In a telling insight into his attitude to NHS spending, the new Health and Social Care Secretary has told local areas they will be free to determine how they speed up the discharge of patients from hospitals. This might be through purchasing supportive technology, boosting domiciliary care or funding physiotherapists to help people recover at home. But Steve Barclay added he would be “looking closely at the impact of how funding is used and using this data to inform future decisions on funding” as part of the government’s devolved and data-driven approach. In other words, prove you are spending it wisely or lose out next time.
Unlike other sectors where industry leaders can simply impose new systems on shop floor workers, the NHS is made up of local areas where local clinicians are best placed to understand and respond to local challenges. Founded a decade ago, Inhealthcare has grown to become a UK market leader in remote patient monitoring by recognising this reality and developing a technology platform that gives clinicians the building blocks to quickly design and deliver digital health services that support patients at home. From the Highlands and Islands of Scotland to the south coast of England, innovation is taking root and springing up across the UK as clinicians embrace the possibilities of the platform.
Clinicians can focus their skills and energy on patients
At its heart, the platform automates as many processes as possible in a pathway, which means clinicians can focus their skills and energy on patients who need the most care rather than having to waste time on mundane administrative tasks. Chief information officers find the platform is resilient, scalable and meets all major information governance compliance and security standards. Innovators with new apps and smart devices enjoy the platform’s connectivity with wider NHS systems, which makes sure patient data flows to the right places. For service improvement teams, the platform offers a fast way to digitise a service without having to build extensive – and expensive – digital infrastructure. Above all, patients enjoy a better experience, being at the centre of their care.
NHS Scotland chose the platform to support the scaling up and mainstreaming of remote patient monitoring services across Scotland. The platform is in use across Northern Ireland and many parts of England, particularly the North East, the southern counties and London. It is also being used by a leading private provider to design and build a patient portal and booking system.
The approach allows new pathways to fail fast or scale fast
If the Inhealthcare platform provides the building blocks for innovation, the Inhealthcare toolkit supplies the drag-and-drop power to rapidly build, amend and deploy new pathways. It enables the co-design and co-development of pathways with patients, allowing for immediate feedback, reducing the overall development cycle and ensuring that functionality meets the needs of service users. One of the company’s newest services, a virtual ward for cancer patients, was built using this toolkit, illustrating how a complex oncology pathway can be quickly created with clinicians to support people at home who are undergoing chemotherapy and immunotherapy. The approach allows new pathways to fail fast or scale fast.
Importantly, the platform provides the ability to measure the efficiency and effectiveness of services, essential for demonstrating value for money. Despite all the hype about data being the new oil, too much ‘data reporting’ still amounts to sending a CSV file to NHS Digital after the event in the hope of generating some insights. In contrast, Inhealthcare’s developers have built a ‘data lake’ to enable new views into the growing amounts of NHS data generated by remote monitoring services to help NHS organisations boost operational and strategic decision-making and unlock the potential of machine learning and artificial intelligence. At a glance, they can monitor how pathways are performing in near real-time and see which are the most efficient and effective.
The UK’s biggest remote patient monitoring service during the pandemic
With its digitally inclusive choice of communication channels, Inhealthcare’s platform supplied the stage for the UK’s biggest remote patient monitoring service during the pandemic. Working with Wessex AHSN, Inhealthcare helped to roll out Oximetry @ Home across a vast swathe of southern England covering seven health and care boards and bringing a lifeline to more than 25,000 Covid patients at a time of enormous need. The service enabled clinicians to spot the signs of deterioration and provide timely escalation for silent hypoxia, while reducing the burden on secondary care. Research published in the BMJ this year demonstrated a significant association between the service and better patient outcomes; “most notably a reduction in the odds of hospital lengths of stays longer than 7, 14 and 28 days and 30-day hospital mortality”.
The same, proven infrastructure is being used by ICBs to develop and roll out remote monitoring services for other conditions, including for patients with respiratory illnesses. This uses blood pressure cuffs, oximeters and thermometers to record NEWS2 scores, physiological ‘early warning’ measurements that are routinely recorded at a patient’s bedside. Elsewhere, hospital consultants are using the platform creating a virtual ward for patients with heart failure and atrial fibrillation who would otherwise need to stay in hospital. They are “starting off safe” with low-risk, tech savvy individuals before expanding to provide hospital care at home for patients with more complex needs. It is easy to see how this technology can help to deal decisively with delayed discharges.
Making information accessible at the right place at the right time
Health Secretary Steve Barclay has announced that tackling the issue “must be an effort that spans a number of different areas across health and care, with social care, primary care and community services all working together with hospitals”. He’s absolutely right but in many places, health and care health organisations hold different sets of records for patients and service users with information typically shared by phone, paper or electronic means, resulting in incomplete views of patient health needs and an increased burden for care providers.
To overcome this challenge, Inhealthcare has collaborated with NHS organisations in a groundbreaking new project to improve the flow of data between different parts of the health and care system and stop patients falling through the cracks. In the new service, which is due to go live in the new year, community nurses will be automatically alerted if elderly and frail patients under their care are admitted to, discharged from or transferred between hospitals. It has the potential to dramatically improve health outcomes for patients by making information accessible at the right place at the right time – and reduce avoidable hospital admissions. Data is moving safely and securely throughout the system to where it is needed, helping to support independent living at home.
As Mr Barclay has made clear, the Department of Health and Social Care is backing local leaders to make the necessary decisions to free up hospital beds and improve capacity for social care, taking into account the demographic needs of their local areas. However, the commitment to devolved decision-making comes with a catch: the centre will be looking closely at the impact of spending and using this data to inform future funding decisions. Ultimately, the government wants the NHS to demonstrate accountability to the taxpayer. With its innovation-friendly platform, toolkit and data-reporting capabilities, Inhealthcare is best placed to support local leaders who need to deliver more hospital care to people at home.
* Bryn Sage is CEO of Inhealthcare and a member of industry group techUK’s health and social care council.
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