Summary
Matt Hancock, Health and Social Care Secretary, has announced the latest vision for IT modernisation in the NHS, This will involve moving applications / data to cloud-based services, and technical standards which will allow NHS IT systems to be interoperable and upgradable. Access to up-to-date patient records and data in real-time will support good quality and prompt care. The NHS IT infrastructure should deliver better services and facilitate innovation. The main section headings are:
- Introduction.
- Guiding principles.
- Architectural principles.
- Our priorities.
- Conclusion.
- Annex A: Case studies.
- Annex B: Sample standards and user needs.
Reference
Matt Hancock launches tech vision to build the most advanced health and care system in the world. [Online]: Department of Health and Social Care, October 17th 2018.
This relates to:
Reference
The future of healthcare: our vision for digital, data and technology in health and care. [Online]: Department of Health and Social Care, October 17th 2018.
Cautionary Notes
Progress has not always gone to plan, in recent history:
Reference
Wheeler, B. (2018). MP’s ‘horror’ at getting £4.2bn to digitise NHS with no plan. London: BBC Health / Politics News, October 2nd 2018.
The Healthtech Advisory Board
An advisory board has been created to advise Matt Hancock’s department, regarding the uses of technology in health and social care, and linking this closely to promoting a culture of innovation in the NHS.
“Medicine is driven by information: better use of data can revolutionise health care”.
Reference
Health technology expert panel meets for the first time. [Online]: Department of Health and Social Care, November 19th 2018.
Technologically-Enabled Redesign of the Outpatient Referrals System?
Professor Stephen Powis, NHS England National Medical Director, believes use of information technology should be able to reduce the thousands of unnecessary outpatient appointments each day. Commonplace digital solutions – including Skype, apps and online tools – could help to prevent avoidable hospital visits, avoid patients taking time off work and school needlessly, while saving on NHS running costs.
Currently there are 127 million outpatient appointments in the UK per year; roughly five times more than the number of patients using A&E. About a fifth of appointments get cancelled, or patients don’t turn up.
Reference
Triggle, N. (2018). NHS outpatients service ‘stuck in the 18th Century’. London: BBC Health News, November 9th 2018.
See also:
Reference
England’s top doctor calls on NHS to use tech to revamp outpatient system. [Online]: NHS England, November 9th 2018.
This relates to:
Reference
Isherwood, J. Hillman, T. [and] Goddard, A. (2018). Outpatients: the future – adding value through sustainability. London: Royal College of Physicians (RCP), November 2018.
Investigation Into Nursing Workforce Planning and Deployment Technologies
Possibly of interest, an NIHR report explores the implementation of workforce planning and deployment technologies for nurse staffing:
Reference
Burton, CR. Rycroft-Malone, J. [and] Williams, L. [et al] (2018). NHS managers’ use of nursing workforce planning and deployment technologies: a realist synthesis. Southampton (UK): NIHR Journals Library / Health Services and Delivery Research. November 2018, Vol.6(36).
Extension of the 100,000 Genome Project?
The 100,000 Genome Project (launched in 2012) reached its target in December 2018. The NHS has early plans for Genomic England, a company set-up and owned by the NHS, to recruit genomic volunteers whose sequenced genomic information (duly pooled and anonymised) may contribute to developments in the understanding and possible future treatment of serious health conditions, including cancer and dementia.
Reference
NHS to offer paid-for DNA tests if patients share data. London: BBC Health News, January 26th 2019.
Global Digital Exemplar Blueprints
Reports of Acute Global Digital Exemplars, and Mental Health Global Digital Exemplars, which are partnered with “fast follower” trusts to support the faster spread of best practice and innovation through the of use of world-class digital technology and information:
Reference
Older patients spared dementia and falls by NHS tech roll-out. [Online]: NHS England, February 7th 2019.
The Topol Review
The Topol Review covers education and training plans for preparation of the health care workforce to make better use of digital technologies; including genomics, digital medicine, artificial intelligence, big data and robotics.
Reference
The Topol Review: preparing the healthcare workforce to deliver the digital future. London: Health Education England, February 2019.
Comment and analysis from BBC News:
Reference
Pym, H. (2019). Could patients become their own doctors? London: BBC Health News, February 12th 2019.
Information as an Asset Project
Published in the wake of the Topol Review (even sharing some very similar artwork), there is an update to the Hawley (1995) “Information as an Asset” Report:
Reference
Information as an asset: today’s board agenda. cilip/KPMG Position Paper. London: cilip [and] KPMG, February 2019.
Imperial College London’s Care Research and Technology Centre
Possibly of interest, research into developing the “healthy dementia home” will study the use of sensors and wearable devices to monitor physical deterioration, or changes in patients’ behaviour, which could put persons with dementia at risk of hospital admission. Other applications being research include RTLS/RFID tracking, robotic devices and sleep monitors.
Reference
Technology to keep dementia patients out of hospital. London: BBC Health News, April 17th 2019.
Capacity Tracker: Faster Checking for Availability of Care Homes Vacancies
A digital portal allows health and social care staff to get current information about vacancies in local care homes, thereby enabling patients needing care home placements to be supported for discharge from hospital sooner.
Reference
Digital tool to help reduce avoidable lengthy stays in hospital. [Online]: NHS England, April 15th 2019.
World Health Organization (WHO)’s Corrective to Over-Optimistic IT Mania?
This guideline offers an approach to weighing the evidence on how digital health interventions can contribute towards health services improvement. The methodology involves careful and balanced assessment of such interventions based on impact criteria including benefits, harms, acceptability, feasibility, resource use and equity.
Note: “Digital health interventions are not a substitute for functioning health systems, and there are significant limitations to what digital health is able to address”.
Reference
World Health Organization (2019). WHO guideline: Recommendations on digital interventions for health system strengthening. Geneva: World Health Organization (WHO), March 2019.
There is also an Executive Summary covering evidence and recommendations.
Further related documentation:
- Research considerations.
- Web Supplement 1: Evidence-to-decision frameworks.
- Web Supplement 2: Unpublished systematic reviews and GRADE tables.
Issues Limiting Analytical Capability in Health Care
The Health Foundation’s “Untapped potential: investing in health and care data analytics” report explains nine benefits from more investment in analytical capability:
- Supporting clinical decision-making.
- Supporting innovation and improvement in care.
- Facilitating board-level oversight of complex organisations and care systems.
- Improving everyday management.
- Improving responsiveness to national initiatives and regulation.
- Improving resource allocation.
- Improving patient flow.
- Supporting new data and new digital tools.
- Helping patients and raising public interaction with health-related information / patient information.
Reference
Bardsley, M. Steventon, A. [and] Fothergill, G. (2019). Untapped potential: investing in health and care data analytics. London: Health Foundation, May 2019.
The Learning Health System (LHS): Use of Data for Learning and Improvement
More on analytical capability, from a Nuffield Trust briefing:
“A learning health system’ (LHS) continuously analyses data which is collected as part of routine care to monitor outcomes, identify improvements in care, and implement changes on the basis of evidence”.
Reference
Scobie, S. [and] Castle-Clarke, S. (2019). What can the NHS learn from learning health systems? London: Nuffield Trust, May 2019.
Scoping the Future Development of Digital Technology in the NHS
A Social Market Foundation report considers the potential of digital technology throughout the patient care “journey” (i.e. from prevention in the community, diagnosis and referral involving primary and secondary care, and the management of long-term conditions):
- Stage 1 of the patient journey: preventing diseases.
- Stage 2 of the patient journey: diagnosis in the community.
- Stage 3 of the patient journey: digital technology in primary care.
- Stage 4 of the patient journey: digital technology in secondary care.
- Stage 5 of the patient journey: managing long-term conditions.
Reference
Keohane, N. [and] Petrie, K. (2019). National Health Servers: delivering digital health for all. London: Social Market Foundation (SMF), May 2019.
NHSX: to be Launched in July 2019
NHSX comprises “digital leaders” from NHS England, NHS Improvement, and the Department of Health and Social Care, working to direct national policy on NHS technology, digital and data. NHSX first came to attention in April 2019, and via this report covering national policy on digitisation from the acute trusts angle.
Reference
Castle-Clarke, Hutchings, R. [and]. (2019). Achieving a digital NHS: lessons for national policy from the acute sector. London: Nuffield Trust, May 29th 2019.
An April 2019 DHSC press release mentioning NHSX:
Reference
NHSX: digital experts will be part of cancer and mental health teams. Department of Health and Social Care, April 4th 2019.
Speculations on the NHS Estate in the future?
Reference
Wenzel, L. [and] Evans, H. (2019). Clicks and mortar: technology and the NHS estate. London: King’s Fund, May 2019.
There is also an Executive Summary.
June 2019 Update
Plans for the NHS to become a world leader in using artificial intelligence (AI) and machine learning:
Reference
NHS aims to be a world leader in artificial intelligence and machine learning within 5 years. [Online]: NHS England, June 5th 2019.
