Adopting a digital transformation strategy in the face of tight budgets and cuts could save the NHS from becoming increasingly burdened and possibly collapsing as the healthcare service we know.
Health secretary Jeremy Hunt has committed £4bn to invest in technology for the NHS, but the level of digital transformation and its maturity across 239 trusts is mixed at best. Achieving a data-sharing, paper-free NHS appears a little way off.
However, it's not all doom and gloom. Solid projects have been undertaken recently to adopt more digital services over traditional on-premise IT systems in public healthcare.
These projects are not as comprehensive as the IT overhaul undertaken by the Cambridge University NHS Hospitals Trust in partnership with HP, but they do show how the NHS is beginning to use more digital technology that yields results.
And it can do this in many ways, from tapping into big data to adopting cloud services to shift away from non-critical IT infrastructure.
Cloud-based services are one way for the NHS to reduce the cost of running on-premise IT estates and tap into the server and network expertise offered by cloud providers.
The Royal Cornwall Hospital Trust worked with Hitachi Data Systems to build a private cloud to support IT services and handle a growing amount of patient data.
The previous infrastructure suffered outages and was not up to the task, and the Trust opted to use Hitachi’s Unified Compute Platform Pro across two data centres. The system uses VMware for virtual machines and Hitachi Unified Storage VM and Content Platform services, allowing the trust to support critical and non-critical IT infrastructure.
The trust can also scale the system to meet the storage demands of digitalising patient data and clinical images, and implement new clinical applications more effectively. These can then be integrated with Cornwall Council to link health and social services for local people.
The private cloud allows the trust to carry out IT operations more efficiently, as storage, compute and network infrastructure is managed across its three hospitals rather than requiring on-premise systems for each site.
Royal Cornwall also benefits from an infrastructure with the flexibility to address future IT demands and digital services without seeing IT costs skyrocket.
Hitachi’s private cloud allows the trust to support 12 community hospitals in Cornwall and more than 18 GP surgeries, allowing them to access data remotely and deliver care more flexibly.
The end result of moving to a private cloud is a hike in the overall performance of the trust’s IT, and the removal of some of the technical constraints that had hampered the upgrading of clinical applications. The trust can better focus on how technology can aid, rather than simply support, services.
Diagnosing big data
Many private sector enterprises are improving the way they collect, analyse and use big data. It has become a trend that the public sector cannot ignore given the benefits in terms of decision making, efficiency and cost cutting.
Wrightington, Wigan and Leigh (WWL) NHS Foundation Trust is one of the latest healthcare organisations to put big data to better use, especially for front-line clinicians.
The trust used visual big data analytics software from Qlik to identify patterns in raw data and create an A&E application that provides visual information on staffing levels and patient flow.
Access to this data allows the Trust to run A&E in a more efficient way and reduce costs with out hampering patient care.
The direct result is that the Trust has reduced A&E waiting times by 30 minutes, cut fees to staffing agencies and avoided poor service delivery fines from the healthcare commissioner.
WWL became one of only 11 trusts that managed to hit the government’s A&E targets last year, and saved nearly £1m in costs. The money has been reinvested in hospital equipment and patient care without requiring any increases in budget.
The trust may be at the early stages of digital transformation, but its achievements demonstrate how making use of the right digital tools in the right areas of the organisation can yield results and ease pressure on performance and budgets.
A dose of AI
The NHS’s access to patient records and medical information means that it sits on a veritable treasure trove of medical and human data.
Some hospital trusts make good use of the big data they collect, but analysing huge amounts of diverse and sometimes dispersed data takes a lot of effort and automated analysis is increasingly necessary.
It is here that artificial intelligence (AI) can play a part. Google-owned UK AI firm DeepMind has an agreement with the Royal Free NHS Trust to access 1.6 million patient records. The company has developed an app called Stream that allows hospital staff to monitor patients with kidney disease.
The agreement is controversial in its access to sensitive data, and a clause allows Royal Free patients to opt out, but the use of AI technology in the NHS is an innovative approach to data analysis and the deployment of digital services.
The Royal Free project will run until September, and could pave the way for other initiatives once clinicians and patients become more comfortable with companies making use of their data to improve patient care.
IBM is injecting AI into healthcare via the firm's Watson Health division. This uses cognitive computing and machine learning technology to provide information based on medical and wellness data and help clinicians and other staff make better, more insightful, decisions.
Pressures on the NHS mean that finding the time, resources and will to make innovative use of digital technology can be difficult, but the recent launch of the DigitalHealth.London Accelerator should make things easier.
The facility has been set up to help small and medium businesses in the healthcare sector develop and drive new technology targeted specifically at the NHS.
It will allow 30 small digital health businesses each year over an initial three-year period to work with healthcare experts and clinicians. The idea is to refine the companies' products and simplify some of the technical and administrative intricacies of the NHS, such as knowing how to deal with sensitive data.
Big data bedside manner
The digitalisation of the NHS is centred predominantly on putting data to use, but this needs to be approached in a careful and sensible way.
Blackpool Teaching Hospital NHS Foundation Trust found this out the hard way when it was fined £185,000 by the Information Commissioner's Office after inadvertently publishing the private details of 6,574 members of staff.
Details such as National Insurance number, date of birth, religious belief and sexual orientation were leaked after the trust was required to publish equality and diversity metrics annually on its external website.
This was not sensitive medical data, but was still protected and indicated that the NHS needs to be very careful when using such information. The NHS must achieve operational and health service value from the data, but have safeguards in place to prevent the wrong type of data being accessed or exposed.
This is a significant challenge, as seen with the difficulties and setbacks experienced by the NHS’s Care.data initiative to provide an online platform for UK citizens to access their medical records.
These challenges should not be ignored, but they should also not be allowed to stifle NHS innovation.
There is potential for hospitals to work together and engage with the private sector to adopt best practices and technology that facilitates the use of data effectively and safely.
In many ways it is early days for digital technology in the NHS and arguably the healthcare industry as a whole. Startups offer plenty of innovative products and services, but it takes time to get medical certification.
There is increasing adoption and development of IT services such as the cloud, automated analytics, AI and virtual reality, and the potential to put all this technology to use in the NHS is huge.
The results can be significant when these technologies are deployed in a businesses-oriented way, and digital transformation is arguably one of the few ways to save the NHS from decline.
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