Judging the young Inventors for #DigiInventorsChallenge in association with Andy Murray and the Digital Health & Care Institute (DHI)

There has been huge excitement in the Sopra Steria Scotland camp recently as we eagerly opened the entries sent to myself, Emily Walters and Graeme Harvey who were picked to be part of the judging panel for the Inaugural Digital Health and Care Challenge 2017.

Teenagers across Scotland are competing in the #DigiInventorsChallenge, giving them the chance to develop a new invention that will transform health, fitness and wellbeing amongst the nation’s young people using technology. The ideas include everything from fitness apps, gaming controllers and online challenges.

The winning team will see their idea come to life through the Digital Health & Care Institute’s innovation model as well as developing the skills and experience needed to make their idea a success.

I am sure the experience will stay with the winners for a lifetime and set them on their way for careers within digital health.

The role of the judges was to critically evaluate the submissions and decide on a shortlist of six teams that will bring their ideas to life at #DigiInventorsBootcamp.  We were all extremely impressed with the original and innovative ideas we received and we carefully considered the following elements when making our blind judging assessment;

  • What is the idea and how will it work?
  • What health and care problem does it solve and why is that important?
  • How does the idea apply to digital technology
  • Why would people want to use the idea and what benefits would it bring?
  • What design and manufacturing problems may occur, is there an outline of a business plan?

When I originally started talking with DHI about being part of this challenge there were three key reasons why I wanted to get involved:

  1. The challenge offers the #DigiInventors insight into a career in tech
  2. Working with young people and gaining powerful user research in their concerns on health and care and how digital services can transform outcomes
  3. Bringing the winning idea to life and working with the DHI to see the design developed and commercialised

Now the shortlist has been issued and so many different ideas have been generated I can see how powerful this kind of engagement is in getting young people to develop creative and entrepreneurial skills.

The next step is planning for the #DigiInventorsBootcamp where we’ll be meeting with the finalists to help take their ideas to the next stage. I’ll be back with more on this later in the year!

See more about Sopra Steria’s involvement with this great initiative.

Improving digital services in health care

As I awaited with eager anticipation for the second day of the Digital Health and Care Conference in Edinburgh to see digital innovation and progression in the Scottish Health Sector, a sobering thought from one of the speakers on the first day came to mind.

Whilst many retail and banking sectors have embraced complete digital transformation in their operating models, I’m sure you’ll agree that many areas of the health sector lag behind. Indeed, according to the Department of Health only 2% of current interactions are digital.

Person-centred interaction will always be at the heart of health and care, but that interaction can be better informed, more efficient and better organised , if supported by data and technology? To clarify my point I wanted to provide some examples:

  • GP Referral to Treatment (RTT) – whilst we are progressing in providing information available to the patient, why is it still difficult to provide information to the citizen regarding all the critical points in their pathway? As a patient, the only information one currently obtains is by telephoning the appropriate Health Board, contacting your GP to get them to do it, or receiving one of the paper-based letters to tell you that you’re ready to be seen by the Consultant in XX weeks time.
  • Booking an appointment – online access to GP appointments is available, but if you’ve ever gone through the process with your GP practice (at least in Scotland) it is overly complex and convoluted. I consider myself to be IT literate, but this process doesn’t seem to have the most important person in mind – the citizen. In effect, this has made little impact on a citizen’s day-to-day experience with their practice and the business model within it.

At the risk of sounding obvious, these two examples – of which there are many more – cry out for a rethink of the way the citizen interacts with services. Do we ask how a user wants to interact with the RTT process? Well, here’s an example in point. One of my family members is going for a hip replacement sometime soon. I want to emphasise ‘soon’, as they don’t actually know when. I’m sure the medical speciality know, so why can’t we provide this information to the user who wants to know to be able to plan their life effectively? Indeed, can we take learning from other sectors e.g. retail where the user is able to track the progress of their product from purchase to receipt. Why can’t we make this possible for the above example…? And I’ve not even considered the potential financial savings.

How do you get into the hearts and minds of the citizen?

The challenge that most commercial organisations had when the digital revolution started was that they created brilliant online presences which nobody used. Picture technological tumbleweed… So, commercial organisations incentivised customers to use the online functionality by offering discounts, online-only tariffs, faster fulfilment, flexibility etc. But how does this transpose itself to health care?

Looking to our Nordic neighbours, Daniel Forslund, Commissioner for Innovation and eHealth, Stockholm County Council conveyed it so well during the conference. Digital has to become the new norm. However, in order to do so, we need to incentivise citizens to use these services. This means providing digital services that the public want to use, as  and when it becomes beneficial.

Using the GP appointments example above, citizens choosing to use digital services could be given preferential appointment times – i.e., most early session appointments could be reserved for online bookings, whilst still maintaining slots for other methods of booking later in the day. These early morning sessions could also be available to book using SMS facilities from the citizen’s mobile phone.

As many of the key speakers at the Conference mentioned, digital transformation doesn’t have to be difficult, but we have to focus on the value it brings to the citizen – what information do we expect, how do we want to interact, etc?

Using service redesign techniques with the focus on putting the citizen first will enable us to deliver transformational services. It’s been done in so many areas already, so why don’t we do more for our ‘Health Consumers’? Indeed, one of the delegates argued that it’s about applying good practice that already exists in other sectors and transforming its use to new areas. Whilst I agree partly with this, I don’t think a ‘one size fits all approach’ can be taken – what happens when good practice doesn’t exist for a similar service? For me, and it sounds obvious, driving the input from service users is the key to transformational change in the way citizens interact with Health, designed by the user for the user.

Interested in hearing more about our approach to transforming customer journeys through service redesign? Leave a reply below, or contact me by email.

Game Changer: Giving children the opportunity to lead a healthy and physically active life

I started my local reading group a number of years ago and since then we’ve become good friends, so when I announced at our meeting the other night I’d spent the morning at a primary school, they were rather surprised. “You work for an IT company, don’t you?” Asked Katy. Not quite I thought, but I’ll save our digital transformation partner credentials for another conversation… I then got on to explain about how I’d had such an inspiring morning and about the strategic partnership with Widnes Vikings Rugby League Club, Halton Clinical Commissioning Group and Cheshire and Merseyside Women’s and Children’s Partnership Vanguard and how that had taken me to Weston Primary School in Runcorn for the launch of Game Changer, a programme with the ambition to make a significant impact in raising physical fitness and promoting healthy lifestyles in children and their families.

Physical activity is a critical part of Game Changer, as is healthy eating and the goal is to change habits. To kick off the programme at Weston Primary School, the entire Widnes Vikings team came along to put the children through their paces with a series of fun exercises and games. It was incredible to see how the children responded to the rugby players and so encouraging to see how they really wanted to get involved and take part in the physical activity sessions.

Sopra Steria’s involvement in the programme started a few months ago with discussions about how technology could support the Game Changer programme. Our role as technology partner is to develop the applications and web site side of things, which combined with a wearable device is looking to provide a fun environment for monitoring exercise levels, support gamification to encourage participation and link to important advice for leading a healthy lifestyle. With the data that is downloaded from the wearable devices, Liverpool John Moores University, another partner, will be able to develop statistics that can be fed back to the children and schools in a fun way, to encourage further participation.

In September Game Changer will reach out to 36 schools across Halton and each one will be looking to unlock an extra 15 minutes of physical activity each day. It is an incredible programme, I’m now asking myself how I can find an extra 15 minutes a day for exercise… Can you find the time too?

Find out more about Game Changer.

Breaking Barriers: building a sustainable future for health and social care

Collaboration, Integration and Innovation are the key themes of ‘Breaking Barriers – Building a Sustainable Future for Health and Social Care’, a report written by Professor Lord Patel of Bradford OBE, The Rt. Hon. Hazel Blears and Dr John Bashford.

At the ‘Breaking Barriers’ summit in central London this week, Lord Patel of Bradford launched the report by saying that:

To have hope of surmounting the challenge being brought to bear on health and social care funding for the NHS and local government we need new ways of delivering public services that are collaborative, integrated and innovative and which offer realistic, practical and replicable solutions.

Breaking Barriers offers a vision ‘for an integrated health and care system that uses it’s estates and infrastructure wisely and collectively within a single, unified financial and budgetary framework at local and national level’.  As the business transformation partner supporting the report, Sopra Steria has provided insight into how technology can best support the Breaking Barriers vision. This insight has been summarised in our thought leadership paper, published to coincide with the release of the Breaking Barriers report.

So what does this new model mean in practice?

Breaking Barriers proposes bringing together what is often a dispersed physical health and care estate into a local, shared physical hub that will help to generate collaboration, integration and innovation between agencies.

 To demonstrate how this may work we have developed a model, shown in this diagram that considers how innovative and collaborative methods can help to reduce, divert and manage demand.

At the top of the funnel we seek to develop long term solutions that prevent demand entering the Health and Care system in the first place. If we can influence good health practices at an early stage we can reduce the incidence of ill health and therefore reduce the need for care interventions.

An example of this approach is a project that Sopra Steria is supporting in Halton, in the North West, where over 30% of primary school children are overweight or obese.  The ‘Gamechanger’ project encourages children to take an extra 15 minutes of activity each day with the objective of making Halton school children the most active and healthy in England. By laying strong healthy foundations at an early age we aim to support and encourage a healthy long term lifestyle. It’s being initiated by Halton CCG, and the local Rugby League Club Widnes Vikings, collaborating with a number of stakeholders including Sopra Steria, Cheshire and Merseyside Women and Childrens’ Services Vanguard, Halton Borough Council and Liverpool John Moores University. We’ll be supporting this initiative developing a website that will have content to encourage healthy behaviours, and by using technology to incentivise children to eat well, and participate in exercise and to monitor their individual health goals.

The second layer of the funnel diverts demand by moving appropriate care from the physical environment into the virtual environment. For example, introducing patient self-service where appropriate and using invisible technologies, such as sensors, to support greater independent living within the home – these ambient technologies are particularly useful as they can monitor the home environment and the health of individuals remotely and without any direct patient input, so there is no need for them to learn or understand the technologies involved.

The final element of our approach is to use IT to help manage the remaining demand more cost effectively and giving patients an improved experience – for example automating processes, introducing electronic care records and simplifying administration.

Making change happen

It was clear that a desire for change exists amongst the health and care community represented at the summit. One of the speakers talked of the chemistry between people that is so often the catalyst for change and many of the people that I spoke to agreed that the way forward would be to build that collaboration across agencies by making a commitment to working much closer with colleagues to build stronger links across related services.

There seems to be a head of steam building that small steps of collaboration will lead to much greater integration and innovation to steadily improve the way that care is provided.

But this approach also recognises that achieving sustainable change requires a long term commitment that will only succeed if sufficient capacity is created to ensure that health and care service delivery remains unaffected.

‘Breaking Barriers’ addresses the issue of releasing additional capacity through the proposals for property and asset rationalisation to make more efficient use of buildings and assets. But also through the development of community partnerships to provide assets, services, skills and funding in similar ways that we have seen in Halton with Widnes Vikings offering their stadium facilities to support community health projects. The use of sports facilities in this way created a real buzz and fizz at the Summit as everyone shared similar ideas and contacts within their own areas.

I was greatly encouraged by the passion and commitment to achieve integrated health and social care by the speakers and delegates at the Breaking Barriers summit; there was a clear desire to achieve positive change in the health and care systems to deliver improved outcomes for patients and citizens.

Breaking Barriers challenges us all to return to our individual organisations and deliver collaboration, integration and innovation for real change for the better.

Read more in our thought leadership paper

What are your thoughts on the Breaking Barriers Report? Leave a comment below or contact me by email.

The use of technology to improve health care outcomes

Knowledge, it is said, is power. The advent of wearable health monitoring devices is being seen as an enabler to promote healthy outcomes through the use of technology. Giving one the ability to track a diverse range of health indicators from sleep patterns and calorie monitoring has meant we now are capable of having real-time personal monitoring tools that potentially could improve our health and well-being outcomes.

However, unlike the next consumer gimmick, these devices are already beginning to have an impact on the health sector, with the ability to disrupt the traditional reactive patient treatment health care model. Recent studies show that the use of healthcare apps for Apple devices is growing more than 80% faster than the apps in the entire mobile industry.

But that’s not all…the use of these devices and the data harnessed by them has the potential to reach out and revolutionise patient care, to a much greater audience than those who want solely to measure their day-to-day exercise progress or calorie intake. Numerous examples are out there, but there are a couple that I want to share with you:

  • Accessing a patient’s electronic health record and broadcasting it to Google Glass, for example, allows a clinician to view patient data, including lab data and vital signs without the need to divert away to a computer
  • Linking a patient’s personal health data recorded on a wearable device to an electronic patient record (epr) in a clinic/hospital setting. Apple is working with a number of suppliers, towards transferring data between Apple’s Health Kit platform and the epr. Medical professionals could use the ‘right data’ to detect patient warning signs more easily and prevent diseases and complications before they worsen rather than reacting to them after they occur
  • Intel’s funded partnership with the Michael J Fox Foundation to research into improving the monitoring of Parkinson’s disease. Through the use of wearable technology, patient data is collected to measure symptoms and track the disease’s progression. Data collected from patients, for example, following a new therapy routine or taking new medication and the effects this has on movement frequency may lead to further insights into the disease

Whilst wearable device technology is attracting much interest in the health sector, it’s important that we do not lose sight that technology alone will not solve the sector’s problems – I have seen this many times where today’s tech becomes tomorrow’s doorstop.

The sector needs to look at ways to ensure that through the use of technology, society at large will benefit (…and assuming regulatory issues, buy-in from heath care professionals and personal privacy concerns amongst others can be resolved – but that’s for another blog!).

There needs to be a clear focus on the “meaningful” data to be targeted to improve specific health outcomes, otherwise the market will remain dominated by fad and noise and more big data. Technology should be aligned to areas e.g. chronic illness such as diabetes, or epilepsy where it can help shift from a reactionary care model to predictive and preventive care, leading potentially to a reduction in patient visits to surgeries/hospitals. This may in turn aid to the reduction in long term patient health costs.

Finally, it’s worth noting that at a recent conference I attended one of the speakers outlined that just under 2% of Scotland’s population account for approximately 50% of health expenditure; many of these will be chronic patients for whom these technologies may benefit greatly.

What do you think? Leave a reply below or contact me by email.

Interoperability and information sharing

Experiences of early adopters in information sharing have not found the path to be as straight forward as first envisaged. Through their efforts and lessons learnt, we can now share some of the pain points and critical success factors encountered along the way towards a holistic approach for treatment. These lists are not exhaustive but provide some of the inputs and opinions collated.

Pain points:

  1. Who is driving the change – e.g., dominance of health “medical model” over social “care model”
  2. Differing work cultures between health and social care
  3. Financial funding arrangements of agencies
  4. Inadequate technical infrastructure to enable a cohesive working
  5. IT skills gap for some workers
  6. A major concern around confidentiality, data protection and privacy of the patient/ client
  7. The costs and risk factors associated with integrating data
  8. Constructing large databases

Critical success factors:

  1. Developing integrated datasets and information systems
  2. Alignment of financial incentives, and sharing benefits and risks
  3. Developing an integrated workforce and culture
  4. Scope defined and managed by a centrally governed design authority
  5. Enterprise Architecture operations within transformation program governance
  6. Anticipate the demands of the business transition
  7. Deep and wide stakeholder involvement
  8. Mature Digital platform – application integration and ‘model office’
  9. Developing IT service operating models for end-to-end not just a single client organisation

Considering both these pain points and critical success factors show us that for successful information sharing, we need a set of standards.

For years NHS England, the Health and Social Care Information Centre (HSCIC) and their previous incumbents have been advising on interoperability standards. As a result the development of the Interoperability Toolkit (ITK) was introduced for the NHS. This has been beneficial to system integrators by adopting the standard through ITK compliance. Further developments have seen a shift towards Open Interoperability and suppliers of systems providing Open APIs, which have become necessary as the ITK was initially developed for healthcare systems.  However in the age of Digital Integrated Care it has become necessary for disparate systems particularly in social care, community services, OOH/111/999, etc., for information sharing to be accessible at the point of need.

The creation of a virtual record enables vital information to be retrieved in real-time, a care plan formulated, and appropriate actions taken to provide immediate help.  This implies that retrieval and collation of the above information to form the virtual record resides on the end-user health and social care systems. In this context, following a period agreed by partners (multi agency/professional teams…) – for example 24 hours – the virtual record will expire, and no database or repository has been created.

The initiatives and approach in Scotland (the refreshed eHealth Strategy 2014- 2017) and Wales (Health Social Care and Wellbeing Strategies 2011-14) are also good examples:

  • Scotland Ayrshire Councils, in partnership with NHS Ayrshire, have developed a system (AYRShare) enabling effective, timely and secure sharing of information to help address concerns about the well-being and protection of children and young people
  • The Welsh Government is seeing real progress through the ‘Community Care Information Solution’ which allows information to be shared “instantly” across different Welsh health and social services. The first deployment is scheduled for later in 2015 in Bridgend County Borough Council to health, social services, mental health, therapy and community services. Other projects that have benefited Wales are data sharing and matching trial to identify vulnerable citizens
  • NHS England has also started exploring some of the processes and ways of working for adoption in their own programmes

Citizens and patients are willing to share information across care settings if they feel it benefits their health and well-being, but are keen to still have the option of opting in/out.

These guidelines provide an Information Sharing Framework to work with and a set of early learnings from others that are collated below for easy reference. Each section contains a list of key considerations:

  1. Business requirements – ensuring that agreement is reached by stakeholders, estimating the size of the project and how much it is going to cost. At the enterprise level it must meet the organizational objectives and still be solution independent
  2. Outcomes – the results of the work carried out in delivering a solution and could be, for example, supporting the integration of care across a health and social care – a Portal Solution
  3. Governance – this context would be around Information Governance and that all parties involved in meeting the requirements of minimal data persistence for the portal solution
  4. Agreements – in most cases the framework agreement as part of a selection criteria process during the tender phase and prior to the supplier being awarded the contract
  5. Legal Considerations – generally applying to and covering
    – consent/informed refusal
    – opt in/out
    – beginning of life
    – end of life care
    – safeguarding
    – accountability
    – negligence
  6. Organisational considerations – aligning their IT Strategies, roles and responsibilities, maturity
  7. Informatics considerations – data sharing and migration planning – the information systems (data and application) and technology architectures

We share information every day of our lives through social media and the internet, but yet when it comes to sharing health and social care information we see and experience blockers. In addition, there exists an age divide in terms of competency in the use of technology, particularly in the elderly as mobile interoperability becomes a the more accepted way in sharing of this information.

What do you consider as some of the critical success factors and pain points in the delivery of Integrated Care? Leave a reply below or contact me by email.

Mind the GaaP – shared technology platforms and data analytics

The outcome of the government’s digital strategy has been higher adoption of on-line services and the introduction of new technologies – including social media, mobility, analytics and cloud computing. But as government delivers services that are simpler, clearer and faster to use it also creates increased expectations.

First, citizens demand services that are often universal but also reflect the levels of personalisation they get as private consumers. But government operates as a series of silos. Services, processes and technology reflect inward-looking departmental needs.

Second, the public finances demand that government boost productivity using innovative digital technologies. The government saved £18.6 billion in 2014-15 through various reform projects. But the savings attributable to digital transformation are significant but relatively small (£391m).

In an environment of increasing citizen demands and top-down cost reductions, how can technology help government be more responsive but at least cost?

Government as a Platform might reduce unnecessary bureaucracy and costs

Two years ago the Government Digital Service (GDS) set out to transform twenty-five major public services. Twenty digital ‘exemplars’ are now publicly accessible. GDS continues to work with departments to build these and other services in agile and iterative ways.

The next phase of the government’s strategy is ‘Government as a Platform’ (GaaP). This is the sharing of the core infrastructure of systems, technology and processes across departments. GOV.UK Verify is a good example. Rather than having to prove who you are to every government department, Verify uses certified companies (and public and private sector data) to confirm a person’s identify once and for all. Other potential platforms are payment processing, case management and appointment bookings – common services used all around government.

GaaP offers a number of potential benefits. First, enhanced user satisfaction by eliminating the need for a citizen to input unnecessary data and information. Second, cost savings by eliminating administrative procedures and processes (and associated transactions) that are not needed. Third, wider economic benefits by making the data open, as others who are unrelated to government can create new businesses that complement public services. Forth, citizens or community groups might also use this data to hold government to account.

Tailored and automated services offer even greatest benefits

In the private sector an ability to share systems and data through technology is leading to a more personalised service. A user is in full control of navigating, choosing and terminating a set of offers. Back-office integration enables the private sector to offer proactive, enhanced and efficient services.

How might this approach be applied in the public sector? At its most simple, the government might pre-fill data in an application form that it already possesses, based on taxation or benefit entitlements, and notify the citizen via email or text of any changes. But more significant improvements to the quality and cost of public services are available through the analysis of this data (a data platform), leading to earlier and more focused interventions.

For example, approximately 40% of hospital admissions in England are unplanned admissions. They are a problem for hospitals because they are costly and disruptive and increase waiting times. Vulnerable patients with complex physical or mental health needs tend to be the biggest problem.

The detailed analysis of historic patient level data, identification of patterns and predictive risk modelling can predict and identify ‘at risk’ individuals. Unplanned admissions can then be avoided through changes to the hospital discharge process and better co-ordination of care.

Taking it to the next level, ICT-enabled simulation and decision-support tools are also able to analyse large and complex socio-economic data sets on deprivation, crime, health, education, etc. This deeper analysis can inform early intervention and screening programmes, with resources focused on communities and individuals who most need them.

Costs can be avoided by highlighting incidences of unnecessary care or delays in treatment. And by making evidence-based information about options, outcomes and uncertainties available, patients are also in a better position to make informed choices about the treatments available to them.

This proactive approach may not be appropriate for all types of service. It will, for example, depend on access to necessary data and protection and legal access. But, when applied to high-risk and often disproportionately high cost individuals, the savings potentially far outweigh the up-front costs of investment.

What do you think? Leave a reply below or contact me by email.