Chris Barker, CEO, Spirit Health Group writes about how everything has changed, but nothing has. In order to meet the challenges facing a post pandemic NHS, the digital transformation agenda needs to accelerate even faster.
Digital transformation was at the top of the NHS agenda for this decade – one that has been accelerated by the plethora of digitally enabled ways of working during the pandemic. While the last year has undoubtedly heralded the spring shoots of transformation, there is so much to be done to build upon this and accelerate further. Do stakeholders, for example – both patients and healthcare providers (HCP) – understand the value of digital to drive change at a fundamental level? The issue is not simply ensuring that the temporary fixes inspired by the pandemic successfully transition to standard practice, but rapidly building on that foundation to enable the greatest value from digitisation of all elements of healthcare provision.
From telemedicine to remote monitoring and proactive care, the NHS has barely scratched the surface of digital transformation. The pandemic has without any doubt accelerated the need for digitally enabled and empowered ways of working. From the backlog in outpatient appointments to postponed screening programmes and, critically, the potential exodus of exhausted front-line staff, the efficient, effective and intelligent care enabled by the right digital technologies is now an imperative.
Changed perceptions
Many of the extraordinary transformations in the way care was delivered over the past year have supported wider digital confidence in both patients and HCPs. For clinicians who were previously wary of delivering care remotely, for example within a care home, the COVID-19 risk assessment led to a complete change in approach – and they discovered that remote care works, as long as everyone has access to the right information at the right time.
There is huge momentum – certainly at a national level – to use digital technologies to transform the way patient services are delivered; to build on the adoption of telemedicine and federated service delivery – for example with COVID vaccination clinics – to drive further change. But this is not new. From the long term plan to the creation of Integrated Care Systems (ICS), the use of digital technologies to deliver joined up, patient centric care across both health and community services is firmly established on the NHS agenda.
The challenges presented by COVID-19 enabled organisations to bypass some of the traditional constraints associated with delivering IT projects across the NHS. Yet the success of many of the temporary solutions, albeit digitally enabled, were as much down to the extraordinary drive and resilience of individuals as any technology. Progress has been made with blood, sweat and occasionally tears – but in truth the changes made in digital transformation within the NHS to date are only the start of the journey.
Capture the moment
As the NHS moves forward with digital plans, which are fundamental to help the short-term restoration and recovery of key services post-pandemic, it is vital to learn from the past year, reinforce new digital confidence and avoid losing the innovations that have been achieved. As NHS Reset outlines, this is about guarding against slipping back into past behaviours that undermine the power of digital technologies to positively transform lives – for both patients and NHS staff. It is about addressing health inequalities, governance and workforce issues; and, fundamentally, it is about integration, whole system thinking, clinical practice and innovation.
This will demand significant, consistent change. It will require not only an investment in digital technologies but also a commitment to support staff at every level with digital skills, with the knowledge and ability to intuitively leverage systems and tools to support new ways of delivering care.
The message must also be correctly framed. We know that remote care services, when supported with immediate access to shared care records, are incredibly effective – anecdotal evidence suggests that an individual can effectively manage twice as many patients as in a traditional face to face model. But in a clinical-resource depleted NHS, digital technologies must be about so much more than efficiency.
Clinicians now have faith in remote care. They know it can be effective and can improve patient outcomes and the quality of life – as well as the clinical experience when implemented effectively. It is now important to show those clinicians what true digital transformation can enable – and that requires a shift away from reactive to proactive healthcare provision.
Proactive medicine
The NHS care model has, by default, been reactive. Interventions generally occur only when patients present with disease, often in crisis, which creates a huge additional burden and stress for HCPs. Digital technology can completely change this approach, reducing the risk to patients and providing both patients and doctors with tools that allow more proactive, personalised care.
The data captured by remote monitoring solutions for at-risk patients is linked to personalised care plans and evidence-based algorithms that automatically trigger HCPs at the point of patient deterioration – allowing them to intervene proactively and, where possible, avoid acute admission. These tools, which are increasingly being used in long term conditions (LTCs) like diabetes, COPD and asthma, also give patients access to digital education and, thereby, greater control in the management of their conditions. The downstream impact on services is significant.
Minimising crises and enabling information sharing through monitoring also provides GPs with the ability to further embrace the new routes of access with which patients have become familiar over the past year. From telephone to online, providing patients and HCPs with the ability to interact in an intelligent and informed manner will help to reinforce the value of digital medicine to all.
In addition, healthcare economies are using digital technologies at a local, even regional level, to enhance services through collaboration between primary, community, pharmacy and acute organisations, offering both physical and virtual joined-up support to help patients better manage their health, and enable real-time, proactive intervention to prevent patient deterioration and exacerbations. Adding education and advice around disease management, combined with health population analytics enabled by new, exciting technologies such as AI and machine learning, can transform the way in which patients think about their overall health, as well as improving care pathways for specific diseases - providing huge value to HCPs, patients and the NHS at large.
Conclusion
This is not a ten-year digital vision. This is an immediate imperative and something that a digitally driven NHS should be driving towards now. The technology is available and proven – the barriers are, in the main, culture and perception. Which is why, despite everything changing, nothing has changed – yet. The NHS needs to push forward with education to build confidence in digital technologies and, critically, to sell the benefits.
This is a huge change in working practice – but it is a change that will deliver enormous benefits for HCPs, benefits in the way they work and the patient outcomes they achieve. The right digital technologies, in tandem with proactive care and the ability to deliver care through multiple pathways, will remove tedious burden from clinicians, releasing talented, experienced individuals to maximise their skills with patient centric care. It will help them to reach more patients but, critically, not just by replacing face to face with remote care but through intelligent, information driven care, where patients and HCPs are empowered by information collected continuously through monitoring tools.
If the NHS gets this next stage of digital transformation right, it will pave the way for more innovation; for new, better ways of keeping patients out of hospital and away from the risks of hospital acquired infections. From clinics in supermarkets to the use of assisted discharge and remote monitoring solutions to get people back into their homes more quickly, digital technologies have the power to transform lives. It is the way that aspect of the digital model is presented and deployed to all stakeholders that will be the foundation for a health service fit for the needs of the 21st century.
