Healthcare and other related services in the public sector are ripe for change, fuelled by the growing trends of mobile working, cloud computing, access to data, and the Internet of Things (IoT).
Cambridge University Hospital Trust has been one such recent example of a significant IT overhaul which, with the support of HP, transformed its hospitals into facilities with digital rather than paper records, providing access to that data with mobile devices and the ability to work remotely.
The move from analogue to digital services is being driven in two ways. The first is the need to make savings in a challenging environment in which government cuts and tighter budgets on public sector services are biting hard.
The second is to facilitate a better and more efficient way of delivering care, something the monolithic and arguably outdated systems such as the centralised Electronic Health Record (EHR) system used throughout the NHS that struggles to deliver in a world now familiar with rapid data access and mobile technology.
Dr Chris Farmer, associate medical director for IT at East Kent NHS Trust, sees EHR systems as the past, predicting that less centralised and diverse access to patient records and clinical information is the future of modern healthcare.
"In a hospital environment, you've got a lot of data governance and other issues, but my feeling is I'm not sure that the EHR is necessarily the answer, and actually having data standards and databases that can be accessed through multiple applications may be the future," he told V3.
Digital data in motion
Farmer has carried this ideal through with the hospital's adoption of messaging platform Careflow, which facilitates communication and collaboration between the hospital's medical teams.
The app collates clinical workflows and information, enabling doctors and medical staff to communicate and discuss patients and tasks without relying on a mix of pager, phone, fax, text message, email and paper charts.
Farmer described the app as a secure combination of Facebook's and Twitter's communication tools, and explained how it can be used to send alerts on tasks and patient needs to the mobile devices used by medical staff.
But, key to the Careflow app is how it enables clinicians to access medical records and other data on their preferred mobile device and through web browsers, rather than forcing them to use an EHR system which is often accessible only from fixed locations.
Careflow has provided 430 clinical staff at the hospital with more flexibility in how they access medical records, leading to 600 handovers and 1,000 messages and alerts per week carried out through the app. Further staff are being added to the rollout, so more of the hospital's workforce will become increasingly mobile.
Farmer explained that giving clinicians access to data in the way that suits them, rather than using prescriptive systems, has delivered a successful mobility strategy that allows more effective provision of care.
"I think with mobile technology, unless you allow diversity in how people access the information in the way that they want to, you are not going to be successful," he said.
The flexibility of data and mobile working is often greatly increased when cloud computing is added to the mix.
East Kent's Careflow app sits on Microsoft's Azure cloud platform that offers storage and compute power with the security and data governance needed to handle sensitive medical and patient information.
Gary Davies, sales director at Careflow, told V3 that the growing acceptance of cloud adoption in tandem with wider use of mobile technology will deliver better care in the face of tight public sector budgets.
"The NHS has political pressure on it to change and become more efficient. So it's looking for things that enable it to do that, probably more than it's ever done," he said.
"Cloud computing really does allow a lower cost of entry for what we would describe as an ‘enterprise solution' when you compare it to traditional systems where you have to buy very large amounts of hardware and servers.
"These pay-as-you-go models are becoming increasingly important to public sector organisations that don't have large budgets that they can throw at projects these days because they are not being made available centrally."
Internet of care
Tapping into the major technology trends is by no means limited to large NHS hospital trusts, and is seeing adoption in the social care sector.
Peterborough Council is pioneering digital transformation in local government with a social care project that mixes mobile devices, wearables and the IoT.
Working with startup Alcove, the council is trialling the deployment of a mix of sensors, tablets, smartwatches and RFID technology to effectively create an IoT network in the homes of 100 people who require care, such as the elderly or disabled.
Richard Godfrey, assistant director of Digital Peterborough, explained to V3 that Alcove's systems can be set up to monitor movement and temperature to identify anomalies in expected parameters, and send an alert to the person's family or carer if something is amiss.
For example, someone who needs to take medication at certain times can be prompted via a sensor that detects whether a medicine cabinet has been opened when the patient is due to take their medication. If it identifies that the cabinet has not been accessed, it can send an alert to the person's smartwatch to remind them.
Another use case is when movement is not detected in a home for an unexpectedly long time. This sends an alert to the smartphone of a family member or carer.
Godfrey explained that the use of Alcove's technology is an evolution from the old systems used to alert social care providers when a vulnerable person required attention.
"We want to move away from the old school red button, red cord approach to a much more 2015-approach by having sensors configured to alert you when things are happening rather than waiting for someone to push a button," he said.
The aim of the system is to facilitate proactive social care without needing scheduled check-ups from carers or family members.
This in turn allows people who require care but are not at the stage of needing round-the-clock attention to remain independent and in their homes for longer, but have the comfort of knowing that a system is in place that keeps them safe with unobtrusive monitoring.
Alerts can be sent to family members first rather than carers, allowing a family to have a more active role in the care of a vulnerable relative and offering peace of mind that a relative is being looked after in their own home.
The benefits are twofold: people in need of irregular care remain safe and independent, and the council's resources and money are freed up for those in the community with more pressing needs.
Godfrey highlighted how making use of the latest technology can help local councils make budgets go further and allocate them more efficiently.
"I think most councils are in the same boat. Social care is our biggest expense, but also therefore the area where you can make the most savings by using new technologies and enhancements," he said.
We have the technology
Both of the above projects demonstrate how adopting the latest technology has the potential to propel outdated public sector systems into the 21st century.
Godfrey added that the UK already has the technology to drive positive efficiency and deliver improvements in the care sector, but that hurdles are encountered when introducing changes to a system with which people are familiar.
"In a way the technology is relatively simple. The change management and changing people's way of working is the difficult bit," he said.
This was experienced by East Kent NHS Trust when it introduced Careflow into the hospital, as there were concerns about cyber security and the consumption of personal data allowances, and fears that medical staff would be constantly monitored.
The Trust took steps to alleviate these concerns, one of which was to open the hospital's Wi-Fi so that clinicians can use Careflow with a dedicated network rather than mobile broadband.
Godfrey's approach to introducing Alcove and other technologies into the council has been to develop it and roll it out while working in tandem with the council's departments to help them understand the potential of technology to make their lives easier, and get their feedback on what works and what does not.
"I can give you all the technology in the world but if you don't change how you work it, it is pointless. As a council we're investing heavily in the change process, and the old ways of working are going to start dying out," he said.
"It's not doing it to the departments, it's doing it with the departments. You get a lot of the hesitancy when [change is] being done to someone. We want them to be fully involved in the process from day one."
Yet despite this final hurdle, more technology is making its way into the health and social care sectors, as demonstrated by the government recently embarking on an NHS app testing scheme with three developers.
Furthermore, technology companies such as IBM are creating dedicated platforms for harnessing big data, machine learning and analytics technology aimed at improving healthcare delivery and research, making the adoption of cutting-edge technology easier than ever.
Cambridge University Hospital Trust, East Kent NHS Trust and Peterborough Council are spearheading technology evolution outside central government, and the next generation of public sector health and care services could be radically different from today's.
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