Interoperability and funding remain barriers to healthcare transformation

The problems facing digital and data initiatives in the NHS are only ‘10% technical’, conference told

Credit: Ragnar Singsaas/CC BY 2.0  Image has been cropped

Digital solutions in health are becoming more and more normalised, but the challenges facing digital transformation stubbornly persist.

The latest Digital Health and Care conference hosted by PublicTechnology sister publication Holyrood recognised that sustainability and the scaling up of good ideas remain elusive to those looking to modernise the way we look at how healthcare is delivered in Scotland.

The biggest challenge is the sustainability of our healthcare system itself, with the ageing population meaning that increasingly, fewer working-age people will be supporting those that require acute care.

“We have to have a change of perspective for our healthcare today,” said Mike Fuller, regional director of marketing for InterSystems, the company behind Scotland’s connected patient information system. There are few nations in the world that can afford the healthcare we ascribe to in vision documents. It’s just not affordable” 

He added: “We simply don’t have a structure that supports people.”

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Fuller warned that change could not come from technology itself, but from people working together to shift models of care.

“Let’s not be distracted by the shiny new toys. Digital transformation is not the whole story,” he said. “Ten per cent of the problem is technical … we need to work together better.”

Modern medicine is still in “the dark ages”, he suggested, because it is yet to harness the amount of data available. The payoff of interoperability would be “the tipping point when data changes our lives”, he concluded. 

“We have so much data in healthcare. Isn’t it our responsibility to use it well? … If we have data and we have perspective, we change our behaviour.”

Culturally, though, many patients and clinicians are reluctant to share data, even when Google and Facebook have become the norm.

“Everyone’s got a toothbrush, but no one wants to share,” said Fuller.

The use of data featured heavily in the Scottish Government’s new digital health strategy last year, which established national leadership and a national approach to information sharing, making sure patients are in the centre of decision making.

“Fundamentally, when we design a service in Scotland, we have a commitment that says people will be in the room,” said Colin Cook, director of digital for the Scottish Government. “We did not want a strategy that replicated the old world, in a slightly faster or flashier way.”

Cook praised innovations in Scotland, pointing to the fact many of the ideas to come out of the entrepreneurial CivTech challenges had been in health and care.

However, pilots and prototypes were still not being scaled up across the country, he added, calling for more “digital maturity”. 

Projects should “be designed from the beginning, I hope, with national intent and ambition in mind”, he said.

Who’s in charge?
But financial sustainability remains a question. Stuart Anderson of the University of Edinburgh’s school of informatics said it is only mentioned once in the strategy.

“How can you transform something which is 140,000 people with a limited budget?” he asked.

Cook said it was his job to pitch for upfront investments, and that it was about “arguing for the resources necessary and putting it in the projects that make the biggest difference”.

“We need to accept that directors of finance are the real ones in charge,” said Richard Corbridge, CDIO of Leeds Teaching Hospital Foundation Trust.

Delegates heard how the English trust had ignored the wishes of NHS England to outsource IT to private companies and built its own electronic health record, which is now being rolled out across Yorkshire and Humberside.

The conference also saw delegates break off into ‘campfire’ sessions to look at some of the more innovative solutions being pioneered, including technological ways to support independent living and the use of AI.

Sam Trendall

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