are getting ahead of ourselves in the discussion.

As if on cue, I look at my watch – we have been talking for 29 minutes. “I’m really sorry!”, Minesh says…. “I have a patient call in a minute”

CAN MUSIC MAKE THE WORLD GO ROUND?

We talk with Andrew Given, Development Director of the English National Opera company in London, about the new ENO Breathe project that has taken both healthcare COVID support, and music markets by storm.

The answer to the above is yes, and no. It is not music per se but it is opera, and the deeper answer is; yes, – very possibly, and in ways that we could not have imagined.

Even more curious, is that – it is not like Opera is a household accepted musical item. It has that bourgeois middle class image which even ENO, the common man entry point for opera, inhabits. And yet here we have a project that is open for all and has to be so, regardless of musical ability or background.

ENO Breathe is a joint project that is a fully structured, thought-out, and managed collaboration, between the ENO, and Imperial College NHS Trust, that delivers a programme of breathing exercises, and participation in singing routines and soft lullabies – to help long term COVID suffers get over their condition.

It is a brilliant concept that astonishingly has no public funding – its initial pilot of 12 patients back in August was crowd-funded to the tune of £12K, by ENO Members, in just seven days. And Imperial College cover their own costs.

It is a marriage of expertise that can make, and is making such a difference already, across a divide that would not have been visible or noticed a year ago. You could say ENO Breathe was an accident, the result of perhaps an even more strange accident – where the seamstresses and costume teams at ENO – plus an increasing army of ENO staff and volunteers, produced the Scrubs for various hospitals, due to a national shortage of protective workwear.

From there, it is a short step to ask – “well, what else we can do?”

From those initial conceptual discussions in early June 2020 – ENO Breathe now has a network of regional NHS Hospitals all signed up to registering their COVID Patients into the scheme. Hospitals include all the main London hospitals, plus Liverpool Royal Infirmary, Manchester, Newcastle, and Oxford. Patient entry into the scheme has to be by referral only, from one of the above hospitals, or from a medical practitioner.

This is no singing group or roll-up choir practice. ENO Breathe is a medically based process that uses opera expertise at its highest level – for the good of patients who need help and who probably have never inhabited an opera house in their life.

And whilst Andrew would be supremely comfortable if patients in return, all became ENO Members, his more urgent need is to continue the funding process.

ENO is currently looking for corporate sponsors, who wish to be visible in their COVID support and also by implication, support for the Arts. It is a truism that every patient is somebody’s employee. You could argue there is a vested interest in corporates protecting their employees in a wider sense.

We finish our discussion. Andrew is sitting in white T-Shirt, in his pristine white lounge area at his home. He has other calls to make, One of the ENO mantras, is that opera is open to all – but I don’t think even he imagined how this would work out.
 
If you are interested in supporting ENO Breathe, please contact Andrew at agiven@eno.org and if you like to know more visit https://eno.org/eno-breathe/’
 

HAS HEALTHCARE CHANGED FOR EVER, BECAUSE OUR LIFESTYLES HAVE CHANGED FOR EVER?

We chat with HIMSS Global Clinical Director, Charles Alessi, about where healthcare is going for all of us, and what will be the key changes. It’s a wide ranging discussion…

It’s an obvious question with no obvious answer, because our original assessments of just 10 months ago, may well be incorrect.

Charles Alessi looks intently at me across the screen, we are on FaceTime, – he is dressed casually in a pastel coloured polo shirt, sitting in his relaxed lounge area of his home in south west London, there are rows of books behind, a sort of academic university professor ambience and it reminds me of my own one/one sessions all those years ago. As a former Chair of the UK’s National Association of Primary Care, and as an advisor to WHO – Charles is well placed to be talking about the problems of our time.

And COVID per se, may not be one of them. “There have always been pandemics,” he says. This particular COVID-19 is really a child of the 21st century, perfectly suited to our super connected societies where global travel between dense population centres  is as common as a daily commute” Charles is more referring to our personal ability to survive and manage ourselves in lockdown, or rather – survive the absence of face/face proper contact, and the distance management that is the glue that holds us all together and allows us to cope.

“Starting the day at 08.00am, from my living room, with a call to Tokyo – and then a 10.00 call to Berlin – with London time zone calls in between – and then the 17.00 call with California – all whilst sitting in my own arm chair and not having moved an inch – is not what our bodies and brains are designed for. We as humans, need the travel time, to adjust, to refocus, to wind down between sessions, so to say.”

So no – our Lifestyles have not changed for ever. We will inevitably return to the travel to meetings, as soon as it is safe to so do – because we are becoming disorientated without doing so.

Healthcare on the other hand, has indeed changed, and we cannot put the genie back in the bottle. It is obvious that telehealth, or telemedicine, and the remote monitoring of our conditions by clinicians, makes sense, and reduces costs. And where all of us are moving towards a single version of truth of our own health. And yet, this democratising of healthcare – Charles argues – has not happened. And so we have systems and processes designed to fix individual instances, but where in times of a pandemic, are forcing whole decades of instances into just a few months or even weeks. How can we possibly cope?

The key to where our health processes should be going, is at the beginning, where we stop being a binary society, – assuming we are all “well” – until we flick the switch one random day and find we are sick, we have a lump, a pain, whatever. And then we go to places called hospitals to fix the issue.

Our focus now should be the age of precision early management of our individual health. At a time when you and I as individuals already know from the data on our wrist, what is wrong with us even before the doctor ever speaks to us, we are now in a position to manage where our own health data and symptoms, and what Charles calls “non communicable diseases” , can take us, for our own good.

I was expecting somehow a medical discussion and yet this was not it. This was a look at where society is going, and what are we doing as society. But you and I as individuals, are society.

I always remember being late substantially for a meeting. I called ahead, as if my excuse – “I am in traffic!” – was good enough.

“But you are the traffic”, was the response.

Are you a Citizen Data Scientist? I’ve no idea…

Anna Rossudowska has written to us from the Alteryx company, asking us to join her Seminar, where she is speaking. There is only one problem. I have no idea what she is talking about. We have called her office and as soon as we get a deeper discussion, we will be pleased to inform you. In the meantime…

“Citizen data scientist” is a term that seemed to catch on overnight. But what exactly is a citizen data scientist? And what’s this up-and-coming talent group doing to their businesses?

Join this live webinar series to learn everything you ever wanted to know about citizen data scientists — including how to become one. You’ll discover:

*How citizen data scientists have changed the analytics industry + the future of democratised data science

*Steps to become a citizen data scientist

*Ways to demonstrate value to your business and develop your analytic skills

*Get ready to unleash the next stage of your analytics journey. Register today.

WEBINAR DETAIL DATE 17 February – 3 March TIME 11:00 – 12:00 GMT