It is hard to argue with the ambitions of the National Information Board (NIB). Once achieved the NHS will be better equipped to face future challenges from patients, clinicians and ultimately the tax payer.
However the challenge that the NIB has, as Professor Wachter eludes to in his report “Making IT Work” is that making changes to an organisation as devolved and fragmented as the NHS can be long and drawn out.
The frustrating thing is that most of the the technology exists today to do much of what the NIB wants to do.
Below are from the NIB’s vision and strategy (Annual Report 2016):
“Patients and citizens should be empowered with improved access and personalisation of care, working in partnership with professionals to more effectively manage long-term conditions and prevent avoidable lifestyle-related diseases.”
“Development of personalised digital care records means patients will be able to access and contribute to their own medical records.”
“Our vision is to deliver online services that all patients need to help them manage their own care and wellbeing, at home and on the move. By doing so, we will also relieve the pressure on front-line services.”
“We believe that health and care digital information and services should be available to all who want them. We will work hard to widen digital participation so that the benefits of online services are made available to everyone, including “hard to reach” communities, using the technologies they know well. “
“Health and care professionals will have the ability to set automatic notifications to inform decisions, and make use of tools and applications to monitor and communicate remotely. Additionally, consultation time can be used to better effect if patients and citizens take a more active role in their care, and can work collaboratively to achieve the best outcomes.”
“New collaborations with technology companies and patients will unlock the potential of the digital agenda and create products that can offer smarter, faster, improved healthcare and grow the digital health and care sector. “
What this is talking about is the development of digital care models where patients use technology in addition to existing care to help them manage their own health & condition better, and so reduce pressure on the NHS.
The technology is here and it is already happening up and down the country.
My recommendation to the NIB is to look at good examples of digital innovation within the NHS and adopt them. For example:
NIB talks about accredited NHS apps that connects patients to their healthcare team. In Leeds, over 7,000 patients with chronic pain use a mobile app that securely feeds back reports to their GP and specialist teams and has reduced hospital referrals by 75%.
NIB talks about tools that helps patients take a more active role in their care. In County Durham and Darlington, 500 patients on warfarin who used to attend clinic every few weeks for tests now monitor at home. This has saved the local Trust over 21,000 outpatient appointments, and the self-testing patients are healthier with a 50% reduction of having a stroke.
NIB talks about collaboration with technology companies and patients. Inhealthcare support a digital health joint venture with a major NHS trust, provide the digital infrastructure for one of the NHS England test beds, and have numerous co-design projects with NHS organisations across the UK.
NIB talks about widening digital participation so that everyone can benefit including “hard to reach communities”. Take the above INR self-testing service in Darlington as an example. This reaches 99% of the population, including those not on the internet because patients can choose a communication channel which works for them – an automated telephone call, email or an app.
NIB talks about providing healthcare professionals with tools to monitor patients remotely. Our integration with hospital systems means that nurses in out-patient clinics can treat a remote patient in 30 seconds instead of 4 minutes, and health record updates into GP records means that the entire care team have access to the latest information.
The technology and the innovation is here today. We just need to get on and do it.