President, Global Government & Health at BT Global Services
The only way the NHS will be able to find £22 billion of efficiency savings, strengthen out of hours services and develop new models of care simultaneously is by exploiting the disruptive power of smart technology.
Success depends on implementing IT solutions in ways that break down information barriers, win the trust of clinicians and secure the cultural change which allows people to think and work differently.
All of this has to be integrated into existing systems and ways of working.
Greater efficiency and higher quality require staff to access and share patient information quickly and simply. The difficult part of this transformation is overcoming organisational barriers to relentlessly focus on the needs of patients – making sure information is held securely while allowing the right people to see the right information at the right time.
For example, we have recently worked on a system which allows authorised care workers to securely see alerts about patients who are vulnerable or at risk, and they can access A&E attendance records from within a mental health care system.
Risk is one of the big problems with IT. Transformation programmes based on technology can sometimes end up costing too much, not deliver the promised benefits and damage an organisation’s reputation.
These risks can be drastically reduced if everyone understands that the key is using the technology to deliver changes in the way people work – the technology itself is not the transformation.
BT has seen this approach at Nottingham University Hospitals NHS Trust, which has equipped its 4,000 doctors and nurses with mobile devices to replace pagers, fixed telephones, static PCs and obsolete patient monitoring systems.
With an average of 2,000 calls for assistance every week, doctors could easily have 10 concurrent bleeps to respond to and no way of knowing which was the most urgent. Now staff across the trust are able to see and share real time information, hugely improving their ability to respond quickly to deteriorating patients.
As one ward sister put it: “I glanced at my screen and I could see immediately that there were three patients who had all escalated within 15 minutes of each other. I’d have been oblivious to that before.”
This system is working well because clinicians played a major role in designing it, so nurses felt it was built around the demands of the ward. They saw the benefit and wanted to change how they worked, enabling the new approach to be rolled out in just six months.
Telehealth highlights the wrong and right ways to use technology to bring about change. There have been examples of telehealth kit being dumped on GPs with little thought for the way care needed to be reshaped to get the benefit.
Where doctors see telehealth as a way of transforming the relationship between the patient and medical services to increase independence and reduce risk, however, the results can be dramatic.
In a BT survey of 1000 patients receiving telehealth support from Peninsular Community Health in Cornwall, 90% of respondents said they had benefited.
Almost two-thirds felt more supported and safe, half said it helped them manage their condition better, and 69% reported reduced visits to their GP.
It was also plain that age was no barrier to using technology; once trained, older patients were easily able to integrate it into their lives.
Clinicians were equally enthusiastic, citing greater efficiency and productivity. They will accept change if they can see how it helps their work. Winning hearts and minds requires a personal approach demonstrating what’s in it for them as much as what is in it for the patient.
At a joint King’s Fund / BT event in June on providing higher quality care at lower cost, South Warwickshire FT chief executive Glen Burley described how it took three years to win the trust of clinicians and transform the way the hospital was run.
He talked to them about patient stories and mortality rates rather than targets, ensured they felt ownership of the change programme, and got them working around the flow of patients through the hospital rather than focussing solely on their part of the care pathway. His most important performance indicator is the annual NHS staff survey.
The successful transformation programmes I’ve seen and worked on have been built around great vision and leadership.
They’ve started with the problems faced by patients and staff, they’ve brought people with them on the journey, and they’ve had the courage to dismantle old ways of working in favour of new approaches.
Technology is an enabler, but it’s the skills, planning and passion of the people that make the difference.
This article was first published in The Information Daily, which is owned by Boilerhouse Media. The Information Daily publishes features and podcasts on social value, localism, the NHS, data, smart cities and more.
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