Service deliveryAdult Social CareDigital: The missing link between primary and secondary care

Digital: The missing link between primary and secondary care

Healthcare technology industry sees care in ‘tunnel vision’: Dr Phil Richardson, Chief System Integration Officer, Dorset CCG talks about what needs to change

The healthcare technology industry can sometimes see care from a narrow product perspective. That is, it sees primary and secondary care as entirely separate markets and focuses on providing technology to support only acute care, which has been the more traditional customer. Despite good intentions, the industry can inadvertently reinforce an ‘old’ way of thinking – that somehow acute hospitals are more important than the rest of the health and care system. This simply isn’t true.

It is important for us all to understand that only a tiny percentage of patient care is provided within hospitals. The vast majority of care takes place outside of hospital, in general practice and the community. If the industry fails to recognise the links between different parts of the health and care system, and why they are equally important, we cannot hope to use technology to create a shared, joined-up way of working. For the sake of the people living in our communities, this view has to change.

The challenge for vendors

Much of the challenge results from a lack of understanding of general practice by the industry as a whole, and a lack of knowledge of how the system links together. For me, it’s the missing piece of the puzzle. I have to ask: is the problem a lack of awareness, or an outdated mindset?

This partly stems from a disconnect between what everyone says the technology will do for the patient, and how it works in practice. We often hear the vendor speak about the patient, and then, within a sentence or two, the patient is forgotten and all of the focus is on the AI, the app, or the data, how much money the NHS will save and why it’s the best on the market.

As part of Dorset Integrated Care System (Dorset ICS), we are actively addressing these issues with innovations such as the Dorset Care Record: a full Electronic Patient Record (EPR) which is shared across general practice, community services, social care and acute care. Technologies such as this were developed from and are used from a patient-centred thought process. For example, we think of questions such as: how do we help populations where there are high levels of deprivation? How do we help this community where the residents are older? This community struggles with employment – how can our system help it with that? This is the way the industry needs to be thinking. We’re not trying to solve tech problems. We’re trying to solve health problems. And by health, we don’t mean disease. We mean overall wellbeing.

Away from technology, towards patients

We see that the technology is there. It is alive and being sold daily to NHS organisations across the country. What the system greatly needs are the skills and knowledge to implement the technology properly – in a way that champions collaboration between health and care professionals, while ensuring the safety and health of patients. We need to move away from products and services for an organisation in a building, and think about solving complex health and wellbeing challenges for a system such as the population of Dorset.

GPs understand this and are at the forefront of care integration. Vendors, generally, tend to focus on providing a solution which doesn’t always address the right problem. If a vendor excels at extracting data, then they will say that data extraction is the problem and they can solve it. The same can be said of a vendor that is excellent at reporting. Solving problems with data extraction or reporting means nothing if it cannot enhance the mental health, physical health, and wellbeing of the population.

Vendors must be involved in the conversation at the problem definition and design stage. They must think: what is the real problem that we are trying to solve? And how do we become part of a collaboration to solve it?

It is true that sometimes the NHS can put barriers in the way. Framework requirements, procurement processes, and the need for a track record and reference sites all become hurdles to leap over. There is a collaborative way of working which needs to be adopted to make this successful, and to create more of a focus on the common goal. At Dorset CCG, we are interested in the organisation which does not want to sell us things, or provide solutions that miss the point, but to co-develop, open, disruptive innovation as part of the team.

It is important to attend conferences and events like the Healthcare Partnership Network, because it is there that we can bring that collaborative atmosphere together. We can share ideas and start the conversation to tackle the challenges.  You are not there to sell a product. You are there to create a partnership, and to make a difference. Changing vendor attitudes and concentrating on the patient (and how technology can enhance their care), should be a joint priority in the healthcare industry and the NHS today. If you already think this way, then talk to Dorset. We, like other progressive, integrated systems are open for business.

Our end-game is not the end-to-end integration of data. Our end-game should be, and will always be, the health and wellbeing of our population. What the industry must do is recognise what technology can do to enrich that.

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