INNOVATION AND THE NHS. DOES IT REALLY WORK?

We look at the progress of Great Ormond Street hospital, London, and ask – was COVID the driver of their reach-out; and can other hospitals learn from this?

I’m sitting at my office desk and the good people at HIMSS media have sent me a long link so I can easily register. The details of my credentials are already known to them and already pre-filled when I click the link. I am on auto-pilot, I click “yes”. Many times. I am going to the HIMSS20 Conference in Helsinki, except that it is no longer in Helsinki. It is staged in a TV recording studio somewhere in west London.

Instead of trains and planes and hotels – I click on this virtual panorama and I could be walking around the Convention Center at Orange County Orlando – I feel sucked in, I pass by the names of the well known vendors, who have their Announcements, and Booths, and I almost miss it. Hidden on Day One, is the modest title:

“Lessons learnt from COVID-19: Supporting and protecting the front line”.

It is redolent of my own far distant days at Uni, the modesty of a non-engaging title that we all know hides far greater truths:

“Some new thoughts on Mozart’s Figaro”.

I pick up the phone, and get through the wait on reception at Great Ormond Street, and get connected. Catherine answers the phone. She is a nice lady.

“Do you want a Soundbite?” She laughs.

I laugh, in my turn. No. I want everything. I want to know how you do it.

What is obvious about this Presentation by Sarah Newcombe and Catherine Peters – is that – despite the turbulence of today’s times, and the recognition that everything has changed – in reality, nothing has changed. As Catherine says in her notes below – Great Ormond Street hospital started on this Innovation journey some four years ago. And HIMSS itself has always been the byword of digital tech reach-out. Speaking at HIMSS has always been a sign that you have made it.

Except that there are of course differences, Innovation itself does not necessarily mean tech. It may simply be a change in the way you approach things. There is no mention of technology in Steve Job’s mantra “think different”. And this is the point of convergence with Catherine’s thoughts; her standout advice is – if you want to get it right, then – “have a Plan; and do it now.”

You can argue that anyone can have “technology”. And anyone can have buzzwords. Just a few years ago it was “interoperability”. Today it is “digital”. I am not sure I know what “digital” actually means, but that does not matter. This discussion and presentation , is the journey that every hospital should be taking but that few have the courage or expertise to do, without a RoadMap.

The notes below, are the RoadMap. This is what Catherine says:

RB; “Innovation” is supposed to be the flavour of 2020.  If COVID had not happened, would you have gone down the innovation route that you discussed at HIMSS?

CP; GOSH has been on a digital maturation pathway for the last four years. The implementation of an enterprise wide electronic patient record (EPR) platform in April 2019 helped us leap forward on this journey. Having a fully digital and paperless health record meant that our staff were able to adapt to COVID rapidly and to continue to work remotely if needed.

The patient portal was included as a key element of our EPR from the outset, and we had actively encouraged patients and families to sign up prior to COVID. However, as the pandemic started, we could see the power of integrating video visits into the portal. Through concentrated power of will and the benefit of a highly functional team, we were able to work with our telehealth and EPR partners at a pace that was breath-taking and skilful. From a completely standing-start, we were able to deliver video meeting capability for 5000 staff and establish fully embedded video-visits capability within our EPR within eight days.

Our vision at GOSH has been to use technology, data and analytics to provide safer, better and kinder treatments and care. This has required strategy, focus and a plan. For us, true digital innovation needed to be a living, breathing entity underpinned by an empowered and enthusiastic workforce where continuous improvement is part of our culture. Innovation that is not nurtured or a fad does not thrive and become a reality.

We are very fortunate to already work within a highly functional and motivated team and for us, COVID has been an accelerating agent; COVID helped focus the minds of those around us to really move at a pace that is difficult to achieve in more normal times. In effect the COVID pandemic forced us to fast forward our plans

RB; Did you have to change your way of dealing with patients?

CP: Our patients are complex, and we have high numbers of face-to-face outpatient visits. This had to change, and we reversed the ratio of face-to-face and virtual appointments within a couple of weeks

The interactions between clinical staff and patients required both groups to adapt to new ways of working (environments, communication and medical assessment itself)
We also had to promote and actively sign up patients to the patient portal in order to schedule video visits. This in turn has opened up the possibilities of the patient portal to many patients and families. Messaging, lab results release and access to letters have been the most popular features of the portal. In turn this means we have improved engagement and communication with our patient groups.

This has fostered our patients being greater partners in their own help. Surely, the patient and their family are the most important members of the care team? We have developed bespoke functionality (“heads-up”) whereby patients are encouraged to ask their doctor or nurse any questions on their mind before each clinic visit. We feel this is a powerful tool to enhance the connection between patients and their clinical team. We are really happy to share any of our news ways of working and ultimately feel this type of capability would strengthen any outpatient consultation.

RB; The impression we had, was that although you have changed how you cope with things – actually you are still restricted by existing processes, i.e., protocols, policies, etc – that in themselves become a substitute for actual new things. How much did you have to throw the rule book out, so to say, or actually – you have never been restricted – there is an inherent flexible mindset?

CP; There are many ways in which our staff and patients have had to be flexible and change working patterns and environments. At the onset of the pandemic, team meetings, patient discussions, and operational meetings moved to telehealth and video conferencing platforms. Patient safety, clinical governance and safeguarding of course remain of paramount importance.

As a specialist children’s hospital, it is vital that our governance, while done in a timely manner, is done to the highest standards. Our approach to using technology and data successfully has been to incorporate it into the workflow of clinicians and we ensure it supports care delivery. This approach itself acts as a built-in parity check.

We also wanted to help the system and all paediatric patients across the country during the pandemic. Working closely with our colleagues in North Central London, we opened up GOSH to take patients with general paediatric conditions.

Our hospital is centred geographically between many other large hospitals. We were able to support patients and staff in these other locations by opening new ward environments and transferred general paediatric patients to our site. This in turn meant beds in other hospital units were available for adult COVID patients. We onboarded over 200 paediatric staff from other sites within weeks. The need for adaptability and flexibility has been required and achieved in so many areas of clinical care and we are really proud of our staff and patients.

Our greatest asset has been our staff and we are very fortunate to have full executive backing at Board Level in the Trust to leverage digital tools and capability to make a difference and enhance the care we delivery.

AHIMA launch new EU collaboration in AI and Telehealth.

The American Health Information Management Association (AHIMA) and Frontiers Health, along with  the Healthware Group, recently agreed to a content collaboration that will serve health care professionals in both Europe and the United States.

It comes just prior to the launch of the annual AHIMA Conference, this time Virtual, in just 10 days time. (We will be talking with Michael Bittner, AHIMA Media Director, early next week, on  the key notes to be covered)  In meantime – What they say is this:

“Frontiers Health is recognized across Europe as a transformative organization with a long history of promoting innovation in health care,” said AHIMA CEO Wylecia Wiggs Harris, PhD, CAE. “Like AHIMA, they see the human behind health information and health policy, making our collaboration a natural fit.”

Frontiers Health, in cooperation with Healthware Group, is hosting two education sessions, focusing on telehealth and artificial intelligence in health care, at the AHIMA20 Virtual Conference taking place October 14-17. The sessions will feature speakers from companies like CarePredict, Intouch Group, Kaia Health, Vitality, and Wysa, as well as other global players from the digital health space.

In addition, both organizations will collaborate on sessions at the Frontiers Health Hybrid Conference this November. AHIMA’s international team will host several sessions within an overarching theme of “Data Driving the Future of Health.” AHIMA experts will discuss data consent, privacy, interoperability, patient access to their health information, and more.

“This collaboration serves AHIMA members and health care professionals in Europe, as both groups will have access to new content and resources with a global perspective,” Harris said. “It will also help AHIMA increase its international footprint and reach health care audiences around the world.”

“I am pleased to expand our collaboration with AHIMA and look forward to hosting two dedicated Frontiers Health sessions at the AHIMA20 Virtual Conference,” said Roberto Ascione, conference chairman of Frontiers Health and CEO & founder at Healthware Group. “Frontiers Health will share its extensive knowledge and first-hand experience in strategic spaces like telehealth and artificial intelligence. Through its cooperation with AHIMA, Frontiers Health will promote and contribute to the pivotal role of digital health innovation in the new normal.”

Death by Webinar! Yes I know it’s interesting, I really don’t have the time…

As we all get cleverly online  and  “reaching out” is the new reality, are we already suffering from  just too many people and organisations competing for our time? 

Or to put this an other way – are the “good moments of connection”. being already drowned by the mass of things we never wanted to know about anyway, or sales and PR pitches masquerading as bona fide information moments?

There is nothing wrong with a good sales pitch, but there are times and places.  What we have done here is pick out a few good ones that we heard about last week, that you might like to know about:

We Are What We Eat

We catch up with Nutrition Consultant Olga Preston, about how what we eat, impacts how we behave.

We are not talking about getting tetchy in the morning, – although that may be the case. This is serious stuff. We are at the sharp end of solving and reducing symptoms of, serious mental health issues, by understanding, analysing, and even rejecting, the food that we have queued for at the supermarket just a few days before.

And it’s not that Olga does not have experience of these issues. As a former nutrition specialist with the Brain Bio Centre in Putney London – and now branching out on her own, with her own portfolio of patients, Olga is convincing as she talks to me by phone.

“You know that sugar makes you anxious?” She says.

I didn’t know that. Neither did I know that my favourite pasta carbonara is also less than ideal.

“You need some chicken and steamed vegetables”.

I demurred asking her about my glass of Chardonnay in the evening. But what is clear is that, once you get beneath the recipe and menu level of conversation, there is an increasing awareness by all of us at a community level, that by just changing a few things in our diet, we can reduce the mental issues that also seem to be on the increase. And these are the issues that conventional medicine, with its dumbing down side effects, seems powerless to handle.

Apparently, NHS GPs do not normally refer patients who they feel have mental issues, – to a Nutritional Therapist Nutritional Therapist, despite the latter qualifications.

Olga’s patients are referred by private clinics. She specialises in children issues, particularly autism and ADHD, with a small reserve area for adults with depression and psychosis. he will shortly have a separate facility at the ION Clinic in Richmond. We talk about other influences, the use of Music to stimulate people with brain issues, etc, and what she says is that people are now comfortable and accepting that there are different therapeutic tools, to do different jobs.

Olga is an an accomplished Seminar speaker – and I don’t want to delay her any longer. I think about grabbing a large sandwich at the train station, but apparently too much bread is not great for me either.

Olga can be contacted directly at; olgaprestonnutrition@gmail.com

DOES CUSTOMER EXPERIENCE DEPEND ON DATA?

We look at the latest CX Conference from IQPC for the Telco industry, where, if any market depends on data, it is this one.

You would be forgiven for thinking that this is yet another data-driven conference. It is not like we haven’t had enough of these already. And you would be both right – and wrong. But it is an awkward balance. Workshops that describe “leveraging your current data goldmine to deliver a better customer experience” – are a mouthful and redolent of putting square pegs in round holes.

Since when has a “customer experience” – been the result of some IT focus on “data”? And do customers, who presumably are the beneficiary of these discussions, care – when their only contact contact with their telco, is the guy who keeps them waiting on the end of a phone.

It’s a tricky one.

But these questions, have to be addressed. The behaviour of the guy on the other end of our phone, is determined by the solutions and methodologies that he has before him, And that includes the understanding of the psychology of the whole business of choosing, buying, keeping using a telephone. After all, it’s not as if we can do without them – and in many ways, the single unique focus on the telco industry means its focus is what its players want to know about, within their own market. This was not a touchy feely conference.

Having said that, if you accept that the data that we ourselves create when using a mobile – can be assessed to see how both sides can benefit in the future – then this is the Conference you should have attended.

And the data and tech players are many. Key specialists line up to talk about their own experience, their customer experience, with long titles such as; Head of CX; Chief Experience Officer, Data Transformation Manager – then moving on to the more commercial “VP Sales” – with which we are more familiar. It is three days of intense but relaxed discussion. You choose the sessions you want to look at, and it is up to how proactive or reactive you wish to be. Key topics range from the evergreen “how do I stop churn”, to..”how do I train my call centre properly”. They are practical, basic,

We sat and chatted with a random selection of delegates, from large and small players, who came to “keep up with what is going on” – and with a broad range of vendors, who increasingly are moving from the pure tech of handling data, to a more customer focussed look at how you and I behave.

If there was one standout dawn of realisation, it is that we have all moved on from GDPR. Nobody mentioned it to me, and I wasn’t going to start that discussion. And lets face it, as consumers, we weren’t interested in it anyway…

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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New Faces in International Healthcare

We look at the new faces in healthcare promotion, and ask; why aren’t the old ones keeping up?

It cannot be a surprise to anyone that the new kids on the block, and who are bringing a whole empire of new digital medical tools to the market – is China. Not only are we seeing – every week – an announcement from the elder statesmen of HIMSS Asia about their presence in Shanghai – but the most compelling and forceful marketing piece comes from Yolanda Li, at the CMEF Trade Fair in just a few days – also in Shanghai. What she says is this:

“The China International Medical Equipment Fair (CMEF) was launched in the year 1979. It has now become one of the world’s leading global integrated service platforms in the value chain of medical devices, covering products and technology, new product launches, procurement and trade, scientific collaboration, academic forums, brand promotion, education and training. The fair widely covers more than ten thousand products, including medical optical and electro-medical devices, smart health-care and wearable equipment, and services including medical imaging, medical examination, in-vitro diagnostics and hospital construction. More than 7,000 medical device manufacturers from over 30 different countries and regions have annually exhibited their products and services with us at the CMEF. For trading and exchanging of medical products and services, about 2,000 specialists and talents and almost 200,000 visitors and buyers including government procurement agencies, hospital buyers and dealers from over 100 countries and regions gather at the CMEF.

What you could get from the CMEF Spring 2019:

1.An optimal opportunity to be exposed to one of the largest medical devices showcase with well-known exhibitors and their new production release;

2.The best chance to look into rapid-growing Chinese medical devices market, knowing the latest technology and tendency;

3.Meeting industrial experts on various conference and our CMEF Featured Country Day activities.

And she goes on….“Please visit our official website for the 81st CMEF Spring latest floorplan, completed exhibitor list, onsite activities and conference:
https://www.cmef.com.cn/g1225.aspx”

This compares with the latest Announcement from the VITALIS people in Gothenburg, regarding their own Conference just a week later.

Except that… I read with great interest, the announcement from Yolanda, – because it was in English. The VITALIS editorial, was in Swedish – and I brushed over this. I have no idea what they are saying.

The point of which is twofold; if you are serious about international, then it has to be in English. Doing local language says just that – you are local end of story. And as a Brit, writing on these pages – let’s not forget the importance that the “british language” has in the world.

Is There Too Much Data?

We look at the plethora of  Conferences in 2017, all focussing on the same Chief Data Officer market, and ask – why is life so complicated?
I don’t want to say we are not grateful. The specifically focussed “new generation” of Speakers and Vendors, all have something relevant to say. But this is the problem. Taken as a whole – there is just too much that people have to say.  It used to be just the one Conference, and the concept of the CDO was  twinkle in the eye. Now, we have the Chief Data Officer Europe 2017 Conference in London, from the 20th Feb, focussing on GDPR.  We have the Chief Data Officer Forum, from IQPC, in early May;  and then we have a Chief Data Scientist Conference, in September. I don’t know what a Chief data :Scientist”  is. All of which means that the whole area of expert opinion of a CDO, is diluted because from what we can see, there is no wrong opinion. What works for you, works for you.  But it might not work for someone else.
So where’s the value here?
The answer is in making it simple – and choosing the vendors, and venues, that intuitively make you feel at ease, and where the value is explained in something that mortals can understand. But “managing”  the process of your data is not just important for any corporate – it is vital and financially risky if you are not in control of the information which may reside anywhere in your ,multitude of databases.
Best up are the Adaptive Blogs, – you can register online at; http://www.adaptive.com. Their regular weekly Blog explains Metadata whilst giving you the options of digging deeper.
We talked a few days ago with Samantha Geenty at IQPC, who started the whole market in our view, just a couple of years ago; their “forum”  concept, which we have reviewed earlier on this Site – is a clever way of bringing people together at like levels of expertise and need.
And we are delighted to be reviewing the upcoming event in Covent Garden from Corinium, on the 22nd Feb.  As I said earlier, it’s not like I’m not grateful.

HIMSS after Obamacare

We look at the immediate US vendors who are keen to be visible in US healthcare in just a month or so. HIMSS orlando starts in just over one month.  expect to see a Litany of new Press announcements.
First up – Proximity Systems, Inc., the leading provider of innovative furniture solutions to healthcare will be at HIMSS 2017, Feb. 19 – 23, Booth # 4363, showcasing a new line of self-disinfecting cabinets designed to reduce the transmission of infection pathogens in healthcare environments.  With hospitals are under increasing pressure to reduce opportunities for nosocomial transmission from device workflow, the Proximity cabinets reduce bioburden on hospital surfaces around the clock, independent of human intervention.
Then we have;  Tyto Care, a telehealth company changing the healthcare technology landscape in 2017, and recently lauded as one of the top solutions coming out of CES. As the first complete telehealth solution enabling live, remote patient examinations of the ears, nose, throat, skin, heart and temperature, Tyto Care offers an experience comparable in quality and diagnostic potential to face-to-face visits— from the comfort of home.  Telehealth is transforming the US healthcare market, and we are keen to see how this will develop without the funding (if it goes that way) for US citizens generally.