A conversation with Uday Bose, country managing director and head of human pharma at Boehringer Ingelheim UK & Ireland.
To help reduce the impact of the COVID-19 pandemic on healthcare services and to free up resource to help tackle the backlog of appointments, fostering a culture of innovation is essential to the improvement of health. By delivering new approaches through proactive technology-enabled care models, we have the opportunity to benefit health outcomes for patients and drive positive lasting change across society. The importance of innovation is not a new phenomenon, and its value is increasingly being recognised. In fact, the need to place innovation at the top of the agenda was set out last summer in the Government’s Innovation Strategy launched by UK business secretary, Kwasi Kwarteng, who outlined that “the countries that secure leadership in transformational technologies will lead the world – it’s our job to ensure the UK keeps pace with the global innovation race.”
We believe that digital transformation is essential to creating a more sustainable healthcare system, and that’s why Boehringer Ingelheim (BI) proudly sponsored DigitalHeath.London’s 12-month Digital Pioneer Fellowship programme this year. This initiative supports NHS staff in London and the South East to lead and deliver digital transformation projects in their organisation. Support for this programme reinforces our commitment to improving the health of people now, and for future generations.
As this year’s programme draws to a close, I have been reflecting on a conversation I had earlier this year with three of the Fellows. I was inspired by the work of Shereen Boreland, a senior digital innovation pharmacist working at the Royal Brompton Hospital within the adult Cystic Fibrosis (CF) team, who is currently developing a self-monitoring app in an effort to put patients in the driving seat of controlling their health. Through our discussions, I gained valuable insights from Felix Vaal, a senior project manager for Digital Health at Chelsea and Westminster NHS Foundation Trust, who is driving the ‘Mission Control’ project forward. Mission Control is aiming to apply the success of recent digital innovation pilots from the NHSE Test Bed Project across the Trust’s outpatient service and adapt them to meet the challenges now faced from COVID-19. I was also impressed with the impact when patient needs are central to innovation, demonstrated by Chris Gumble, who is a project manager in the long term conditions team for the South West London Health and Care Partnership. Chris works across several innovative projects all designed to move diabetes care forward such as the ‘Prevention Decathlon.’
Adapting innovation to respond to local needs
It is without a doubt that patient engagement throughout the innovation, design, and production process, is imperative for the successful uptake of any product. Studies have evidenced that patient involvement in the design of healthcare services, improves the relevance and quality of the services, as well as improves their ability to meet patient needs. So, I was interested to hear from the Fellows’ perspectives, the vital role that patients play at every stage of innovation.
Patient centricity has been, and continues to be, a key motivator running through all three of these Fellows’ projects and indeed the projects of all 37 Fellows on the programme this year. It is a crucial way of ensuring that the Fellows are responding to the bespoke needs of the community, to better meet the requirements of society more broadly. As highlighted by Chris Gumble, innovators must be thinking “from a people’s perspective rather than an organisational perspective” to build solutions that truly hold patients at their core. Shereen Boreland also explained that, after many years working with patients directly in the CF specialty, she was able to identify and acknowledge “the benefits that developing her app would have on patients” which motivated her to team up with the digital innovation team to try and make a difference.
From a more technology-focussed orientation, Felix Vaal has been heavily involved in facilitating patient-centric digital innovations. Through patient administrative workflows, clinical requirements, reporting and integration, he has been working to ensure that patients remain at the heart of the digital healthcare strategy. Partnering and actively involving patients within the system is crucial to ensure healthcare innovations are successful.
With COVID-19 creating additional unforeseen challenges, there was potential for the Fellows experiencing delays to dwell on the impact of the pandemic or berate themselves for not innovating fast enough. Felix, Shereen and Chris all highlighted how the programme has helped them to overcome pain points to drive their projects forward. With many NHS staff under huge amounts of pressure, with little spare time available outside of their clinical roles, the peer coaching network opportunity facilitated by the programme was described as invaluable. Shereen outlined that “without being on the fellowship or having access to people that could help me overcome difficulties, I’d probably be at a bit of a stalemate with my project at the moment.” The connections established through the mentorship process helped to validate ideas, provided experience and guidance to share best practice and expedited the ability to implement positive change.
Typically, innovators tend to make strong impressions, setting ambitious goals and feeding off the creative energy of others, fostering such tendencies isn’t always straightforward. The Digital Pioneer Fellowship includes six days of learning to support design thinking, problem solving and evaluation. Such sessions helped advance timelines and deadlines, while also encouraging the Fellows to recognise their own strengths through self-reflection exercises. Chris Gumble outlined that these sessions helped to “accelerate confidence in his abilities” and he is “no longer worried about celebrating success” whereas before he “felt he was reaching a bit above his skillset” with Felix Vaal also agreeing that the programme has had an impact on his “attitude and approach.” If you have faith in your ability to innovate, and you've done it before, you're more likely to approach your next project in the right frame of mind. Adopting a positive mindset is a key factor that will help to drive projects forward.
Overcoming barriers through co-creation
It is important to recognise that, whilst digital can make healthcare more accessible for some groups, it can also exacerbate digital exclusion for others. Inequities in education and access to technology can lead to reduced digital capabilities and skills. This can further cause the exclusion of communities based on language barriers and geographical blind spots, ultimately causing a variation in health outcomes.
The Fellows had, in some cases, been able to combat digital inequity through charitable contributions. Shereen Boreland highlighted that, through funding, her project has been able to provide access to “self-monitoring equipment including Bluetooth enabled scales, spirometers and activity trackers for every CF patient taking part in the project.” This democratises access and eliminates any disparity of care. However, this isn’t always the case. Chris Gumble’s diabetes prevention programme, was originally designed to be delivered in a face-to-face environment with digital elements running through. However, to remain aligned to the COVID-19 restrictions, the project had to pivot to a virtual platform, which by default created barriers for patients who may not have sufficient access. Chris was aware that he needed to “address digital inequalities in both workstreams” as much as possible. So, by working with the local community, he got direct feedback, to ensure the information is relatable and actionable to all. By doing this, a sub-project was developed which was co-created with the community and will be delivered in local places of worship by the local community leaders, this reduces the barriers to entry and showcases that although “there is going to be digital inequality in some form...there is always another option.”
It was truly inspiring to discuss all three projects and to celebrate the successes made by the Fellows on the programme, recognising their collective foresight, drive, and determination to positively benefit the health of others. Despite all three projects being unique in their goals, the commonality of patient centricity was clear to see. From our collaboration with the Patient Association, it is critical that any digital health innovation must engage, and ideally co-create, with patients from an early stage in the development process to ensure the solution is fit for purpose, so it was great to see the Fellows aligning to these goals.
It was also clear that the complexity of navigating systems is real and continues to be an ongoing challenge. Such challenges are also highlighted in the An Innovator’s Guide: Navigating the barriers to digital health, which is designed to act as an essential reference tool to help innovators navigate the health system and provide a pathway for digital health technologies to improve services and help reach patients.
This programme reinforces BI’s commitment to delivering sustainable innovation with the NHS to help drive better outcomes for ALL patients which is why our support of DigitalHealth.London’s Digital Pioneer Fellowship has been so important to us. Enabling change makers to identify opportunities, make progress through digital transformation, and provide support to navigate the UK healthcare landscape is a high priority. This helps to harness the true potential of digital, in a way that places all patients at the heart of care.
