IS THE UK NHS THE VICTIM OF ITS OWN STANDARDISATION?

We all agree that having healthcare standards is a great idea. But what if those standards no longer reflect society? We give a four-point RoadMap that every hospital and surgery should follow.

It’s a truth universally accepted that hospitals, and healthcare in general – are not keeping pace with the demands put upon it. The common excuse, equally universally trotted out – is that – well, – there are just too many people, too little funds. We all live too long, and there is less porridge for the three bears. Goldilocks will have to wait for the second sitting.

It’s a lovely story, if only it were true.

The unfortunate facts are that there are plenty of new advances in clinical improvements. Dozens of brilliant apps that monitor and send your health data wherever it needs to go. And more than enough new ways of managing yours and my health processes, better than we have ever done it before.

So what’s the problem?

What it comes down to is – unless you are one of the very persistent few – almost equally universally, none of these advances will ever get taken up. They get squashed and quashed under the mountain of fear of making change. As they used to say in the sixties, nobody ever gets fired for buying IBM. Or not adopting anything else.

And the excuses are many and varied, and they range from – “well, let’s wait until the hospital down the road does it, and we can see how they get on” – to (and this is my favourite – ) “we only ever procure when there are two of anything”. Which means that, by definition, advances that are ground breaking – and that may well be fully tested elsewhere – will never see the light of day because of their very uniqueness.

Somehow, the reliance on rules that might have worked once, has metamorphosed into a protection for the hospital, and an obstacle for the patient. And its a funny thing.

Fear of making change is manifested in various ways. The obvious and simple one, is the routine adherence to protocol, to frameworks, to rigid pathways. It is what I call the “Baby P’ scenario. What if the patient could have been saved? Not our fault. We were following the rules, mate!

I totally “get” the need for a fixed process. Any large institution – and there are non larger than the UK NHS – need a clear process, that guarantees basic universal care. But this attitude, of either passively putting up a barrier – or increasingly alas often, proactively putting up barriers – and that we see so often in this sector, far from leads the way into better healthcare. It guarantees that we stay stuck in ways of behaviour, of technology that simply does not work any more, and that puts lives at risk.

This is most prevalent in areas such as Diabetes, or in theatre management. And now more recently, in telephony and call handling. Hands up the last time you got through to anyone in less than five minutes?

We are not talking about small numbers here. Whole regions are seeing exponential rises in costs, because of a simple refusal to adopt new proven practices. The growth in personal health data, smart watches, means that you and I and the rest of the civilised humanity, have already invested personally in devices that can save us. We just want our hospitals and clinics, to do the same. After all, they are actually paid to do so.

If I asked earlier – what is the problem – then what is the answer?

First – throw away the reliance on frameworks. They are our of date. In the modern world of open metadata access and speed of data delivery, hospitals can make instant judgements on any mix of criteria.

Second – ensure you have a process for adopting new technology, particularly mobile based. Look for the solution to a clinical problem, not wait until you are forced to make a choice.

Third – ditch the protocols of management behaviour. Look at each individual scenario.

And Fourth – recognise that society itself has moved on, and demands better from its professionals, – and that it is right to demand better. There is no value for a hospital of surgery in only defending it’s interests. We pay these institutions to defend our interests, not theirs.

The fact is – as we have described earlier in these pages – healthcare has moved into a Community setting, where prevention and early diagnosis can be identified so much earlier and faster. This has meant a sea-change in attitudes as to where to spend money, and a battle between the various silos of the whole healthcare process, to protect their own individual pots of money.

So where do we go now?

First, we need to recognise that this article is simplistic – that the divisions of primary care and secondary care – of CCG and Hospital, are ingrained. And whilst this article puts the onus firmly on hospitals to change management attitude – it may well be the outreach of a proactive CCG that determines where our healthcare is going.

Perhaps surprisingly, despite the issues of the above reflections, there remain plenty of hospitals and clinics that do indeed follow these mantra, who each month have a clear day where they review technology, who engage with non-NHS organisations in order to get a wider and more critical view. As my colleagues in Edinburgh NHS tell me – “if you always do what you always you did – then you will always get what you always got”.

At a time when there is pressure and PR to invest more financially – the need right now is be brave, in our view – and redefine the structures.

Because without this – patients will increasingly vote with their feet and go into some sort of private scenario, and slowly but surely, the management attitudes and strictures that drive the NHS at all levels, will bring itself down. Don’t say I didn’t warn you.

DOES AI WORK IN HEALTHCARE?

 

We take a look at a recent Study from across the Pond by the guys at Black Book Research, and ask – why are we not having the same results in Europe?

If there is ever a case for not believing what you hear, or putting your finger to your face and pulling your eyelid down – “you’re kidding, right?” – it is in the happy figures that are quoted by Hospitals about their impending use of AI.

There are two reasons for this. Firstly, AI is frequently confused with “let’s do a bit more work on our EHR”, or more simply – “AI is a technical solution so we give it to the CIO to solve.”

When handled correctly, AI is none of those things; rather, it is a clinical evaluation of what we need in clinical management, and work backwards from that.

We see frequently, in the Uk as our base, hospitals having little or no plans or concept as to what actual benefit can be achieved – and in some cases, actually throwing out the AI project they had started in the first place. One Consultant told us he had moved back to pencil and paper.

And yet, the concrete figures from across the Atlantic from colleague Doug Brown at Black Book Research, are compelling and convincing. What they say is; some “44% of healthcare organizations already report using AI in one form or another, and 88% of surveyed C Suite officers expect widespread implementation in next 5 years.”

Practical benefits include, in the USA at least, significant reductions in payments claims being refused, because there is a faster, more accurate process for matching data from all relevant parties.

Whilst the Study spends a lot of time talking about Coding and IT issues – it also goes on to pick out those vendors who have best succeeded in giving a practical advantage to all sides. Doug goes on to say; “Overall, 89% of all hospitals surveyed report cutting transcription costs in half or more while improving the transparency of dictation and transcription processes within one year of implementing end-to-end coding, CDI and transcription software tools. 94 % of providers realized operational efficiencies without impacting clinician workflows. “

What is becoming apparent is that in healthcare, despite the need for enhanced platforms and IT speak etc – the key driver is the identification of what actual benefits you are trying to achieve – and then let the tech do the rest.

Do Lawyers need AI? Good question…

We look back at the recent IQPC Conference on the need for AI, within the legal profession, and ask – who needs this anyway?

It’s a stupid and naive question. Lawyers are the byword for heavy and voluminous documents and the search for precedence.  You can argue  that if anybody needs some sort of automated way to find the data that will  get you  out of jail – it is your lawyer.  And whether this is criminal or private or commercial – the economics are clear; understanding  and devising new ways to handle a legal process – and then automating it – can save billable hours.

And that is the question, and why this intriguing and intensive and experience lead two day event,  was so critical – and explains why of all industries, the legal profession is the last to seriously take a peek under the hood, of the benefits of an AI process.  In a market that so depends on its billable hours – why would you want to reduce your billable hours anyway?

It took a day of separate speeches and discussions and coffee networking – before on Day One, we reached this nadir. It was worth waiting for.

Key speakers and delegates from some of Europe’s leading brands, had flown in from across Europe and taken the DLR  from across the road, to meet at Canary Wharf, and listen and contribute. A key strategy and benefit of an IQPC event is the informal inclusion. Nobody is afraid to say what they mean, and everybody understands that the more they contribute, the more they benefit, from everybody else.

In many ways, the informality belies it’s importance as a means of sharing important best practice. And this allows the delegates to ask the difficult questions. Day One, where we were present, allowed all parties to go beyond their earlier preconceptions that billable hours are the key essential, set that aside, and say :”well, there are other ways of doing this now”. 

What is clear is that – unlike say financial services or Chief Data environments, the legal profession does not come to the table with a problem  that it has to fix. People don’t use lawyers because they want to – it is because they have to. This has allowed the profession to do its own thing, in its own way. Up to a point.

Sure, this Conference was friendly, supportive.  Key corporate legal decision makers rubbed shoulders with public sector movers and shakers. Networking around the water cooler on steroids if you will.

But what is clear, now, is that internal competition from one lawyer to the next – and also the growth and competence of Inside Counsel, has woken up the need to be more commercial. The need indeed for survival, in a real world, has finally kicked in. 

CAN A.I. HELP THE LEGAL PROFESSION AND CAN IT INDEED HELP YOU?

We take an advance peek at the upcoming AI Legal Forum from the experts at IQPC, in London this week, and ask – where does AI fit into this very personal relationship-based industry?

The AI Legal Forum is rocking up at what should be already the centre of UK artificial intelligence. With its base for two days this week at the Hilton London Canary Wharf, the venue is surrounded by the movers and shakers in the banking and financial industries. If anybody depends on accurate use of data – it is them.

So we are in good company. The Forum already has some of the UK’s leading Legal Firms as Speakers, including a couple of large Media companies and PDA vendors. It is a broad church. And it needs to be,.

Reading through the nice announcements, what the Forum is there to do, is ask questions of its delegates rather than deliver information. Sure, there will be experience lead discussion – but as much can be gained from the feedback as the initial presentations from each leader or speaker.

A key element will be the redefining of how legal firms calculate their revenues, from what source. A major bugbear from customers who require legal advice is the constant focus on billable hours, and this is a key topic under discussion, as we move in to new ways of assessing client value.

It’s about time. But then, in the legal profession, you could say it has always been that way.

The Need to Communicate. So why is the Age of Video already dead?

As the various Trade Fairs open their doors this month and next, we look at the best ways for vendors to communicate with their audience, and why do corporates keep making the same mistakes. And what else is there, that can replace it?

I am in my office and I am hit by the promotional email from the one of the many tech trade fairs in London, and there and is an invitation to watch an Interview. It is a topic I want to assess. So far so good – I click on their screen and away we go.  After approx four minutes, my phone goes – I take the call – which generates other immediate calls, and further emails to back up the calls. The video interview is some eleven minutes long. I never reach the end of the interview. And I have no clue what the speaker is really trying to say.

I am walking past some trade stands at a financial services conference and the clearly important person, he is wearing a tie for God’s sake – is being professionally interviewed on video by a cool team of camera people, in black t shirts, cables and microphones strategically placed. It is a Lage Corporate thing, they have a big stand and enough money to use some space for an “interview area”.  Nobody will actually view this interview either. It will be too boring and not say anything that you probably didn’t know already and above all –  will not be engaging, because the important person is unlikely to have the personal skills to get people’s attention and then keep them engaged. 

And yet – the concept of video as a means of communicating, despite being available for several years, has  suddenly has become de rigeur, essential. At a time when we all recognise that PowerPoint no longer cuts it as a communicating device,  and we all “get” that “seeing is believing”- the question is;  why do so many companies get it so wrong? And are we seeing the end of what could have been a golden age, even before it has truly begun?

The answers are that we do not understand what are we trying to achieve by video – and that we are not talking about technology, but human experience and human nature.  So,  here are some essential pointers;

1. Quick and Dirty, actually works. Placing a camera on a table and just recording someone speak their words of wisdom, with minimal after editing, as long as it is short, clear, you say what you mean. 30 seconds is all it takes. It is ideal for Interviews where you are simply making a point. The file size is small enough to email out.

2. The classic CEO Interview does not work. The impression is one of an ego trip and it works against you in this age of saving money and austerity.

3. Use professional actors – even for the shortest project. They are trained to engage with their body language, style of speaking, choice of delivery. You may be a great sales presenter or tech consultant but the National Theatre and Hollywood have not called you. You have other gifts. Leave the delivery of your message, to people who are trained to do it.  This is ideal for the longer Interview, where you want the discussion to retain attention, but never make this more than two minutes. 

4. Use your new found friendly actors, to do the internal communication in your own company. Your biggest problem is more how to keep your own people engaged and motivated – than ever going get new business.  Let the actors use humour and be original in how you do this. 

5. Be clear before you start, what you want to achieve. Spend as much time on round table discussion with all involved, draw up flow charts, shopping lists, – as the time to takes to actually create the video script, shoot it, edit it and so forth. Remember- every battle is won, before it is ever fought.

6. Think about what else can keep people’s attention. In our business, we use Comic Books, to stimulate thought from our readers and visitors. Everyone wants to be a superhero. Make sure your storyline (ie, your message and point you are trying to make) – is compelling, and then let your Designer and Artist do their magic. 

Ultimately – this is all about communication at a human level. Whatever the data or numbers or clever marketing analytics might suggest – the essential of business remains the individual and what they decide to do, as opposed to  ending when you have found out who they are, and  your ability simply to get to them. 

New look at Digitalisation in healthcare

The recent Seminar announcement from EHTEL is worth visiting – we look at the specifics… what they say is this:

Digitisation in health opens up tremendous perspectives for new data-driven services. Our webinar to debate how individual health data combined with data collected in health and social care will provide the fuel for innovation in the future.

The implicit question is: What is Europe’s role in data economy and could maintaining trust be the biggest opportunity for Europe?

Jointly with Sitra, EHTEL is pleased to invite you to a webinar around the IHAN approach for trustfully personalised health services. Sitra’s IHAN® project aims to build the foundation for personalised wellbeing and healthcare services. It is a collaboration effort for European organisations. Evidently such an effort can be of interest for eHealth Competence centres, and all projects and initiatives involved in managing digital health data, also with a view for Artifical Intelligence based services.

Having been inspired by an EHTEL network meeting, we will inform on what IHAN is all about. What are building blocks for the IHAN rulebook like architecture, interoperability and trustful use? What are the core technical components including identity wallet, consent management and logging. How can these components be built according to IHAN requirements?

As an example, My Travel Health – Tokyo 2020 will be presented: The pilot project aims to benefit all stakeholders – travellers get medical attention faster and more precisely; the provider’s health data is securely exchanged with traveller’s consent; and medical teams can quickly get trusted patient information in their own language.

EHTEL moreover understands the webinar as an important milestone to define an AI-friendly environment in health and social care. This idea will be highlighted in more detail at the EHTEL 20th Anniversary & Symposium early December in Barcelona.

The Seminar is Monday 16th sept, at 15.00 CET; or 14.00 UK time. Join via: Skype for Business (connecting details will be shared upon registration)The Seminar is Monday 16th sept, at 15.00 CET; or 14.00 UK time.

Full Agenda is here for download,

Clever People. Important Discussions.

We engage with the very clever people on both sides of the table at the Millenium Hotel London and ask – why do I not understand this?.


The answer is, of course – that I am not meant to understand it. The whole point of working with people who talk in languages and have skillsets that I do not understand – is that on my side – I have competences that are completely unknown and confusing, for them too.

Business depends on the communication of competences across the divide, and this is why every year as ritual, the IQPC Conference on AI, and on Intelligent Automation – has become a must see event, de rigeur. At whatever level of vertical corporate you are – Data and its automated future, are the way things will go for your industry and you need to be ready.

And it’s not that I am stupid. Mark Whitehorn’s discussion on where automated data can take us, was powerful but as a mere marketeer, was deliberately over my head.

But not over everybody’s head; the questions from the floor were equally intellectual and important, and there was a meeting of minds among a whole section of delegates and the speaker of this initial presentation.

As if recognising this small imbalance – Alasdair Anderson stepped up into the Panel and gave the more business focussed view. And this is the secret so to say, of the IQPC Conference; the balance of many views, and the opportunity to meet with one’s peers, from whatever provenance.

If there were two fundamental questions raised and answered, they were; what does it take to implement this stuff? It is ok having the technology, but here has to be a willingness and an understanding to do so.

As one delegate said; “what does it take in terms of incentive, to open the doors of the people who implement and deliver the benefit of, AI?” And from another colleague – a simple question: “Will this technology make the boat go faster?”

As always, the benefit of the IQPC Conference is as much in its casual networking between episodes.

I have to dash for an evening engagement but by mid afternoon delegates are already in deep discussion. There will be more hopeful of the same, next year.


IQPC schedule of similar conferences can be viewed at; www.iqpc.co.uk

Managing Energy has never been more important.

We look at the upcoming Future of Utilities: Smart Metering Update 2019 conference on Smart Metering of Energy and ask – why has it taken so long?

In brief – this topic has been discussed and received focus – for the past five years even to our knowledge. But in those earlier halcyon days, small interruptions such as hacking and global warming were but twinkles in our eyes. Nowadays of course – things have changed. As my colleague at a Cyber Security company in Israel tells me – “there are two types of smart meter; those that have been hacked and nobody knows it; and those that are hacked and everybody knows it”. And for sure everybody knows about global warming.

So the upcoming Conference from Marketforcelive, in central London this June, is timely. This is the latest and important opportunity for leaders in the Energy space, to sit down and say – how are we controlling access to the flow of energy, both remotely and at source. Saving energy has been defined as the secret sauce of modern energy management, We are not as naive as before.

Whereas before, delegates that subscribed tended to come from the pure data and tech environments and talked in a language that you or I could not understand – nowadays, this Conference will attract the commercial leaders and all those on the peripherals. Energy control is essential big business in a world where such is the reach of media, we are all experts now.

With an impressive Speaker List – we expect “Future of Utilities: Smart Metering Update 2019”,to become a Forum for exchange of ideas that are proven and that work, a significant development from other Conferences in the past that were merely talking shops.

The Conference takes place on the 18th June; go visit it at; http://bit.ly/2wGAiqZ. our longer report will follow shortly after.

Making Better Business Decisions is not Accidental

You would be foolish to run your business without a Plan, without a RoadMap, without guidance. This is prevalent of everyone asking for advice – but nobody taking it. Kayla Chiara of the Dimensional Insight company, writes to us to say that, whilst the growth of BI is slower than everyone expected – nevertheless the need is still paramount, and that her company can help. Here’s what she says; we publish her eloquent announcement:

Dimensional Insight®, the maker of Diver Platform™,  one of the leading data management and analytics solution vendors, today announced its strong showing for the 10th straight year in Dresner Advisory Services’ annual Wisdom of Crowds® Business Intelligence Market Study. In this year’s study, Dimensional Insight saw increased performance in several key measures, and it maintained its perfect “recommend” score.

The annual Wisdom of Crowds Business Intelligence Market Study surveys users across geographies, functions, organization sizes, and vertical industries. Users are asked questions about business intelligence trends, as well as questions about 27 specific vendors on 33 different criteria.

In this year’s report, Dimensional Insight was noted for its scores that remained “well above the overall sample in 2019.” The company was also an “overall leader” in the two market models included in the report, placing in the top right corner of each. The Customer Experience model plots sales and service scores on the X-axis with product/technology scores on the Y-axis. The Vendor Credibility model plots a value score on the X-axis with a confidence score on the Y-axis.

In addition, Dimensional Insight was noted for being “best in class for sales product knowledge, product customization and extensibility, consulting experience and continuity, and overall integrity.” The company also had a perfect recommend score.

“We congratulate Dimensional Insight for its strong scores over the past 10 years of the study,” says Howard Dresner, president, founder, and chief research officer of Dresner Advisory Services. “The vendor ratings are based solely on the voice of the customer, and, based on this assessment, Dimensional Insight continues to provide significant value and satisfaction to its customers.”

“At Dimensional Insight, our customers are the focal point of everything we do, and helping them deliver real results to their organization is paramount,” says Fred Powers, president and CEO of Dimensional Insight. “These scores reflect our customer-centric values and we’d like to thank our users for their continued support of our company.”

To learn more about the Wisdom of Crowds Business Intelligence Market Study, you can download a copy at http://www.dimins.com/awards/dresner-report-2019/.

Healthcare. How to make AI work for You.

We look at the constant hype surrounding this overblown topic and ask; can it deliver for you?

On the basis of what we have seen – probably not. Although according to multiple independent reports “When it comes to healthcare AI, the UK is the powerhouse of Europe” – there are conflicting statements by  UK Government saying that “dealing with the NHS remains challenging”. And looking at a recent statements from others,  the evidence from startups and those tech companies who are at the forefront of developing new AI based solutions, take up is small, and there is  “little benefit to the value proposition”, from using AI per se. So there is a conflict between commercial take up – and perception of relevance.

What is worse, is that we are already seeing one hospital terminate their digitalisation journey, because – as one clinical Consultant told me – “it just doesn’t work”. 

The reasons  it “doesn’t work”  are many and varied, but largely fall into two camps,  first of which  is because the introduction of AI or Digitalisation, is not an IT or Tech discussion. It is a business process discussion. It is an HR and best use of people, discussion. If it remains easier to flip the paper pages of a file to see someone’s latest notes – then that is what it is.  But also – the announcement of a single IT decision point of the new NHSX quango, is itself a misnomer. At the upcoming Digital Health Conference, focussing on the new NHSX facility – there are no less than six Decision Makers all involved in the decision making process

So… what are the practical steps that you need to take, to get the best out ofAI based new technology?

1. Understand and create a Roadmap, of what you want to get out of this process? If it is simply to shore up your existing practices, then forget it.

2. Know which areas you  wish to include – both from a data access point of view, and also groups of people.  The more groups involved, the worse it will be.

3. Understand that what works for one hospital, may probably not work for you. Make clear choices about solutions that can deliver a specific benefit.

4. Do not engage in Trials.  AI data management is not a clinical discussion, and the algorithms used are already proven. You are already good to go.

5. Have milestones of progress. 

6. And only when you have all of the above written on a piece of paper – then involve your IT people.

You may well now find that the money you had previously allocated for something nebulous, will indeed deliver when broken down into manageable practical specifics.

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