Leeds first city to launch fully integrated NHS GP Electronic Patient Records service through GP Connect

NHS Digital have announced the launch this week of the first fully integrated GP Electronic Patient Records system to go live in the City of Leeds.  Leeds is the second largest city in England with a population approaching 785,000 so a decent test for working practice results.

This digital transformation has been facilitated by the NHS GP Connect programme service which works with various GP clinical system providers to develop Application Programming Interfaces (APIs) to make data from clinical systems available in standard form, so that it can be used across different systems.  In the case of Leeds, TPP (SystmOne) joined forces with EMIS Health to create this vital, secure backlink to GP practices.

The new system unlocks the digital records of all patients across the City to hospital clinicians, connecting primary and secondary care providers 24×7. It will enable authorised clinical staff to view GP records digitally and have source GP patient information to hand to better inform their care of patients.  The move reduces the burden on GP practices having to share  information via traditional unsecured routes like fax.  This is the first in a sea change of healthcare updates for the City, as plans are made to add more benefits in 2019.  These include secure access to structured medications (to optimise use of medicines), provision of allergies information, a more efficient appointment management system between practices and the integration of social care and mental health care records.

Richard Corbridge, Chief Digital & Information Officer at Leeds Teaching Hospital Trust said: “GP Connect connectivity improves the way data can be used as information in clinical practice throughout the city.  Delivering integrated care for the population is the key goal for every healthcare system and why the investment in digital is so intrinsic to the success of healthcare as a system rather than as silos of excellence.  In Leeds we can now plan to have a fully integrated primary care, social care, hospital care and mental health care record in place throughout the city in 2019, a giant leap and a unique proposition for the NHS.”

Dr John Parry, Clinical Director at TPP said; “This is a very important step to ensuring that patients benefit from having their medical records available for those caring for them , wherever they are receiving care”.

Dr Shaun O’Hanlon, chief medical officer at EMIS Group said: “We are delighted that connectivity via GP Connect is available right across Leeds. This important partnership with NHS Digital is part of our company’s wider commitment to providing the tools for system interoperability using open NHS standards across the UK, and helping clinicians drive up standards of joined up patient care.”

This marks a significant chapter for the NHS in contrast to the dismal days of NPfIT (National Programme for IT ), the NHS IT programme started in 2002 and scrapped after 9 years by the then coalition government and a public bill of £10 billion.  The journey to transformation in the NHS deploying Electronic Patient Records (EPR) has been slow and painful, but now with a number of vendors rolling out EPR services across the country (including: Cerner, Epic, Emis, Rose, eCare, Intersystems and System C), the pace is quickening for standardised data platforms to make an integrated healthcare service a reality rather than a dream.

French regulators throw the first big GDPR punch at Google with £44m fine

Google has fallen foul of the French data regulators with the announcement yesterday of an impressive £44m fine against the global search engine giant.  In a move that has sent the tech industry chattering, this marks the first major European penalty since the rollout of GDPR on 27th May 2018.  It was going to happen sooner or later, it was just a matter of who first?

Google’s blunder was their covert process of gathering data to personalise ads without ‘sufficiently’ informing user, burying the detail in terms and conditions and using pre-ticked boxes (contrary to new legislation).

CNIL, the French equivalent of the UK’s Information Commissioner’s Office filed two complaints as soon as GDPR came into effect.

Commenting on the severity of the fine, CNIL advised that the action was “justified by the severity of the infringements observed regarding the essential principles of the GDPR: transparency, information and consent”.

The penalty is the largest to date under the European Union privacy law, known as the General Data Protection Regulation, which took effect in May, and shows that regulators are following through on a pledge to use the rules to push back against internet companies whose businesses depend on collecting data.

The fine announced on Monday is far lower than the maximum penalty under the European privacy law, which is 4% of global revenue. For Google, that would be more than $4 billion!

The response has been largely welcomed in the wider MSP community as a prompt to improve better marketing processes, echoed by Amicus ITS.  Like many others today, Amicus ITS uses Account Based Marketing, so the lawful consent required is applied directly with the customer.

The news is a salutary reminder for vigilance with firms to ensure they comply with GDPR and offer flexibility in providing services through different marketing channels that create the variety and correct routes for data capture through websites and other means (which these days is translated as the increase in companies offering AI chatbots when communicating services or offering information with 3rd parties).

Are you surprised by the fine?  Who do you think is going to be next up for punishment?  Give us your thoughts.

How trusting are local authorities today with the cloud?

Cloud computing is a necessary direction for all in the public sector as directed by central Government.  In 2017, leading industry body TechUK issued a peer paper called ‘Building Local Government Trust in the Security of Cloud’.   In this, the widely held concern around security of cloud services was addressed, providing information, advice and specific messaging for local authorities.

The drivers of the shiny digital future underpinned by cloud computing were identified as:

• Internet of Things (IoT)
• Mobile applications
• Big data analytics
• Artificial Intelligence (AI)

The opportunity of cloud adoption is to enable ready access to computing platforms, ‘on demand’, creating efficiency and cost savings, with flexibility to allow for greater innovation, productivity and operational effectiveness.

A GovNewsDirect survey of 2016 did quote a growing concern over security of data in the cloud.  The counter was for organisations to use the cyber security tools, solutions and educational initiatives to introduce secure cloud computing and inform the user.

General Data Protection Regulations (GDPR)
Added to this, GDPR in May 2018 made all organisations sit up and take notice around effective management and processing of data for EU citizens. With penalties of 4% of global turnover or €20 million for any breach, a more thorough and diligent approach has added to the configuration considerations for cloud architecture and storage.

Accepting a half-way house to cloud?
For many public sector organisations, a full blown ascent to cloud migration is not feasible, often because of complexity around their legacy apps or workload types and the cost implications as the ROI for cloud is poor.  In this scenario, we are seeing and hearing greater noise around the hybrid cloud format, Hyper Converged Infrastructure (HCI) solution.  This on-premise hybrid solution has garnered advocates in the public sector, as being a viable and desirable way forwards as part of their digital journey, better suited for workloads with higher GB volume where performance is needed.

Digital vision, a budget to transform – mixed with a healthy dose of reality
For even the most progressive Councils in England, the drive to digital transformation comes with various challenges.  Glyn Peach, Director of Digital Services & Corporate Programmes at Swindon Borough Council, commented to us: “As part of our Transformation Programme, Swindon has evolved a highly effective Software Defined Data Centre and we’ve made solid progress on front end citizen services, moving many services online and providing self-service capability.  But true end-to-end user integration is still a little way off.  We are seeing great opportunity in data analytics and assistive tech.  This is starting to have an impact through our ‘Community Navigators’ programme supporting Adult Social Care and using preventative technology which can identify the risk of isolation and spot abnormal behaviour that may indicate a problem for the elderly in our care homes in Swindon.  If we can more broadly implement interoperability opportunities and open systems, this will ultimately pave the way for common standards that in the long term will bring down the costs of new tech and save money for the tax payer”.

Helpful tools

Cloud journey checklist
• Ensure your cloud service meets your organisations’ needs aims and objectives securely.
• Understand what type of data is involved and what levels of assurance are required.
• Work with cloud providers who have their own independently audited compliance framework standards (eg. ISO27001, Cyber Essentials Plus etc.)
• Use the latest cloud security technology to solve issues or business problems (ie around remote working or revenues and benefits)

Is it safe?  What information do you want to share with the cloud?
The levels of data privacy and security from different providers will differ depending on the type of information you are sharing when using a cloud service.  Amicus ITS has a Cloud Services Framework for helping organisations determine their own path. Take a look at our Cloud Assessment

Glyn Peach added:  “While the IT department may not handle the physical infrastructure or management of Shadow IT applications and services, IT does carry the burden of ensuring security and compliance for the corporate data that employees create and transmit through Shadow IT sources.  This creates mixed feelings toward Shadow IT, as some enterprises are willing to embrace the innovation and increased productivity it can deliver, while others aren’t as willing to look past the increased risk of security and compliance complications of Shadow IT”.

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Councils moving their infrastructure to cloud is a positive first phase.  Embarking on the path of true digital transformation is a second, far larger project which requires input from everyone and requires a re-examination of the entire way of doing business.  It is exciting though and with both parts of the journey, relies on careful planning, a strong strategic vision, good leadership, buy-in from the board, plus trusted partnerships.  Firstly in fostering and directing the talent of inhouse IT teams and then identifying the areas where further support or specialist technological solutions are needed to drive higher performance, enablement and ROI, adding new frontiers of value that come with our brave world of tech.

Q What has been your experience of cloud migration?  Has your organisation been able to make the leap to digital transformation, or is this part of a longer strategy which has either started or is being planned?

 

Beware Santa’s horses bearing gifts

Tis the season to be crafty!   Just as Amicus ITS was reaping the results of its own competition for staff to design a winning Christmas e-card for 2018 incentivised with online gift card vouchers for prizes, came the news report issued last Monday by security firm Barracuda Networks that Santa’s gone a bit phishy in a Gremlins kind of way in the run up to Christmas.

The increasing sophistication of social engineering has created a new cyber security workplace scam targeting receptionists, office managers and executive assistants.   The report states: “These types of attacks are very hard for traditional email filters to pick up because they are targeted, have a high reputation, and do not contain any obvious malicious signals”. 

Here, hackers will pretend to be the CEO or senior managers, using tactics like implied urgency and directed emails asking specifically say, for Google Play gift cards.  Phishing emails can also include a ‘signature’ implying it was sent from a mobile device.  Alternatively, the scam can be built around a secret ‘reward’ for employees.  There are no malicious payload links, or suspicious file attachments and they are often sent from trusted email domains.

Spokesman for Barracuda Networks, Asaf Cidon commented: “When sending social engineering-based attacks, attackers have always used context and timing to their advantage – and the Christmas season has opened the door wide to a lot of cleverly designed executive impersonation”.

What can you do about it?
Organisations should have the relevant anti-malware, spyware and adware in place.  Other security tools can include more advanced spybot software and AI-based security solutions to detect anomalies in email addresses that the CEO would not use, or behaviours which would recognised be uncharacteristic.  But alongside all of these technical competencies, it comes back to having an educated and informed workforce across the board, vigilant and trained to spot attack efforts and know the right remedial steps to take:

• Use HR to work with IT to help with employee messaging to avoid falling for these scams and to understand what technology is needed to ward off the attacks.
• Awareness spread through the employee network should reduce the time between attack and detection and prevent more extensive damage.
• If a gift card email scam hits your organisation, why not set a procedure in place for employees to be required to gain direct management approval to verify any financial requests.

Have you experienced this type of attack?  How did you react.  Anyone seeking advice on security measures around their IT systems can contact Sales on 02380 429429.

What’s in our MSP crystal ball for 2019?

Amicus ITS has just completed its annual Technology Strategy Review to look at the trends and demands we have seen from our customers in 2018.  We have also taken the opportunity to look at the wider development of technology solutions affecting our public sector customers and those which we believe are likely to have a significant impact in our industry in 2019.

A recent CRN survey of a group of VARS captured interesting views on where they are spotting trends around datacentre technologies they believe are tipped for take off in 2019. Their key results included:

• AI (Automation) – driven by monitoring and decision making
• Hyperconverged Infrastructures (HCI) – single platform flexibility
• Intelligent Edge (IoT)
• Network Automation (underpinned by software defined networking (SDN) – Cisco and VMWare
• Data archive + data backup – hyperconverged backup (vendors like Rubrik and Cohesity)
• Cyber security

So what’s our view?

After 30 years, Amicus ITS recognises that our success centres on our core strengths offering 24×365 IT Managed Services.  This gathers together service desk and other disparate services and software management for each customer.  Customers can buy umpteen individual technology solutions, but it’s helping run the whole service, understanding the customer and being able to spot what adds value that makes an MSP’s role special.  Some customers are in an advanced state of cloud enablement, others undergoing the journey to cloud through us. Others are preparing to embark.  With so much technology out there, we are transparent enough to acknowledge we cannot do everything ourselves inhouse.  So strategy for us, is around consultancy, with regular health checks and the nurturing of our technology partner ecosystem to match what is best in breed and need, so we can tailor what’s right our customers.

Looking at the drivers for our customers and based around conversations that are resonating most strongly, we would identify Hyperconverged Infrastructure (HCI), cyber security and smart working around people-centric technologies as the key go to strategies for the public sector.

Whatever the dictats may be from Government, the price of an entire shift to cloud is beyond the reach of most councils (and is also too complicated and expensive for many), so HCI continues to form a happy medium.  Citrix Virtual Apps and Desktops Service on Citrix Cloud delivers secure, virtual applications and desktops from on-premises resources or from major public cloud providers such as Microsoft Azure.  HCI really lends itself well to this strategy, offering the ability to adopt a cloud-first architecture but maintaining complete control over your application and desktop resources.

Added to this, the protection and compliance offerings around cyber security rightly command attention (though better on the front foot than reactive), as organisations not only want to protect data, but interrogate it to analyse behaviours and manage systems better.  Ultimately, whilst local authorities continue to battle with legacy systems, true end-to-end integration will be challenge to achieving true digital outcomes and the rollout of 5G networks will underpin many advances, but the journey has begun, so the consultancy around the best routes through cloud and most effective spend will continue to foster development and progress for us.

What do you think is going to be a focal point for the industry in 2019?  Let us know?

Artificial Intelligence in the NHS – transformative benefits requiring open mindedness and a well-considered plan

In June’s budget announcement, new healthcare minister Matt Hancock announced the NHS funding headlines:  real-terms funding growth for the NHS of 3.4% per year over the next five years, amounting to an extra £20.5 billion by 2023/24.   The Government’s intention is to marginally ‘frontload’ the extra money, meaning 3.6% in each of the first two years. The NHS budget for the year 2018/19 is set at £113.8 billion.   Nonetheless, whatever these headlines, for NHS organisations to calibrate themselves correctly to be able to transform their IT services in 2020 and beyond – they must be IT fit.

Examples where healthcare AI is starting to make a difference
• Precision AI – AI is revolutionising healthcare tech using graphics software in areas like radiology.  Here radiologists can use AI-based video analytics to find brain bleeds or tumours in MRIs and another creates 3D colour representations of organs from a chest x-ray.
• Predictive AI – using muscle:fat ratio from CT scans, AI analytics is being developed to create predictive clinical outcomes for illness or disease.
• Natural Language Processing (NLP) – layering this onto data could enable AI algorithms to have access to all patient information vs a small part ie. making sense of badly written disparate medical notes.

Artificial intelligence impact on business
By deploying the right AI technology, organisations can gain the ability to:
• Save time and money by automating routine processes and tasks
• Increase productivity and operational efficiencies
• Make faster business decisions and greater strategic direction, based on outputs from cognitive technologies.
• Avoid mistakes and ‘human error’, provided that smart systems are set up properly
• Use insight to predict customer preferences and offer them better, personalised experience
• Achieve cost savings, by optimising your business, your workforce or your products
• Mine vast amounts of data to generate quality leads in Sales and grow an organisation’s customer base in business.
• Increase revenue by identifying and maximising sales opportunities
• Grow expertise by enabling analysis and offering intelligent advice and support

Some of the challenges around AI
With so much rapid innovation taking place in technology there are enormous digital capabilities on offer especially around AI.  One challenge for healthcare ICT leaders may rest with how they prioritise their spend to evidence best return on improvement and experience for both staff and patients in future years.   On top of this, AI needs access to good quality data.  Not something commonly associated with the NHS.   There is a lack of data standardisation and centralisation which continues to hamper progress (despite healthcare attracting plenty of AI start-ups fostering innovation in the marketplace).

Could personal ‘health clouds’ be the answer?
One answer leading to digital transformation could be ‘personal health clouds’?  Currently data is often stored in separate silos on local hospital servers.  There are no data standards nor centralisation.  The physical dislocation of NHS data is coupled with the many governance issues around Personal Health Information (PHI) which create an inhibiting mix.  If patient records, test results etc. could be stored centrally, with the patient confirming who has access to the info, AI could view all data versus only a part of the data.  It could be transformational for the efficiency of the overburdened hospitals – as well as the patients.  A main barrier to conversion is the necessity of patient buy-in, agreeing to the use of their data and trusting that all healthcare trust compliance measures are met and protecting their data 24×7.

Clearly, the opportunities for the NHS to seize are massive.  But just how hospitals and healthcare organisations go about seizing AI opportunity to transform the sector and how we might receive very different treatment in future may largely centre on the following elements:
• All public sector organisations having an ICT digital lead and visionary who is connected strategically to the Board – and fully conversant of the complexities of the public sector environment.
• Preparedness of the project teams to spend the right length of time at discovery to understand and map out the needs and most desirable outcomes for all stakeholders to ensure the touch of digital feels like a light wand not a heavy fist for implementation or users.
• Starting with getting one project right rather than seeking to fix the whole system in one go.
• Working closely with innovative software companies focused on the sector.
• A highly skilled IT team or partner (internal or outsourced) to safely walk the journey together from infrastructure transformation to a better digital future.

Rome was not built in a day, but those straight roads from 2000 years ago are still much admired today.  The transformative opportunities facing the NHS through AI are immense – and since IBM Watson beat Ken Jennings in 2011 the progress of AI has marched on into our consciousness.   AI requires an open-minded attitude and a willingness to embrace new opportunities when they arise.  It’s baby steps to bring about large scale progressive change, but having advanced technological understanding, drive and support to champion and deliver change and connect is a true game changer.    Let us know what you think to add to this article?

Hospital and Council start to test AI in undertaking tasks, as ‘virtual workers’

Ipswich Hospital, part of East Suffolk and North Essex NHS Foundation Trust (ESNEFT) has engaged three robots over the past three months to mimic keyboard and mouse clicks, to assist with routine admin referrals, using ‘virtual workers’.  Handling 2,000 referrals on average per week, this has saved the Trust considerable costs and increased efficiency amongst frontline staff.

• Tasks have included sending scan and blood test results from Primary Care GPs to Secondary Care hospital consultants, with intelligent automation supplied by British software company Thoughtonomy. This works over the existing applications and systems as part of the GP Electronic Referral Service (where patient data is collected and sent to the relevant consultant).

• Initial results claim the new system is eight times more productive than using humans, releasing 500 hours of medical secretaries’ time, working 24×7 and anticipated to save £220,000 over the next nine months. The referral process has been seen to successfully reduce down the referral process from 15-20 minutes, to 5 minutes.

Darren Atkins Deputy Director of ICT, commented, “At the Trust we have a philosophy of making time matter”.   Mr Atkins continued: “Done to scale, intelligent automation has the capacity to massively drive transformation on a huge scale within the NHS.”

Neurology department medical secretary, Christine Harvey added:  “We used to extract information from (patient records) from one bit of software and put it into another bit of software. This was time consuming and carried the risk of mistakes from the patient notes system”.

The technology has been received positively at the hospital, offering flexibility from ‘virtual buddies’, maximising the benefit of automation and enabling frontline staff to spend more quality time with patients and on workload, be more productive and enabled the Trust to cut down on short term agency use.  Technically, the queues and productivity can also be monitored very easily on the move through smart devices.  The scheme has the capability to be extended to using AI ‘staff’ to make appointments and do accounting and patient queries.

A report by the Institute of Public Policy Research (IPPR) states that automation could save the NHS up to £12.5bn a year, or 10 per cent of its annual budget.  The Department for Health identified that the NHS’ infrastructure was “not currently fit for purpose for AI” and would require standardising to fully harness the technology’s potential.  A move in this direction however is clearly signalled as a route to improvement and cost savings for the NHS.

Dr. Bernhard Kainz at the Department of Computing at Imperial College London said: “At the moment the NHS has still an IT problem rather than a data science or AI opportunity.. and rather, it marks an important step towards clinical decision making supported by AI because it makes sparse, unstructured data accessible for automated data processing”.

Meanwhile, in a bid to improve transformation of social care through technology, Bradford Council is in the process of developing a proof of concept for an AI tool in adult social care, funded by NHS Digital and the Local Government Association.  Bradford, working with Rescon Technologies has designed the relevant service requirements which take on board matters as diverse as dental care, financial matters and watching football.  The findings of the project will be known in December and decisions on how to take matters further determined at that time with stakeholders.

For an understanding of the core distinctions between IT transformation and Digital Transformation and routes of developmental interest for the public sector, read Amicus ITS’ latest White Paper here.

If you would like to discuss this with a member of the Sales department, please contact Amicus ITS on 02380 429429