Data InsightDiscussing the future of healthcare – part 1

Discussing the future of healthcare – part 1

Hosted by Blenheim Chalcot and sponsored by Agilisys, the breakfast briefing had Rachel Dunscombe, speaking on healthcare technology

Earlier this month, Blenheim Chalcot, the UK’s leading venture builder, hosted an exclusive event in Manchester that brought together a collection of health technology leaders to discuss what the future of healthcare might look like.

The lively, fast-paced breakfast briefing, which was sponsored by Agilisys, covered a number of themes ranging from the importance of data accessibility and how it can ignite innovation, to how current technology can be optimised to overcome the challenges of disparate, legacy data and systems within healthcare.

Pioneer syndrome

The breakfast roundtable opened with a keynote speech by Rachel Dunscombe, CEO of the NHS Digital Academy, KLAS Arch collaborative UK lead and member of Matt Hancock’s Healthtech Advisory Board. Rachel started by redefining the thinking of imposter syndrome.

“We need to redefine the idea of imposter syndrome – and replace it with pioneer syndrome,” explained Rachel. “None of us have done this before. Not to feel something would be wrong, because it’s new space, but we’re all pioneers, and it’s fine to have pioneer syndrome.

“The situation we face is complex, so it’s OK to be daunted. There’s currently a lot of talk about AI and machine learning, but how the gap between traditional infrastructures, where data is, the historic underinvestment and where we need to be, is a big one.”

Personalised healthcare

Rachel went on to discuss how there’s a need to put the delivery of personalised healthcare first – with data usage at the heart of developments.

“The end goal is about us delivering care that’s appropriate for each individual. Care that is basically not wasteful to the system and is most impactful for individuals. It’s very interesting that the first five years of life are very pertinent to the rest of an individual’s healthcare journey. Yet, today, we quite often clear data away and don’t keep it for life – that’s data that we can learn from to predict outcomes later on in life. It’s personalised and it’s precise. Currently however, we’re very much treated by rote.

“For healthcare systems to get their head around that, they must first get their head around redesigning services that have fluidity built in, as opposed to a one-size-fits-all approach. That requires a very different mindset.

Rachel continued: “We have been off track in the past because of that lack of systemic design. We haven’t considered health, social care, patient flow, specialist care and so on. We haven’t thought about how the data recorded in one system or one place could have an impact across the whole system. For instance, in Greater Manchester, anyone who is a patient is likely to be known by four organisations. How is the data that’s recorded in one organisation got the provenance it needs for the rest of the system?

“Data has always been kept in bespoke formats. We’ve bought systems that store in bespoke formats, don’t store the provenance and don’t codify it in a way that can be used by different algorithms. Data is locked into systems.”

Bad data and the technical debt

Effective data usage is clearly a major talking point for healthtech leaders and it’s a topic Rachel covered in detail during her keynote presentation.

“Bad data quality is clearly an issue,” she explained. “There’s some evidence in the US now that shows if you educate clinicians as to what that data could be used for systemically, it increases the satisfaction with that system, and also the data quality in the system. If you’re going to put a big system like an EPR or an EMR in, you need to spend at least four to six hours of initial education, not just about how to put data into the system, but actually how clinicians can use the system to get data back out.

“We currently miss this point and, as a result, we have a technical debt. This is exacerbated by the fact that we’ve built in these systems that have silos that don’t use standardized data.”

And then there are the traditional procurement issues as well – the procurement cycle is not fit for purpose according to Rachel, who pointed out that it’s something Matt Hancock wants to deal with head on.

“Overall, successful big tech programmes are 22% about the technology, 18% about the governance within an organisation, such as clinical governance and boards, 60% around the clinicians, and the education, personalisation and how you get them engaged with the system. So, it’s 78% about your organisation receiving a technology not by the technology itself.”

Seven steps to success

Taking the above points into account, Rachel suggested there are seven things that health technology leaders need in order to drive successful transformation. These are:

  • Data that can be collected at one point and used at any point in the citizen journey.
  • Solutions that are plug and play for citizens.
  • To be able to get our data in an open standard and codify it where needed, so it can have the provenance across the whole system.
  • Motivated users who input clean data. Spending time educating them as to what that data is used for and motivating them and feeding back and allowing them to see how the data is used, increases the data quality.
  • Real time data exchange. Now, we’re still living in a world of nightly dumps, and the data needs to be cleaned before it can be used.
  • Data independent of UX, so you can multiple patient portals or multiple clinician apps on top.
  • A focus on the future.

Finally, Rachel welcomed the arrival of NHSX, the new joint organisation for digital, data and technology

“I’m looking forward to NHSX because it’s got a new focus on where we need to be. The focus around user experience is key for me, because we need to motivate our clinicians and patients to engage with the system to use the data and input the best data. If we can add open standards and build ecosystems that are fit for purpose and move in an agile way, support this with effective information governance and focus on open source where appropriate we can make a real difference to the delivery of patient care.”

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