How on target is the NHS to going paperless in 2018?

Health Secretary Jeremy Hunt has been seeking a paperless records target of 2018 for the NHS since 2013.   In a recent focused healthcare survey of 67 members of the Health CIO Network and CCIO Leaders Network of clinicians and digital health IT leaders, there remains a mixed response:

•  67% stated they were ‘quite confident’ or ‘extremely confident’ their organisation will be paper-light by 2020.
•  14% stated they are ‘not at all confident’ or ‘not very confident’ of achieving the target.

However, on the question of having “integrated health and care records, enabling effective co-ordination of health and social care, by 2020” there was less certainty:

•  56% said they were ‘extremely confident’ or ‘quite confident’ of achieving this, but a quarter (24%), said they were ‘not at all confident’ or ‘not very confident’.
•  28% said they were confident of giving patients read/write access to their records, while 53% said they were not confident.

The top priorities for most of those involved focused on:

  • moving to paperless working – 73%
  • improving quality of services – 68%
  • supporting new models of care – 67%

When asked about their next major IT project, these were reported as:

1.  Top ranking for personal health records and patient portals, to give patients access to their medical record and test results, plus services such as appointment booking and email consultations.
2.  Next were shared record initiatives
3.  Third were e-prescribing and medicines management.
4.  In fourth place finally, one-third of respondents said Electronic Patient Records (EPR) – suggesting many are perhaps already some way down the line with this already?

Not surprisingly, with all the other cutbacks facing the NHS, this drive to go paperless might have a lot of goodwill in the sector to deliver, but the barriers facing NHS providers can be summarised by two principle points of feedback:

  • lack of adequate resource (73% affirmed that their IT budget was insufficient)
  • lack of staffing resource

With the breakup of the NHS from a truly national health service to a regional health service, primary and secondary healthcare organisations around the country will need to start showing they are making this work and that we are benefitting.  Then, we may wonder why it took so long when other major data institutions such as banks and industries such as insurance groups have managed to do this.  After all a 100-1 shot just won the Melbourne Cup.

NHS

Joined up healthcare technology putting patients at the heart of consultations

With the advent of wearable technology and health trackers, along with social media and the power of Google, many patients are turning to personal investigation to check out their personal health symptons and conditions online using Google, Bing, Yahoo and others.  This marks the evolution of the e-patient.

US cancer sufferer and blogger Dave de Bronkart whose moniker is ‘e-patient Dave’, originally rose to prominence in 2009 and recently spoke at the Intersystems joined-up healthcare event in the US to advocate greater openness in the worldwide healthcare community between patient and the doctor as the patient seeks to know more.

Patients are able to access their digital health records (though relatively few do – 0.4% of GP patients thus far in the UK) and by doing so are best placed to identify any errors in separately held records across service providers and regions.  With access to online services, cost savings for booking appointments online, obtaining referrals, and even doctors using wifi to track patient flow through a hospital, this creates massive savings for primary care providers and hospital trusts.

The mainly holistic but equally powerful change however comes through the doctor being open to suggestion from the patient during consultations, as a result of today’s vast wealth of data available online. This offers patients access to research resources which can supplement practioner’s knowledge as well as reinforce or challenge, which should not be written off.  As e-patient Dave argues, this should bring doctor and patient closer together but could be seen by some GPs as a threat. The patient should be welcomed in bringing their own healthcare research and knowledge to the table.  By being open to this he argues, it increases interaction and creates a more educated dialogue, involving better informed questions and greater degree of insight whether a good or bad prognosis. This ultimately provides the opportunity for perceived delivery of a greater level of personal care through proper and open consultation.

These are concepts advocated by UK health minister Jeremy Hunt, who as the NHS seeks to go paperless by 2018, has tasked Martha Lane Fox with putting together a proposal on increasing the uptake of digital innovation in the NHS.  This will no doubt include proposals to involve greater use of social media or webex consultations, other than the existing social media use of just inviting views or questions by the healthcare organisations which a number have already undertaken.  With the higher motive of saving billions of pounds, there is nonetheless an argument that greater empowerment and enablement will assist trusts as they seek to save money bluntly through technology on the one hand and enable the patient to be more involved in their own care and outcomes.  Just keep a weather eye on the critical issue of the handling of patient data and privacy as this direction evolves.

ePatient-Strategien_1900x800    Dave-deBronkart

IBM and Apple monitor our health

We first reported IBM and Apple’s JV partnership in our blog of 18th July 2014 with AppleCare for enterprises.

The boom in fitness trackers and health apps has prompted the tech giants to make commercial inroads on the opportunities arising from analytic technologies.  IBM has set up a new health unit to create “a secure, cloud-based data sharing hub” as part of their “employee health and wellness management solutions” with the aim that it will provide diagnoses or health alerts for GPs, carers and insurers in future, with the user’s permission.

IBM aspires to offer greater individual insights into people’s health and to advance this strategy, has bought Explorys (which owns one of the largest healthcare databases in the world) and healthcare specialist Phytel (which works with digital medical record systems to reduce hospital readmissions and automate communications).  Added to this, Apple iPhones provide ResearchKit, free software for gathering health data, which Apple states has already been used to develop apps to study asthma, breast cancer, cardiovascular disease, diabetes and Parkinson’s disease.

US consumer technology and wearables supplier Jawbone is trying to engage businesses with its fitness trackers as a way to monitor the health of a company’s workforce.  How does this leave the end user/employee?  For a start, if a company sought to monitor the health of an employee, consent has to be given freely, with the ability to withdraw that consent at any time.

Insurers are also keen to get in on the act, with companies like UK’s Vitality offering rewards to policy holders for undergoing certain activities whilst wearing their devices.  Are we reaching the point though where data analytics lead ultimately to cover being withheld, other than premiums going up or down.

The latest UK Government stats show that 61.9% of adults and 28% of children aged between 2 and 15 are overweight with a higher risk of developing Type 2 diabetes, heart disease and certain cancers.  The cost of health problems associated with being overweight and obese is estimated to cost the NHS more than £5billion every year.

For GPs, gathering data which gives a broader and more accurate picture of exercise undertaken and calories consumed, could alter health directives on the amount of sleep we need, or which exercises are most effective.

Gazing into the NHS’ future, a carrot and stick approach accompanied by bold education messaging for health reform of UK citizens may be the tough approach needed by the next Government.  However, to succeed, with an NHS in crisis on funding and struggling to hold onto its GPs through which the future frontline is directed, many parts of its processes and systems will have to go digital. This comes back to having data shared securely with privacy maintained and strict governance on who it is share by – and that is a big promise to keep.

gsmarena_001

 

 

This Week’s Technology News – 24h November 2014

3D Printing – refreshing the parts other printers cannot reach
The 3D printing sector has seen interesting advances over 2014 with this growing technology in use on earth and in space.  The International Space Station (ISS) has installed its first 3D printer. Before the installation, start up company Made in Space tested the printer in zero-gravity on an airplane. With the printer on-board, astronauts will be able to print physical parts themselves without needing to commission them from earth and get rocketed into space (both costly and time consuming).     Printed parts in theory will be able to replace faulty parts or maintain certain equipment in the ISS.

In parallel, researchers from the University of Oslo have designed bots that can already adapt to unforeseen problems and 3D-print new parts for themselves (ie. self healing manufacture) and apply intelligent best adaptation to its environment.   The options are limitless the scientists believe, based on a few limited instructions ie. what to do, how fast to go, its size and energy consumption.  The ingenuity for an autonomous computer being able to consider thousands of options simultaneously and 3D-print parts to create a new model, creates an intriguing possibility perhaps for ‘3-D Printing as a Service’ for MSPs?

 

Is business ready to accept ‘Facebook at Work’?
Although not formally announced, ‘Facebook at Work’ has been heavily rumoured to be used internally at the company, with a worldwide launch for business imminent.    Apparently, it is distinct from its current consumer model by barring personal details and helping overcome being blacklisted by organisations which disallow social media engagement at work. With the rise of social networking and collaboration, Facebook is cleverly poised through its dominant position with over one billion Facebook accounts, to try to take on the likes of LinkedIn and other corporate-focused social networks like Microsoft’s  Lync and Skype.   The diversification opportunities deepen, as collaboration leads to online storage where users upload and collaborate on documents with other users of the service.

The real question is whether, despite all their canny commercial plans, and even accounting for proper security and governance procedures, will the sheer name of ‘Facebook’ simply scare off a lot of companies?   Ultimately, the scale and impact of social networking cannot be ignored, but overcoming assumptions about the brand and how it will advocate its handling of public and private information will be the largest hurdle facing Facebook as it stares out from this mirror of opportunity.

Facebook

Dictat to go digital in healthcare – or warning NHS funding will be pulled
NHS England’s National Director for Patients & Information, Tim Kelsey, has announced the publication of its ‘Personalised Health and Care 2020 Strategy’.  This paper confirms NHS England’s intention to go paperless by 2018-20, or face having its funding pulled.

At its heart, patient care records must be available across urgent care services by 2018 and throughout all NHS organisations by 2020 to create joined up practice amongst professionals, speed and efficiencies and avoidance of errors (ie. in prescriptions).  Only 4% of records are currently accessible online.

The technical challenge around IT remains that many of the NHS’s PCs are still running the soon to be defunct Windows XP.  If as stated, financial resources will be made available to assist healthcare organisations, this will come as good news for IT teams and MSPs to help support any such migration to make the NHS fit for digital.  However, it must remain an integrated and secure approach.  The BMA’s GP Committee Chair Chaand Nagpaul concluded that “..the most critical aspects to get right beforehand are the safeguards, confidence and trust of patients”.   Added to this, should be the strict management of patient data to prevent it being sold unknowingly to third party commercial organisations for private profit.

Following errors on the Care.data scheme debacle earlier in 2014 which failed to have appropriate data privacy safeguards in place, this is a very valid point, but should not stop  future rollout if armed with correct good practice and security and governance policies. Hopefully, with National Data Guardian Dame Fiona Caldicott now on board, this will no longer be an issue. The key obstacle instead will be how much money healthcare organisations can secure to cover the necessary IT ‘fit for future’ upgrade investments.

NHS

NHS kitemarks for apps
In a separate move, with the rapid increase in health-related apps for mobile phones and other personal devices available in the market, NHS chiefs are backing a “kitemark” for health-related smartphone apps to validate those deemed as safe to use by patients to help them manage health conditions.  It also includes an e-version of the red book recording baby’s immunisations and development to be online from 2016, to counter the loss of key info if the actual book goes missing and the child requires vaccination, review or emergency treatment.

BSI-logo-strap-and-Kitemark

 

This week’s technology news from Amicus ITS – Friday 19th July 2013

NHS penalty for loose disposal of data
NHS Surrey has been issued with a £200,000 fine by the ICO for failing to clear patient records off decommissioned computers sold on through an auction site. The hospital used a 3rd party trust to handle the data destruction, which promised to wipe sensitive data from hard drives before selling on. One PC had 3,000 patient records on it and records for equipment passed for destruction in a 12 month period had been lost. No formal contract, guidelines or monitoring were in place to explain the provider’s legal requirements under the Data Protection Act. The data destruction company was unable to trace computers or confirm how many might still contain personal data. Effective management and regulated control mechanisms extending during and beyond the lifecycle of a company device is critical in order to maintain confidence and commercial credibility.

HP vs Lenovo
Last week for the first time Lenovo de-throned HP in global PC sales. Although all PC vendors saw shrinking sales, HP’s drop of 4.8% was enough to bring them below Lenovo by 200,000 units. An HP spokesman has commented “We don’t like being number two and we don’t plan to stay there”. HP has been caught off guard while restructuring it business, recently losing some large government contracts to Lenovo. Gartner predicts HP will be back at the top after Q4 thanks to the consumer holiday season, an area in which Lenovo currently struggles. With declining PC sales across the board and mobile devices fiercely on the rise, it will be the company who can successfully create the next mass market consumer tablet that will secure dominance going forwards.

Microsoft risky re-organisation
Steve Ballmer has announced plans for a massive restructuring of Microsoft. The product groups are being dissolved, with devices and services divisions in their place. Everything is now aligned around engineering rather than products with four key areas: operation systems, applications, cloud and devices. One division will handle all of Microsoft’s operation systems instead of different teams depending on the product. The objective is to create a cohesive experience for users across the full portfolio from Windows Server to Windows Phone. The danger here is throwing away a corporate model that has made Microsoft the world’s largest software company and a money making power house. Will Ballmer’s risky bet will pay off? We will have to wait a few years to find out.

Broadband in space
Nature report that NASA and the ESA are bringing broadband to space using lasers by creating a much needed data link speed increase between satellites, spacecraft and Earth using laser beams. ESA launches Alphasat on 25th July communicating at 300 Mbps. Separately, the Lunar Atmosphere and Dust Environment Explorer will launch on 5th September. Using an atmosphere penetrating AM-style infrared laser beam and eight ground telescopes, the lasers will avoid radio interference and bring 6 times faster data link speed from the moon. How long it will take for these benefits to impact on consumers has yet to be determined.

esa

This week’s technology news from Amicus ITS – Friday 31st May 2013

UK is simply the best
The UK has again been ranked the safest destination in Europe for businesses to locate their data centres according to the 2013 Data Centre Risk Index report. Scoring strongly on resilience and for ease of doing business, Britain continues to lead the way, strengthened by our status as a major economic global hub. Europe and especially the UK are also embracing BYOD strategies faster than the US, according to Citrix’s EMEA head. So whether your business interests are domestic or global, it is imperative to choose the right MSP with world regulatory understanding and creativity, so a UK based provider could lend you that leading edge.

Cloud best for SMEs
Microsoft backed research claims that investing in Cloud technologies provides greater business confidence. One third of SMEs polled said their prospects were more positive following migration. In the UK, 19% of companies surveyed using Cloud reported they were due to invest in staff, new technology or launch new products to gain growth. Illustrating a divide between those who have moved dynamically to the Cloud and those yet to change, the polarity could hold the old guard SMEs back and prevent them from maintaining commercial edge if they do not proceed to adopt a Cloud strategy.

ICO Compulsory Audits for NHS Organisations
Last week the Information Commissioner’s Office submitted a request to extend its powers to carry out compulsory assessments of NHS bodies and their compliance with the Data Protection Act 1998. Being proactive rather than reactive as in the past, this should ensure fewer data breaches and the ensuing bad press. Considering the NHS stores and transmits huge amounts of personal data, this should be protected and handled in compliance with the DPA. The ICO could be turning up at your doorstep. Are you going to be compliant when they do?

Tim Cook interview at the D11
Apple CEO Tim Cook took the hot seat at D11. With a tradition of keeping their cards close to their chest Apple did offer some interesting insights. On apps and services, Apple said they do not have issues bringing these from iOS to android, if it made sense to do so. On Google Glass, he acknowledged it might not have broad-range appeal, but spoke positively about a wrist device. This potentially hints at the rumoured iWatch. With WWDC 2013 just two weeks away we should not have long to wait for Apple to announce its new product line.

Three screens and a cloud
Microsoft has announced its next generation of gaming console with the Xbox ONE. At the announcement event the focus was not on games but multimedia. TV, sports, Skype and a multitasking Windows 8-like ‘snap view’ to run two apps side by side were included. Xbox ONE will complete their ‘three screens and a cloud’ philosophy that started with Windows 8 and Windows Phone 8. We believe the consistent interface between these three platforms will ultimately pay off in device sales, but more importantly, give customers the confidence needed to invest in the Microsoft services ecosystem.

Xbox-One-console

This week’s technology news from Amicus ITS – Friday 5th April 2013

Amazon’s Cloud Drive finally includes File Synching
Amazon who holds more Cloud market share than both Google and Microsoft have finally added a file synching feature to Cloud Drive. Cloud storage services are a hugely competitive sector and with Google Drive having suffered 3 service fallouts recently lasting up to 3 hours, it could mark an opportunity for Amazon to promote their alternative further. Amazon’s main differential with Cloud Drive in addition to its vast access to users, is its incorporation into the Kindle Fire tablets. This has helped Amazon gain market share. In conclusion the Cloud storage war will be decided not only on features, but the depth and reach to users and its integration onto different mobile platforms.

ICO compulsory audits of the NHS
The NHS is described as having “significant and widespread data protection compliance concerns” in a consultation document, based on an ICO submitted business case. The Government is investigating making data protection auditing compulsory for the NHS. Currently when a serious data protection problem occurs and is exposed, organisations often do not submit to an audit. ICO reveal that only 53% of NHS organisations referred for audit agreed to it, compared to 71% across the whole public sector. Compulsory audits for the NHS will be the right move to increase patient confidence in what is one of the UK’s largest and most important data control areas.

Windows Phone 123% growth
This week Kantar released its latest data of smartphone market share including data for the UK. Over the last 12 months Windows Phone has shown 123.3% growth in the UK, officially making Microsoft 3rd for Smart Phone market share behind Google and Apple, while Blackberry sits in 4th. This surge of customer interest in Windows Phone is likely due to the launch of Windows Phone 8 and a large marketing campaign, still on-going by Microsoft and Nokia. We predict over the next 12 months Windows Phone will see further growth, while both iOS and Android take the hit to make this happen.

IT Outsourcing on the up
In a recessionary market where cost-savings have included bringing services inhouse, one exception may be the ever increasing outsourcing of IT services. A recent study by Bluewolf (a global business consulting firm), found that out of 200 IT decision makers, 32% said they planned to increase IT outsourcing in the next 12-18 months. Additionally 48% believed they would be hiring more contractors vs full time staff. The ability to capture the best talent managing the latest technology, allied to elasticity of workforce, mobile application assistance, infrastructure support services, cloud data management and disaster planning tailored to a company’s needs will be fundamental to providing the necessary resilience and business continuity to firms in a fast changing commercial environment.