Healthcare World Magazine | Issue Five by TheTradeAgency

L E A D I N G T H E D E BAT E I N I N T E R NAT I O NA L H E A LT H CA R E & L I F E S C I E N C E S

Issue Five | Summer 2022

HIMSS22 Europe Leading the healthtech charge

PARTNERING FOR SUCCESS | CONSUMER-DRIVEN HEALTHCARE | BUILDING INTELLIGENT HOSPITALS | REINVENTING PATIENT PATHWAYS

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EDITOR’S WELCOME

Welcome to Healthcare World

his month brings HIMSS22 Europe in Helsinki, one of the most beautiful cities in the region. Hundreds of healthcare delegates will making their way to the Finnish capital to debate the way that technology can aid the sector to reform and reinvigorate itself. Finland is the perfect setting for such a theme. According to Armin Scheuer, VP and Executive Director EMEA for HIMMS, data has already transformed many parts of Finnish society, and the Finns are happy to part with their information to reap the rewards. All health records are digitised and most of the population, minus 210 people, are willing to share their information with Findata for the benefit of everyone else. As he outlines in his informative opinion article on page 9, data is the lifeblood of healthcare. By empowering and engaging the patient, there will be huge strides forward in the way we approach our own personal health. The sector has benefitted hugely from the telemedicine revolution as a result of the pandemic, and now citizens are becoming used to the idea of digitised patient records they can carry with them on their phone, as Lyniate’s Royston AdamsonGreen observes. But, as he goes on to say, there will have to be a seamless experience for the patient to embrace digital healthcare. Equally, they will have to trust that their information is held securely, and by putting them in charge of their consent and privacy settings. And once there is a smooth transfer of information across the healthcare sphere, innovation can really flourish. Currently, many digital providers are finding that partnering is the way forward, either working with similar project or by finding a home on other platforms.

Sarah Cartledge Group Editor Vincent Buscemi of Bevan Brittan gives a broad overview of the issues that companies should take into account when considering such a partnership, and discusses how legal advice is key from the beginning. Elliott Engers of Infinity outlines his view that the future of healthcare is beyond the walls of the hospital. The creation of virtual wards will help reduce the backlog of patients and will enable them to manage their own health from home, thanks to digital options. It will also increase efficiency in hospitals by freeing up staff and beds. SMEs can often go overlooked in big projects. PatientSource has experience of being chosen as a partner by a big hospital and it has worked for both parties successfully, as they reveal on pages 76 and 77. Similarly, innovator and Drill Surgeries founder Moises Ramos Barbera tells us on pages 68 and 69 how he came up with a revolutionary concept to enable better patient care in orthopaedics. If our homes are adapted for old age, then the chances are that we will be able to stay in them longer. Richard Mazuch, Director of Design, Research and Innovation at IBI Group, shows how small changes can improve home life for the elderly, such as sensory bedheads, LED lighting and smart floors. If we begin to plan now, we can manage as we grow frailer. Our expert panel for the Healthcare World Series on healthcare infrastructure delivered varying solutions for the hospitals of the future, moving away from the hospital-centric systems of today towards the hospitals at home of tomorrow. Their in-depth analysis is on pages 32 to 35. Whatever your areas of interest, you’ll find a wealth of fascinating information in this issue. We look forward to seeing you in Helsinki.

The Healthcare World team Steve Gardner Managing Director

Andrew Goldsmith Finance Director

Sarah Cartledge Group Editor

Emma Sheldon MBE COO

Ritu Chopra Operations Director

Joe Everley Art Director

Emma Williams Operations Manager

Fabian Sutch-Daggett Website Editor

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Contents 3

Editor’s Welcome

The next generation of health and care technology: HIMSS22 Europe

The HIMSS22 Europe conference is set to be a landmark of innovation and collaboration, writes Healthcare World’s Fabian Sutch-Daggett

Digital technology can help hospitals manage patient care more efficiently inside and outside their walls, Abhi Shekar, Digital Healthcare Lead at Mott MacDonald, explains

Radar Healthcare rolled out across the UAE in 90 locations

Finding hidden value in the data

Mat Oram CEO and Co-founder of AdviseInc outlines how to improve procurement in hospital systems through the use of data

Patient identity management and the future of consumer-driven healthcare Healthcare must embrace ways to collect, verify, and share digital patient identities to deliver a better patient experience, says Lyniate’s Royston Adamson-Green, Director, Channel Sales UK, EMEA & APAC

The ultimate end-to-end pathway

Mona Hayat, CEO and Founder of Nexus Digital Technology, speaks to Healthcare World’s Sarah Cartledge about how patient pathways can be revolutionised in the UK

Collaborating for Digital Solutions

Vincent Buscemi, Partner and Head of Independent Health and Social Care for Bevan Brittan LLP, outlines the key legal and commercial issues behind collaborations

The need for standardising healthcare recruitment in the digital age

Jim Campbell, Director of Health Workforce at the World Health Organization, speaks to Sarah Cartledge about the need for an international healthcare workforce register in the current climate

Building intelligent hospitals

Earlier this year the Emirates Health Services (EHS) partnered with Radar Healthcare to deliver its quality and compliance software to 17 hospitals and 73 primary care centres across the region. The system is currently supporting them in delivering clinical incident reporting and patient safety outcomes

HIMSS 2022 Europe - Leading the digital health debate Armin Scheuer, VP and Executive Director EMEA for HIMSS, details the importance of digital health and how HIMSS22 Europe can be a crucial venue for innovation

Healthcare World Magazine | Issue Five

The International Affiliate Network –

a pathway to better patient care Sarah Cartledge speaks to Alistair Russell, Head of Business Development at Imperial Private Healthcare about their latest venture to ensure better patient experience

Time to consult

Emma Sheldon MBE

CONTENTS

The Evolution of Healthcare Infrastructure

Healthcare World’s expert panel delivers a vision for the future

Can digital really solve the workforce problem?

Jyoti Mehan of Health Care First considers how digital can tackle the workforce issue within healthcare

Breaking the mould

The future of healthcare is beyond the walls of the hospital, says Elliott Engers, CEO, Infinity Health

News

Ensuring clinical excellence

Delivering capacity through digital

Health Education England’s action learning programme enables individuals to consider workforce planning issues, say Partnerships Managers Finola Preston and Aleksandra Conversano

A digital prescription for making healthcare better

Notes from a Modern GP

Putting faith in an SME Toby Roberts, Associate Director of Information and Technology at the Royal Hospital for Neuro-disability (RHN), discusses his decision to procure an EPR system from an SME as opposed to a big-name solution

Creating next generation health insurance Meeting the needs of today’s society can be achieved through organisational agility, says Aron Thompson at PA Consulting

The value of patient feedback Dr Tom Palser, Consultant Surgeon and Clinical Lead at Methods Analytics and Simon Swift, Managing Director at Methods Analytics examine the need for utilising patient feedback

Tomorrow’s Home: A Salutogenic Role in Health Management By 2050 nearly one in five people in rapidly developing countries will be over 60. Richard Mazuch, Director of Design Research and Innovation with IBI Group, asks how we can support the wellbeing of this growing population

UAE health data localisation in 2022 Al Tamimi’s Andrea Tithecott, Partner and Head of Healthcare & Life Sciences Practice, and Andrew Fawcett, Partner, Digital & Data consider the application of the new ICT Health Law and Resolution 51

How AI is transforming procurement in healthcare Vamstar CEO Praful Mehta explains how AI is altering the procurement process for the better

Changing times

The NHS staffing crisis is not insurmountable, says Dr Patrick Wynn of Health Care First

What’s your score? Romano Toscano, CEO and Founder of MyLifeKit discusses the launch of VioScore

Healthcare can be transformed through change management, says Linea CEO Ian Chambers

Fixing the little things Healthcare World’s Sarah Cartledge speaks to Moises Barbera Ramos, CEO and Co-Founder of DrillSurgeries, about his revolutionary solution enabling better patient care in orthopaedics

The global language of healthcare

SNOMED International CEO, Don Sweete talks to Healthcare World about SNOMED CT, SNOMED International and its global, thriving community

Telemedicine, connectivity and the fly in the ointment Simon Hill, Chief Technical Officer for connectivity specialist Excelerate Technology, discusses the challenges of performing diagnostics in areas with compromised phone reception

Josie Winter, Clinical Operations Director of Advanced Clinical Solutions, explains how to help hospitals reach and secure clinical excellence

Digitalisation is key to unlocking a more holistic systems approach and the delivery of better health services and patient outcomes, write Mott MaDonald’s Digital Healthcare Lead Abhi Shekar and Global Lead for Social Outcomes Kerry Scott

Opinionated Joining the dots

Nexus Digital Technology We are the international experts in health and wellbeing connectivity. We create the tools to give everyone the best chance of optimising their personal health and wellbeing. We partner with organisations and healthcare providers, creating bespoke digital solutions to help engage their people to transform the quality of their lifestyle.

Our Nexus solutions provide actionable data for organisations, so they can measure engagement and effectiveness. The end result is a tangible reduction in the personal, social, and financial costs associated with disease and ill health. To find out more about how Nexus can support your business or organisation, please contact Emily Nicholls, Chief Operating Officer on enicholls@nexus-dt.com

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EVENTS HIMSS Overview

The next generation of health and care technology: HIMSS22 Europe The HIMSS22 Europe conference is set to be a landmark of innovation and collaboration, writes Healthcare World’s Fabian Sutch-Daggett

e are lucky to be present at such a pivotal moment within healthcare. We learned many lessons from the COVID-19 pandemic, and the vast collaboration and ingenuity that emerged from this once-in-a-generation event is not something we have to consign to the history books. Those who developed such technologies, from personal health to portable care, pharmaceutical technologies and diagnostics, data and record solutions,

were vital to getting through the pandemic, and now are enabling the healthtech industry to thrive like never before. The power of technology to revolutionise healthcare has already been proven, and it is now time to take the next steps. For this reason the HIMSS22 Europe conference, running from June 14th-16th 2022, is sure to be the bellwether of the best the healthtech industry has to offer. There is an urgent requirement for development, collaboration, and innovation, and

HIMSS22 Europe will provide a breadth of opportunities for operators from all sectors of the health ecosystem to become involved. On offer at the conference are interactive workshops, thought leadership summits, engagements with governmental speakers and key decision-makers, networking events, and in-person visits to hospitals and care centres; enabling attendees to get truly hands-on with the technology and to understand the real benefit within the population. With more than 120 total experts in the field appearing at the event, and more than 60 live sessions, there is truly something for everyone, from the newest startups to the biggest players in the field. Furthermore, many of these events are CPD accredited, making sure that attendees will be able to demonstrate their engagement with development in the field and a personal commitment to ensuring excellence within healthcare technology. 7

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The conference provides attendees with 7 key thought areas, enabling attendees to focus their attention on the areas which are most applicable to them, while also engaging meaningfully with a wide range of thoughts and opinions. These areas include: • AI: From Evidence to Mainstream Practice - exploring key use cases for AI in the sector, and the challenges to integrating AI into wider adoption. • Digital Public Health - looking at what a data-driven public health system could look like, and the levels at which it should operate. • Digital Transformation Summit - focusing on how people can best evaluate outcomes, ROI and the digital capabilities of the global health ecosystem, drawing on real-world evidence from the HIMSS Office of Scientific Research. • From Silos to Integrated Care - this examines the shift from siloed services to tightly integrated care based on the needs of patients and populations, and providing an in-depth look at the key drivers of integrated care, including policy, workforce and culture. • Person-Enabled Health - a timely discussion regarding the changing nature

of patient attitudes towards ownership of their own health, and how organisations can engage with this in the most effective ways. • Radical Health Outlook - These educational sessions will explore radical health innovations, and how to identify the healthcare innovations that are truly ‘radical’. • Workforce Empowerment - Using practical case studies, these sessions will explore early adopters who create and trial new technologies on the front line, and how we can support clinicians and their teams to better understand, trust and capitalise on technology. Some of the highlights of the event include the Welcome Keynote “Reshaping Health and Care to Put People First”, which “will celebrate resilience in the face of adversity and mark a new, collaborative era in healthcare across Europe and globally,” as well as a discussion on “how key players across the health ecosystem can work together to deliver equitable, sustainable, genuinely person-centred care for a digital age.” A recurring theme on offer at the conference is a commitment to building our health systems back up after COVID, and preparing for the challenges that the future

may hold for us. This issue is addressed in the “Humanity’s Moment for Reimagining Health & Care” keynote, detailing the way that governments are “rethinking health as an investment and recognising that robust healthcare systems are essential to recovery and growth post-pandemic”. Similarly the “Climate Crisis: Healthcare’s Responsibility to Our Planet” keynote, outlines “how rapid digital transformation of healthcare can be delivered in an eco-sustainable way, ensuring the recent explosion of data and technology in patient care helps to solve and not exacerbate the problems.” The event will close out in the beautiful Winter Garden in Helsinki, offering delegates and attendees a chance to reflect and digest the developments and learning at the event itself. HIMSS22 Europe is certain to provide a fantastic opportunity for healthcare operators from Europe and the healthcare ecosphere at large with a chance to engage meaningfully with the latest developments in the healthtech industry. Contact Information

www.himss.org/event-himss-Europe

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EVENTS HIMSS

igital health has been at the forefront of the healthcare debate for a long time. We all understand the need to harness the power of digital which is why it is so important to engage with digital health in a meaningful way. Through collaboration and interaction with our colleagues from all corners of the world, we can push the debate even further, and shine a light on how we can improve. At HIMSS22 Europe, attendees and delegates alike will have an unprecedented opportunity to engage with one another and examine the next steps for digital health together. Thought leaders can look forward to examining

issues to be challenged, what needs to change, and how digital can provide the best tool for revolutionising our health systems. As such, Armin Scheuer, VP and Executive Director EMEA for HIMSS, shared his thoughts on some of the key areas of interest at the HIMSS22 Europe conference in Helsinki. Q: What needs to change in the global health ecosystem? A: I truly believe that we need to realise the full health potential of every human everywhere - which is the vision of HIMSS. Increasing health equity through the

power of information and technology is HIMSS’ contribution to that. In highly developed countries, we would be looking at personalised healthcare, active ageing technologies or the use of artificial intelligence to support prevention and treatments of disease. In developing countries, the focus might be on ensuring access to basic health information and care through the mobile phone. But overall, the three major challenges - at least in developed countries - are the silver tsunami because of an ageing population, the chronic disease burden, and the increase in healthcare cost. Q: How can digital technology accelerate these changes? A: Data is the lifeblood of modern healthcare, and we see a great effort globally to better manage the access and use of healthcare data. Countries across the Middle East are rolling out Health Information Exchange. In Europe, massive government investments are oating into the modernisation of hospitals 9

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- with regards to information systems, interoperability, and patient portals; and the discussion about the creation of the European Health Data Space is making progress. COVID has shown everyone first-hand how critical data is - be it for seeing an overview of available ICU beds and ventilators, to identifying new virus variants, diagnosing Long COVID, or developing a vaccine. Now is the time to continue that path and explore all areas where data can improve health outcomes, drive research, or simplify the lives of patients and healthcare workers. Q: What have we seen IT achieve so far in this field? A: Have a look at Finland, where data has already transformed multiple sectors of society. The country with its progressive health system has 100 per cent of its patient records digitised. This results in high-quality healthcare data - and Finns believe that if they let researchers use that data, the return will be better healthcare and innovative medicines. In 2019 the country introduced new legislation for secondary use of health and social data. Findata has been established as a central authority which grants the required permits for data usage. What is truly amazing is that out of the 5.6m Finns, only 210 citizens have opted out of Findata; and so far, more than 400 research projects have benefited of this approach. This clear regulation of the secondary use of health data is exemplary, as it creates an environment of trust as well as legal certainty for capturing, sharing, and processing data. Q: What are the key target areas for improvement using technology? A: From a patient perspective, I would say it is the move from patient engagement to true patient empowerment. Initially patient engagement has been focused on giving access to health records and data in the EMR. But we are moving into a phase where digital tools - apps, wearables, and sensors - will be connected to the EMR to monitor progress. And that will lead to a shi in the patient / provider relationship in future patients and their health providers will act as partners with patients managing their health and tracking progress towards their health goals and sharing that data with their providers.

Q: And how about underdeveloped healthcare systems globally - how can they change to meet today’s challenges? A: Healthcare systems need to deploy technologies that address their very specific local situation and challenges. In India for example, the stock density of doctors is

Armin Scheuer VP & Executive Director EMEA HIMSS

“Healthcare systems need to deploy technologies that address their very specific local situation and challenges”

7.35 per 10,000 population; in Sweden it is 70.92. Malaria is a huge health issue in many African countries; it is basically non-existent in Europe. We must understand that many developing countries simply don’t have the financial means to fund top-end technology solutions and a simple yet affordable cloudbased EMR, for example, might be more suitable than a leading-edge, high-end system. I guess what I am trying to say is, that we can learn from each other, but we cannot necessarily copy each other. Q: Why is HIMSS22 Europe an important venue for collaboration? A: The HIMSS22 Europe conference brings together the key decision makers from across Europe to discuss the latest digital technologies for shaping the future of health. The EU for example is investing €673bn in “recovery and resilience” of which at least

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EVENTS HIMSS

€13bn is targeting investment in digital health transformation. Healthcare and IT leaders now have a bigger-than-ever opportunity to implement advanced digital systems and solutions - they all meet this June in Helsinki. Q: What are you hoping that HIMSS22 Europe will highlight? A: The conference speakers and participants will look into ways of delivering next generation health and care already today. As we are about to leave the COVID-crisis mode behind us, national digital transformation programmes need to factor in a new key objective: building back stronger and more resilient health systems. I am looking forward to the digital transformation track - which also looks in developing a global understanding of digital maturity. The discussion about the European Health Data Space, the Telehealth & Cybersecurity

masterclasses, as well as inspirational keynote speakers such as the President of Medicine Sans Frontiers, will ensure the event provides multiple perspectives on how to shape the future of healthcare. This includes an outstanding exhibition with the global and local technology leaders and innovators. Q: What do you see as the key challenges in levelling up the global health economy to achieve UHC? A: Universal health coverage gives all people access to the health services they need, when and where they need them, without financial hardship. In Europe and the UK, we have achieved a very advanced level of health equity. But, according to WHO, half of the world’s population do not have access to the health coverage they need; every year 100m people are driven into poverty through out-ofpocket health spending. This is expected to

worsen with climate change as well as with geopolitical crises such as Russia’s invasion of Ukraine. At HIMSS, we contribute through several initiatives - for example to support interoperability, advance nursing informatics and contribute to EU projects such as Gravitate Health. Globally, we need to strengthen cooperation, talk less, act more and to establish accountability across the entire health economy to actively address the crises and opportunities that lie ahead. Promoting “Health in All Policies” - as suggested by the WHO and thoughtfully implemented in Finland, for example, could be a start. Contact Information

www.himss.org/event-himss-Europe

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Building intelligent hospitals Digital technology can help hospitals manage patient care more efficiently inside and outside their walls, Abhi Shekar, Digital Healthcare Lead at Mott MacDonald, explains

ealth systems are often asked to do the impossible - to manage care for huge populations of patients without adequate physical, digital or human resources to meet their diverse needs effectively. Global health policy makers and clinicians know this is unsustainable with rising patient demand and workforce shortages, particularly exposed by the COVID-19 pandemic. A more streamlined, digitally enabled model of healthcare is needed.

There is a growing consensus that the role of the hospital needs to change. Hospitals of the future should focus on delivering specialist care for patients with the most complex needs, while more standardised health services should be delivered more effectively in the community or in patients’ homes. For this model to work, the entire healthcare system – operating inside and outside of the hospital walls – must be seamlessly, digitally connected.

The UK government is embarking on a once in-a-generation programme to build 48 new hospitals by 2030. Similar programmes are also underway in the Middle East and India. Drawing on our digital expertise and experience developing major new hospitals, we have developed a vision for intelligent hospitals of the future with digital at the core. In the UK and the Middle East, we are helping our clients get the human, physical and digital elements working together. Human-centred healthcare When hospitals are designed with the needs of staff, patients and carers in mind, they have a huge potential to enhance their experiences, both within and outside the walls of the building, and improve health outcomes in society. Digital technologies, when deployed with the end user in mind, play a critical role in this. Clinical information systems sit at the core of staff and patient journeys. Beyond

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INFRASTRUCTURE Mott MacDonald

tricky part is to ensure that they connect seamlessly with clinical systems back in the hospitals and across the health system. Smart buildings

this, digital technologies support staff in using clinical data, record how patients engage with health services inside and outside the walls of the hospital, and guide staff and visitor interactions with the physical building. Technology can improve connectivity within hospitals as well as extending links into the community. This encourages greater collaboration between clinicians and empowers staff to become more productive, enabling them to focus on delivering high quality care. It can also improve communication with patients, which is essential if more health services are to be delivered in the community. User-friendly digital tools can be valuable in helping people monitor their health at home and treat, prevent or manage disease. For example, virtual wards are being deployed in the UK to manage patients within their communities and feed information back to doctors in hospitals. While these tools are easy to deploy, the

Smart buildings are key to meeting the needs of staff and visitors, and providing a positive experience. To create smart buildings, you have to start by making sure digital is a core part of the concept, design and construction process using building information modelling (BIM). This brings together data on risks, costs, environmental and social factors that are needed to optimise the design and operations across the full life of the building. A new generation of hospitals are being constructed in the UK with technologies integrated into the fabric of buildings, while existing facilities are receiving digital upgrades. These hospitals incorporate flexible technology architecture, allowing for the collection of data to support and improve building management and operations. For example, within the hospital, digital signage and wayfinding systems can help people to navigate buildings, while lighting and heating sensors can ensure the environment is comfortable. Smart tags embedded in equipment make it easier to identify and locate resources because they can talk to building systems, increasing efficiency, saving costs and improving safety. Smart beds can receive and transmit digital patient information, such as vital signs and medication, helping staff to evaluate patients more quickly and cutting down on administration at the bedside. The incorporation of smart technologies into physical assets gives doctors and nurses the ability to respond more quickly to their patients, add more value through their actions and be rewarded for doing so. Digital integration One must-have for any modern hospital will be a sophisticated data platform which can act like a digital twin, tracking everything that goes on inside the hospital as well as connecting with the services being delivered in the community. UK hospitals are already creating intelligent clinical platforms that bring together all patient information, whether it is generated in hospitals or outside by patients, GPs or social care professionals. This can be combined with operational data to create a clinical digital twin.

Abhi Shekar Digital Healthcare Lead Mott MacDonald

“When hospitals are designed with the needs of staff, patients and carers in mind, they have a huge potential to improve health outcomes in society” Within a hospital setting, clinical and physical digital twins need to be integrated to harness data generated within different systems – whether they are clinical, operational, administrative or facilities management systems. This will enable the creation of a true digital twin of the hospital, which can increase efficiency and productivity. When a patient is ready to be discharged, for example, it should be possible to press a button and kick start a series of intelligent processes, such as scheduling and notification of patient transfer, the dispensing of prescribed medicine at bedside, parking payment charged to patient account, initiation of robots to dispose of used linen, clean the room and delivery of clean linen for the next patient. The case for intelligent hospitals An intelligent hospital is one in which the human, physical and digital all work together to deliver better care, more efficiently and cost-effectively, providing patients, carers and staff with a frictionless experience, and ultimately contribute to better health outcomes within and beyond the walls of the hospital. Patients become more engaged and informed as they are active partners in monitoring their health and wellbeing. Staff become more productive when they are equipped with the right tools and skills to focus on care delivery. Finally, infrastructure, assets and processes enhanced with digital technology are sustainable and become more efficient — enabling better decisions, faster and cheaper. Contact Information

www.mottmac.com

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Radar Healthcare rolled out across the UAE in 90 locations Earlier this year the Emirates Health Services (EHS) partnered with Radar Healthcare to deliver its quality and compliance software to 17 hospitals and 73 primary care centres across the region. The system is currently supporting them in delivering clinical incident reporting and patient safety outcomes

adar Healthcare is a UK based digital health firm and partnered up with MEMITS Solutions, a Dubai company providing IT solutions for the healthcare industry in the Middle East region, to deliver its quality management software to the UAE. “Our key focus is to improve patient safety. We believe that incident and risk management reporting offered by Radar Healthcare’s accredited system and MEMIT’S expertise in delivering cuttingedge solutions, will support us in achieving

the safest patient care in the UAE region.” says H.E. Dr Yousif Al Serkal, Assistant Undersecretary for Hospitals. The software brings together operational and often complex regulatory processes into one platform, including incident and event management, audit management and self-assessment, action and improvement plans, risk management, workforce training and compliance, business compliance and document management and quality performance tracking.

“We are delighted to partner with MEMITS Solutions and to be working with MOHAP on such an important project. MEMITS Solutions has an extensive portfolio of IT healthcare solutions, aligning with Radar and over 30 years’ experience in developing and delivering healthcare innovations, offers a proven and sustainable delivery model for MOHAP,” says Paul Johnson, CEO of Radar Healthcare. The system itself supports providers in enhancing healthcare in a flexible, customised, and cost-effective way, which Radar Healthcare has implemented into the UAE as part of its international growth strategy. “MEMITS works with healthcare providers translating their smart ideas into reality through the most advanced technology available today. Radar Healthcare’s award-winning software is the answer to a challenging regulatory landscape in healthcare and we believe it will bring a huge advantage to the healthcare industry in the UAE, while supporting its further growth,” says Hosam Alrashdan, CEO of MEMITS Solutions.

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Finding hidden value in the data Mat Oram CEO and Co-founder of AdviseInc outlines how to improve procurement in hospital systems through the use of data

rocurement can sometimes be a painful experience for healthcare operators. Not knowing if you’re paying too much, or if you really need what you’re buying, or if it’s the right product for the job can make it tricky to navigate. However, this isn’t to say all hope is lost. In the age of digital and technology, data can be

connected unlike before, enabling operators to find value in areas that they did not know existed. The analysis of data, and use of data, especially at scale within procurement in healthcare, has been enormously beneficial, but the big question is, where do you begin? AdviseInc has been helping healthcare organisations save money throughout the procurement process for years. Utilising our

Price Benchmarking & Spend Analytics tools, AdviseInc has identified millions of pounds worth of variation in more than 200 NHS trusts across the UK, and, as such, has saved these organisations vast amounts of money simply through the usage of procurement data analysis. It doesn’t matter if an operator’s data is poor, or their systems are not connected, they can still benefit from our analysis. Getting the best value To get the best value, you must first know what you’re buying, your customer, have some form of leverage through volume, innovation, or relationship - and you have to really understand the market for the product that you are sourcing. However, for smaller

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DATA AdviseInc

Mat Oram CEO AdviseInc

“There’s always value in the data and we can always help find savings” However, there is no universality between these organisations, and the bigger the ICS grows, the more variation you will encounter between systems and data, and the trickier it becomes to figure out the most pressing needs, posing a different issue from a procurement perspective, but an equally difficult conundrum. Nowadays groups of hospitals are coming together which means they are having to work together and source products together - this can be challenging, but we’re trying to solve that problem for them. One of the challenges to address is how to bring data together from a procurement perspective to allow somebody buying regionally to make the right decision. The correct use of data

organisations, this isn’t necessarily possible, and for larger organisations, it’s sometimes difficult to understand what exactly everybody needs and wants. In the UK, every hospital is responsible for buying their own products - and for a long time there’s been a real push to do things nationally, but there are now two extremes. Buying locally you don’t get the full economies of scale, and buying nationally, you’re too far away from the customer, so there can be a massive disconnect. ICS’s are now having a profound impact on procurement at large across the NHS. By enabling organisations to pool together, smaller organisations can still maintain their independence and benefit from being part of a larger buying organisation.

In the UK, a lot of the ICS’s now have a Procurement Director, but how are they making their decisions? How do they know what might be going on in 5 or 15 different organisations, and what those organisations need right now or where things could be improved? Without the right tools, that’s an impossible task. The solution, of course, lies in the correct use of data. It isn’t as if these data systems don’t exist. Legacy ordering, finance, cataloguing and inventory systems all exist in UK organisations and have done for a long time, but they have never been brought together into a single view. Users must log on to so many different systems, with so many different credentials and formats, user interfaces and methods of operating, that it’s painful and timeconsuming. The only way for a leader at one of these organisations to make sense of it all is to have all the information in one place, providing them with opportunities, pricing, benchmarks, and current inventory. The issue is even more pressing with systems which are not yet integrated. At the current time, more and more healthcare systems are rapidly adopting the ICS model,

but the risk of doing this with legacy systems without properly collating, cleansing and normalising the data poses a gargantuan task and continues to leave many in the dark. However, with AdviseInc’s analytical solutions, this no longer needs to be an issue, even if a company’s procurement data is outdated or not in the best shape. Using our tools, they can still identify key areas to save money without the need for a shiny new data system or months of improvement. Part of the beauty of our system is that it will tell you exactly where your data needs improving, and a lot of the time the data is fine for analysis. There’s always value in the data and we can always help find savings. Furthermore, AdviseInc’s solution can be implemented rapidly, posing no risk to organisations looking to both improve their data and cut a vast amount of cost in the procurement process. Once we receive that data and it’s in the right format, we can start our onboarding process internally. Usually within two weeks an organisation should have access to an application and they can see / analyse their data. Then we improve the quality as we go, but they would receive most of the benefit in terms of where they could save money within two or three weeks. We have proved the concept at scale across the UK. In our first major project we onboarded our solution to more than 210 NHS trusts in the UK to deliver price benchmarking across the whole of England, Wales and Northern Ireland. Within 3 months the system was fully operational for 90 per cent of NHS provider trusts. There was a monumental amount of data to tackle from every single NHS Trust system which we price benchmarked. With successful proof of concepts completed in the USA, Australia and parts of Europe, we’re now looking for more countries to benefit. In short, our solutions are able to handle data which could be old and creaking yet still make it deliverable at scale, and above all, the process is incredibly fast. In our opinion, it’s a no brainer for organisations who want to improve their procurement process and need to save money with most of our customers seeing multiple returns on investment quickly. Contact Information

www.adviseinc.co.uk

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03/06/2022 10:09

Patient identity management and the future of consumerdriven healthcare Healthcare must embrace ways to collect, verify, and share digital patient identities to deliver a better patient experience, says Lyniate’s Royston Adamson-Green, Director, Channel Sales UK, EMEA & APAC

atients’ access to their health records has, historically, not been a straightforward process. And even with that access, chances are high that the data was out of date or incomplete. The merging of advanced digital technologies and our daily routines has driven an expectation that the patient record should be accessible by the patient at the exact time it is needed and, more importantly, independent of the requirement for requesting data from their healthcare provider. Today’s consumers

demand convenience. Unfortunately, challenges associated with managing the unique identities of patients – and the associated patient data – remains a fundamental challenge to delivering this convenience. Healthcare’s heavy reliance on paper notes, signatures, and paperwork to prove identity can cause significant frustrations for patients and providers, including incorrect patient matching, medical errors, repeated services, and poor communication. The rise in visitation to

urgent care clinics over traditional primary care pathways continues to grow, signalling consumers want access to care on their terms: this includes walk-in appointments, neighboring locations, and 24-hour availability. Today, patients are increasingly finding that going to their neighbourhood urgent care clinic or pharmacy to receive tests and vaccinations is far more convenient for their busy lifestyles.

Royston Adamson-Green Director, Channel Sales UK, EMEA & APAC Lyniate

“For the industry to truly empower consumers to oversee their health data, it will have to take advantage of the mobile revolution and create a seamless, password-less experience”

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DATA Lyniate

experience while retaining safety, security, and compliance, healthcare must embrace ways to collect, verify, and share digital patient identities. One possible solution is to leverage smartphones to organise and consolidate digital IDs into a single location. Consumers could then possess a onestop tool that gives them increased ownership of their own care, health data and online identity, without having to administer physical documents. For this to be possible, it will be important that such a solution allows providers to meet emerging standards of patient data access and consent. Furthermore, having a digital “wallet” that retains multiple forms of identification in one convenient place should bypass the need for consumers to remember multiple usernames and passwords. Helping consumers control, manage and consolidate their online identities (or accounts) in one place is not a new concept; however, it has not advanced enough for there to be mass adoption across industries. Historically, aspects of healthcare have been slow to adopt new technologies and will likely be the last sector across industries to follow suit. But what if healthcare could lead the pack for once? And with more convenient access to their medical treatment options, consumers are now becoming more aware, involved, and educated about their health. Importantly, they can also become active participants in managing their health data and ensuring the accuracy of their medical histories. However, for the industry to truly empower consumers to oversee their health data, it will have to take advantage of the mobile revolution and create a seamless, password-less experience. And that must start with a digital identity exchange network that enables providers to meet the demands of today’s tech-savvy consumers by reducing the redundant and paper-based interactions that slow down care delivery. Everything from patient registration to health assessments can and should be automated using digital credentials for fast, contact-less check-ins and 100 per cent patient identification accuracy. From a consumer perspective, patients expect to access and share their digital health records using their smartphones.

Today, consumers can shop, pay bills, stream music, or watch a movie without having to enter in their information every time they open an app. At the same time, they continually receive a raft of forms to fill out when they visit their doctor or a hospital. To deliver a better patient

The COVID effect After two years of masks, plexiglass partitions, cancelled events, and constant reminders to stay six feet apart, most people have had their fill of social distancing. In so many ways, the

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urgent need to remain physically separate has taken a toll on our relationships with one another, straining the bonds that make families, friendships, and businesses function. But even in a time of unprecedented challenges, there is a silver lining: the sudden pressure to go contactless has forced us to get creative about conducting daily tasks at a distance – and we are discovering that some things might be better that way. From kerbside retail and tap-to-pay transactions to meetings that really could be virtual, we have quickly embraced technology-driven strategies to keep people safe while improving efficiencies. Healthcare has had similar lessons to learn. The use of telehealth, texting, and other remote interactions has now ballooned, and early results indicate that both patients and providers are highly satisfied with remote care. The idea of creating a digital-first healthcare environment is nothing new, but the trialby-fire of COVID-19 pushed the industry to expedite major tech projects. The undeniable convenience of these new strategies begs the question: why go back to certain complicated, timeconsuming, high-risk activities when there is an easier way? To continue developing better experiences while retaining high standards of safety, effectiveness, and compliance, we will need to ensure the building blocks of digital healthcare are firmly in place. We must start by embracing innovative ways to generate, verify, manage, and share trustworthy digital patient identities. By creating reliable “patient passports,” healthcare organisations can be sure that the right person is getting the right services in the most efficient manner – whether that person is physically standing in front of a check-in desk or not.

Royston Adamson-Green Director, Channel Sales UK, EMEA & APAC Lyniate

“The digital patient passport could be just what we’re looking for to move forward in the right direction”

What could a digital patient “passport” do? Even though healthcare providers have been using digital patient records for many years, it’s still incredibly difficult to avoid duplicated, incomplete, or incorrect patient profiles. An error rate of 8 to 10 percent is commonly cited across the industry, although some organisations experience significantly more mistakes due to ineffective patient matching algorithms, fragmented data, and siloed health IT systems. COVID-19 exacerbated these issues as millions of citizens fell ill with the virus and required testing. To care for patients correctly, providers needed access to complete and up-to-date records that include pre-existing conditions and other risks that may affect treatment protocols. Multi-step vaccinations needed to reach more communities, with many vaccinations delivered by differing state entities outside the traditional primary care setting. The need to keep track of an individual’s healthcare interactions became even greater. With clean, accurate, and verified information collected into a single packet – and then shared across disparate systems in a standardised manner – healthcare providers could deliver an entirely new generation of safe, impactful services. And by providing patients with a secure digital wallet, accessible via their phone, we would empower patients to not only take a more active role in their own care but help ensure the accuracy of their healthcare information. For example, fully vaccinated patients could use their passports to easily ‘unlock’ certain experiences, such as an in-person visit with their physician, while reducing concerns about exposure for the patient and the staff. Patients could use a passport app to send verified clinical questionnaires and insurance information to a new specialist before their appointment to speed up registration, reduce in-person contact time, and avoid duplicated or incorrectly merged records. Perhaps someday soon, with appropriate privacy and security in place, we could even use smartphone location data in conjunction with the digital passport to automate check-in from the parking lot, skipping the waiting room all together, and be called in when the exam room is free. This is the near

future of healthcare, but achieving these goals depends on widespread adoption of trusted digital identity technologies. How can digital passports become a reality? Healthcare organisations with enterprise master patient index (EMPI) tools in place already enjoy significantly fewer patient identity errors and higher patient matching rates. EMPIs provide a consistent platform to integrate multiple data sources into a single record of an individual’s journey through the care continuum. With a unique identifier and sophisticated record location and matching algorithms, organisations can be confident that newly generated data is being associated with the correct file. The use of the EMPI as an accurate patient directory is a critical tool in the creation of the patient passport. And to further transcend barriers between points of care delivery, we need a portable, privacy-preserving way of dealing with

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DATA Lyniate

patient identity beyond the boundaries of individual healthcare organisations. That’s where the blockchain comes in. Much more than just the backbone of cryptocurrency, blockchain technology can be used as a public ledger to store and manage the life cycle of decentralised identifiers (DID). These globally unique DIDs are used as the anchor points for verifiable health credentials, such as insurance cards, test results, and vaccination records. Using this concept, a trust network between issuers, holders, and verifiers of credentials can be established. With these features, blockchain could be a game-changer for identity management and verification at key stages where patient data errors often occur—during enrolment and at registration, all while maintaining strict patient privacy. In addition, coupling a decentralised identifier with detailed consent policies allows patients to share or restrict access to specific data when necessary, keeping individuals in charge of who sees what data at what time. In the healthcare setting, this decentralised approach to

identity management has the potential to improve privacy and strengthen the ability to verify patient identities across participating members of the care continuum. The patient fit By placing patients in control of their identity and consent preferences, healthcare organisations could enhance patient engagement and offer attractive virtual experiences while simultaneously leapfrogging many of the challenges posed by patient identity verification. Landmark overhauls in healthcare delivery are driving the need to introduce new innovations in patient identification to achieve 100 per cent matching accuracy. As organisations pivot to value-based care and continue to grapple with COVID-19, the need for an accurate and authenticated view of every patient becomes increasingly critical to avoid redundant or unnecessary procedures, billing inaccuracies, administrative burdens, denied claims, and lost revenue.

The COVID-19 pandemic will leave more than a few lasting lessons, including the idea that some virtual experiences are better than their in-person counterparts. With healthcare organisations continually under pressure to improve quality, engage patients, and reduce burdens on providers, the digital patient passport could be just what we’re looking for to move forward in the right direction. At Lyniate, we have been working on such a mission, investing in solutions to empower the healthcare industry to lead when it comes to enabling consumers to control and manage their own data. We encourage you to reach out to us to discuss your thoughts on advancing patient identity management towards a more consumerdriven healthcare landscape. Contact Information

royston.adamsongreen@lyniate.com www.lyniate.com

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The ultimate endto-end pathway Mona Hayat, CEO and Founder of Nexus Digital Technology, speaks to Healthcare World’s Sarah Cartledge about how patient pathways can be revolutionised in the UK

n the UK, patient pathways and referrals are increasingly outdated. While the standard of secondary care and elective healthcare may be incredibly high, the healthcare industry still has a long way to go in making the process of reaching these goals simpler, cost-effective, and less stressful for the patient, ensuring a higher standard of care. Mona Hayat, CEO of Nexus Digital Technology, is clear about the need for patient pathways to be fully integrated and digitalised to improve the entire journey from pre-care to post-care. Mona created Nexus as the digital solution to the growing need for prevention treatments, and to empower patients to forge their own path to health via a personalised wellness journey. In her view, a holistic approach to wellness is key to maintaining all aspects of patient health. But Nexus is more than just a wellness hub. By using the Nexus platform, GPs and care providers are easily able to share and access patient information, providing them with the full patient overview before arrival. Furthermore, Nexus can provide patients with immediate access to online health coaches and other services on the platform, enabling them to receive a higher standard of care throughout their journey. Nexus also gives the incoming patient an opportunity to be socialised before their arrival through access to services and by providing additional information to the patient. This does a great deal in tackling any anxieties. As Mona says, “We are completely equipping the patient to best understand the experience they are about to have.” The need for an integrated patient pathway She goes on to give an example of the current pathway for someone seeking secondary care - either an elective procedure or a specialist referral. It begins with the initial GP consultation, the first conversation with a primary care provider.

Following this, the patient is sent for diagnostics, which would likely occur in a hospital or outpatient facility. These diagnostics have to be returned to the GP and then a referral is made - this is when the patient enters secondary care. This process, while it may be effective, is hindered by the lack of ease in sharing patient information - not necessarily for reasons of security, which must always be considered, but rather a lack of innovation in this space. It is important to recognise where the information sits at this point in time. The GP has access to the patient’s medical records, the diagnostics, and any other information which may be pertinent to the case. Yet, this is where the system begins to show its age. There is no single information exchange where clinicians can access the information they need as soon as possible - which may seem unusual for a national health service. Rather, the patient now has to re-record their information as they move through the admissions process into secondary care. This process is further exacerbated if they are going into surgery or undergoing an elective procedure. The patient now has to undertake a pre-operation assessment, re-record their information and present it. While there could be an argument made here for ensuring that mistakes are not made, and that clinicians are fully aware of the patient’s information and requirements,

Mona Hayat CEO Nexus Digital Technology

“If we could digitalise these systems, there would no longer be question marks around the data as everything is accessible and verifiable”

it seems riskier to introduce yet another potential for human error. “It is clear that this procedure is far from coherent,” says Mona. “At the moment, we often rely on patients to carry printed information to their appointments, and this is without considering the targets for digitalisation in the healthcare sector. If we could digitalise these systems, the ease and convenience it would bring to the patient would know no bounds. In addition, there would no longer be question marks around the data - what date the patient may have had their assessment or which information sits in each form - as everything is accessible and verifiable.” This digitalisation of patient data follows the patient through their treatment pathway, enabling the potential for seamless interoperability from disparate organisations.

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DIGITAL HEALTH Nexus

Currently, the Nexus app has the ability for information to be uploaded as the patient goes through secondary care procedures. “But if we were to bring online some of the other solutions, for instance Health Care First, one of our partners within Healthcare World, immediately you have that seamless endto-end pathway for the patient,” says Mona. “They are the primary care providers and if their services were added to our platform, suddenly you have most information in one secure place via a fully automated system.” The ability to share information Yet, one of the key issues facing the digitisation of patient data is the difficulty and even the desire to share information. GDPR and data protection are absolutely critical, and rightly so - patient information and confidentiality is imperative, especially when dealing with highly sensitive

information in the relatively new arena of digital innovation. These regulations of data protection are absolutely required. “We need to have the processes we have in place for data protection. They are critical, but they do not need to prevent us from having digital seamless provision across our healthcare services because it is already happening elsewhere in the world.” However, this places operators in a difficult position. Even if tools exist to enable information to flow easily while maintaining the highest levels of security and standards, are operators willing and ready to resign control over their data? “From a range of our competitors and partners in this industry we have seen a hesitance to share information and a requirement to maintain a level of ownership over data. However, we believe the complete opposite is needed. How are we going to achieve actual improvements

in healthcare if we aren’t sharing information?” says Mona. And this is where the Nexus platform can resolve the dilemma. By recognising the need to share information, Mona also recognises the need to protect the data. “It has to be owned within healthcare, not within Nexus,” she says. “We are happy for our healthcare providers to own the data because it brings the UK in line with other regions. The UAE and some European countries have electronic medical records that are seamless and end-to-end. If other areas are doing it, why can’t the UK?” Contact Information

www.nexus-dt.com

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Collaborating for Digital Solutions Vincent Buscemi, Partner and Head of Independent Health and Social Care for Bevan Brittan LLP, outlines the key legal and commercial issues behind collaborations

s healthcare innovation moves on apace, it can be hard to keep up with technology. Smaller companies that have to raise investment may find their product or app out of date by the time they can scale it. Other businesses may find their ideas superseded before they can commercialise them simply due to the pace of the market they operate in. For these reasons many companies are coming round to the idea that partnering is the way forward. By presenting their technology alongside complementary ideas or by sitting on other platforms, it could be easier to win business as a consortium rather than as a lone supplier. However, there are other aspects to consider when collaborating or contracting for digital health solutions. These divide broadly into soft (relationships) and hard (legal and commercial) issues to consider. Even if the parties are well known to each other within the sector, the ground rules have to be clear for the partnership to function successfully, particularly if the consortium plans to expand. Soft issues The first area to consider is whether the parties have a history of working together or whether they have worked on similar projects. Clearly, a shared vision is key, identifying the goal and the reasons behind the collaboration. Analysing what distinguishes the collaboration’s offering from others in the market, along with the USP and value proposition, and an understanding of the route to market and roll-out are just the first steps. Reputational issues, such as conflicts of interest between the parties and due diligence, are also part of the initial journey. It’s also vital to see if the risk appetite is aligned and to consider how the organisational structure will fit together. Once these issues are addressed, then the parties should deal with individual or organisational sovereignty, governance

and regulatory responsibilities. Added to these considerations are the availability of time and resources (human and capital) to invest in the collaboration, whether the participants have senior level buy in and if the staff are on board. It’s also important to clarify who will own the project and how much the parties are investing in it. Next, priorities need to be set. The partners should agree what is within the scope of the collaboration, along with the timescales and whether these are realistic and deliverable. Finally, they should agree the project or business plan. Hard issues The legal and commercial issues for the parties cover the actual day to day running of the business or project – the scope and purpose of the collaboration and what each party will contribute, such as data, funding, know how, staff, contacts, sales opportunities and more. It identifies the territory and jurisdiction of the work, where the solutions will be provided and whether there are local procurement rules or a system that needs to be followed. Decisions will be reached as form follows function and they should consider whether the collaboration will be a commercial or corporate joint venture or special purpose vehicle. Equally as important are the issues around data - who is providing data; who will own or have the right to use the data that is collected or generated by the collaboration or project and how will that data be protected? IP issues come into play. The parties should examine the background IP and decide what is needed for the collaboration and what the licence arrangements should be. They will also look at the foreground IP (rights created under or by the collaboration) to decide who owns this (sole versus joint ownership) and how can it be used. Equally, new IP should be considered in the light of development, insights, know-how and advancement. Who will own the discoveries achieved through

the collaboration? Within this scope falls the arrangement around licences, (exclusivity and royalties, ownership versus commercialisation / exploitation). Finally, third party IP rights also have to be recognised in the overview. Once the new partnership is up and running, the day to day issues come into play. Agreement should be reached around supply chain management, input and output KPIs, shared risk and reward which include performance obligations, timelines and deliverables. They should also look at how the collaboration exclusivity will operate and

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LEGAL Bevan Brittan

if there will be restraints or restrictions on the parties such as sub-contracting and assignment. Alongside, there are competition law considerations that include restrictive agreements and practices, and dominant position issues. Governance and decision-making arrangements form a vital part of the agreement between the parties. They should consider whether to implement a joint committee or a partnership board, including compliance and controls and project management (meeting arrangements, membership, agendas, minutes, voting) arrangements.

Financial arrangements such as payment mechanisms, funding and the ability to vary things should the collaboration evolve or if the services or service model is refined also need to be considered. There will also need to be discussions around sharing risks and rewards, as well as liabilities and insurance. Finally, the parties need to consider the term of the collaboration, as well as termination and the effect of termination – the exit arrangements. They should examine what happens to IP rights, data use, exclusivity and restrictive covenants to create a seamless finale if they decide to part ways.

The legal side to a new collaboration may appear daunting, but it covers all eventualities and protects each member in the new venture. This reassurance goes a long way towards giving each partner the confidence to embrace the possibilities that such a collaboration may bring on a much larger scale than if they were to go it alone. Contact Information

www.bevanbrittan.com

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03/06/2022 10:15

The need for standardising healthcare recruitment in the digital age Jim Campbell, Director of Health Workforce at the World Health Organization, speaks to Sarah Cartledge about the need for an international healthcare workforce register in the current climate

orkforce has always been a pivotal issue within healthcare discourse, even before the Covid-19 pandemic threw global healthcare systems into total disarray. As the world’s population continues to increase exponentially in some areas and ageing populations further develop in others, the question of how we can continue to provide and better our healthcare systems is a conundrum with no simple answer. However, the pandemic has provided us with more information than we once thought. By showing us what doesn’t work and which systems are no longer sustainable, we can garner key lessons and kickstart a new strategy that will enable healthcare systems to thrive. Slowly but surely, governments are beginning to recognise the major healthcare problem is with workforce and it needs to be addressed effectively. “A series of reports and reviews of the Covid-19 pandemic recommendations clearly say that in European healthcare systems, the public health requirement, and the preparedness element of our organisations have seen massive underinvestment for far too long,” says Jim. “A good comparison is a budget airline; there’s no bandwidth. If you sell every ticket and 10 per cent of the tickets twice to account for no-shows, if everyone does turn up, you’re overcrowded - and overcrowded means underfunded and understaffed. It’s the reality.” As such, the world is waking up to the workforce problem. With underfunding, lack of resources, and poor recruitment into health services greatly exacerbating the issues which we have faced throughout the pandemic, now is the time to refocus efforts. Yet, when the issue is not only monetary, but largely a human resource issue, where do we begin?

The digital solution The rise of digital health solutions has been one of the most important aspects of the pandemic. Innovators and entrepreneurs have responded rapidly with platforms and apps that have accustomed healthcare workers and patients alike to a new way of viewing their health. Telehealth and mHealth technologies, health monitoring apps, and tracing have all been tools which have rapidly developed throughout the past two years, and the benefits of which have been seen in all fields - chiefly due to the requirement born out of social distancing. Yet this is not something which only fulfils a purpose within the pandemic. Digital health will continue to be the sharp end of healthcare in the 21st century, and long after the pandemic becomes endemic. However, what can digital do to improve the issues within the healthcare workforce? The answer, Jim suggests, lies in regulation. “I personally believe that we should have a global register. We have the technology to do this, instead of having separate registration systems and medical registers, a global system which still operates through licences. We’ve been seeing the use of digital solutions around

Jim Campbell Director of Health Workforce WHO

“In practice, we now have an open mechanism to facilitate qualification, which can be transferable across jurisdictions”

data, information, recordkeeping and vaccinations all come through into a totally different age and now being used to enable public health and safety measures. “Yet, are we ever going to see this change in regulatory behaviour? In practice, we now have an open mechanism to facilitate qualification, which can be transferable across jurisdictions - and could potentially save the industry billions of dollars.” The global scramble for health workers In the UK, a huge portion of the NHS relies on staff who are not domestically trained but have been brought in from abroad - chiefly Asia. However, this is not a sustainable model nor a strategy for a pandemic, especially now that many NHS staff are leaving the organisation to work elsewhere. So, how can the NHS continue

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WORKFORCE WHO

to attract, and most importantly, deliver talent? “At present, the NHS has put £25m on the table to pay for flights for anybody who wants to come and take advantage of the vacancies in the NHS. To say we welcome you with open arms, we will facilitate your migration to the NHS is very positive, especially within the context of the pandemic,” observes Jim. “There was recently a discussion between President Kenyatta of Kenya and Boris Johnson which touched on the unemployed nurses in Kenya who have the opportunity to come and work in the NHS. But you have to ask the question - why are they unemployed in Kenya? It’s not that Kenya doesn’t need these nurses; they just can’t afford them.” So despite arguments to the contrary, the wealth in healthcare is in the population. As education improves and the standard of living continues to rise in LEDC’s, people

will naturally begin to expect more out of life. Within the NHS, career development aspirations, especially for people with tertiary education, are much more available. The person who comes to the NHS is going to benefit, but they will take their skills home. But the pandemic has seen travel restrictions and other curtailments that have impacted the healthcare workforce. “We have seen a moratorium placed on the licensing of health professionals to travel abroad, which can have a huge impact on migrant workforces. The Philippine government put a moratorium on newlylicensed nurses which has since been lifted because they needed the people to be working through the pandemic,” says Jim. Thankfully, the only stoppages of migrant workers we have seen so far have been temporary. However, if situations deteriorate in future, we know that it is

feasible for governments to entirely halt the movement of healthcare workers abroad - which could be devastating for those healthcare systems that rely on foreign workers. In the meantime, a global register of healthcare workers would give an instant overview of availability and capacity. It would cut down recruitment times and enable testing to take place easily. Such systems already exist to enable nurses to renew their licences in some countries, so it could easily be extended to create a global directory. There are still issues which this shift can pose - and many questions which arise from it. Who regulates the data? How can we standardise this? These are issues which need consideration - but at least we understand that we have the ability to do so. Only time will tell if we can successfully achieve this - or not. 27

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The International Affiliate Network – a pathway to better patient care Sarah Cartledge speaks to Alistair Russell, Head of Business Development at Imperial Private Healthcare about their latest venture to ensure better patient experience

nsuring the best patient care is a constant battle for healthcare institutions around the world. It starts from the bottom up – to ensure a quality standard of care, an entire organisation must be operating efficiently throughout, and always striving to improve. For this reason, Imperial Private Healthcare is developing a new collaborative membership, the

International Affiliate Network, to ensure care pathways are seamless between Imperial Private Healthcare and member organisations, and promote the development and training of healthcare. Imperial Private Healthcare is managed by Imperial College Healthcare NHS Trust, one of the largest teaching hospital groups in the UK, and has private patient units on each of its five hospital sites across north and central London:

• The Lindo Wing at St Mary’s Hospital • The Thames View at Charing Cross Hospital • The Robert and Lisa Sainsbury Wing at Hammersmith Hospital • The Sir Stanley Clayton Ward at Queen Charlotte’s & Chelsea Hospital • The Western Eye Hospital “Each of the five hospitals has a long track record in the research and education sphere, influencing clinical practice nationally and worldwide. We provide private patient healthcare in dedicated facilities on our sites, including our prestigious flagship facility, the Lindo Wing at St Mary’s,” says Alistair. Building an international presence The vision of the new project is to create a global network of aspirational healthcare organisations from all corners of the world, working with Imperial Private Healthcare to improve patient care.

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HEALTH SYSTEMS Imperial Private Healthcare

“The network’s ethos is principally around developing healthcare capability around the world, improving healthcare in the regions where we continue to receive patients,” says Alistair. “It’s about supporting the patient experience. We work collaboratively with healthcare professionals to complement and develop local healthcare by advancing clinical services and extending pathways of care with an overseas referral pathway to Imperial Private Healthcare.” Dedicated relationships In order to develop new care pathways and improve existing ones, member organisations work with a dedicated relationship manager to agree a programme of bespoke education and advisory services which are specifically

tailored to their own objectives. Crucially, especially in the age of coronavirus, this programme can be delivered online, locally, or at Imperial Private Healthcare’s London facilities. “The pandemic has actually helped because these days we’re used to doing everything remotely,” says Alistair. “Now Imperial Private Healthcare is set up with so many digital solutions that we’re in a much better place than we were six months ago. But you can’t take away the fact that our clinicians will be having an in-person relationship with member hospitals. Our teams will go out to the hospitals and support them in their development, and to perform teaching and training. We also hope to welcome them to Imperial Private Healthcare.” Furthermore, establishing complex overseas care pathways will potentially

Alistair Russell Director of Business Development Imperial Private Healthcare

“We want to help our member hospitals improve as individual organisations and build a referral network on a global scale” enable patients to be discharged back to their local hospital sooner than they would be with a standard overseas referral, making the patient journey that much easier. The Imperial Private Healthcare advocacy service will also make an invariably challenging experience as straightforward as possible for those who may find themselves in an entirely unfamiliar part of the world – benefiting both patients and hospitals. In addition to the mutually beneficial patient pathway, members also receive tailored benefits – allowing them to receive dedicated advisory services surrounding clinical change, pathway design, technological integration, and governance advice. “We want to help our member hospitals improve as individual organisations and build a referral network on a global scale,” says Alistair. The network is available to overseas members now and the first affiliate will be in place this year. “Our plan is to expand the International Affiliate Network worldwide and we will always be open to conversations”,’ he says. “The key point for us is that we are really invested in improving and advancing healthcare at the local level and building from there.” If you would be interested in joining Imperial Private Healthcare’s International Affiliate Network, please contact Alistair Russell, Imperial Private Healthcare: Contact Information

Alistair.russell1@nhs.net www.imperialprivatehealthcare.co.uk

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Time to consult

’ve spent my whole career working in and around the international healthcare space. With Healthcare UK I helped UK NHS Trusts to make their first steps to sell their services overseas. With Vernacare we exported a UK product to more than 50 countries around the world, for which I was honoured to be awarded an MBE for services to export. Our businesses have been subjected to unprecedented levels of uncertainty over the last year or so, with a lack of clarity and understanding about everything. That uncertainty leads to fear and doubt and there has rarely been such a shared volatile business environment in which to operate. Yet even a volatile business environment offers the potential for significant opportunity, when your offer matches the new needs. Smart businesses have seen opportunities to match their innovations with need, to speed up adoption of their technologies to improve patient care, and to share their successes as widely as they can to help others. To support our entrepreneurs and businesses they need the right advice, the right people, and the right money. This requires a massive investment of time and effort and sometimes we’re running so hard at our goal that we fail to take the time to reflect on the changes that have impacted us. Equally, to understand where our offerings can best fit, we aren’t able to shape and hone our strategy in the

EMMA SHELDON MBE CHIEF OPERATING OFFICER

right way or we don’t have the time to refine our messaging in order to make an impact with the right people. This is where an experienced and independent pair of eyes is invaluable, equipped to support you in assessing where you are against where you want to be. By helping you to plot your path to success, providing a diagnostic to help you identify and address any gaps in your business planning, at TTA we can create the environment to allow the best chance of success to be achieved. Maximising the potential for success In order to understand where you are and where you want to get to, there is a number of critical areas to consider. The first is Proposition Development, crafting and shaping your proposition for the best chance of success. Next is Marketing, making an impact in the right places, generating leads and strengthening your message with strong targeting and significant amplification. International planning with the right strategy for specific markets should include good external intelligence, recommendations, insight and support. Equally Strategy Development, including a review of your business, the current situation and your ambitions, the competitive landscape and the strategic imperatives for success are vital.

Prepare for investment by identifying the key criteria to support the right investment, and ensure you tell your story succinctly and correctly. Recruiting for growth by finding the right people remember that poor, costly recruitment decisions can be the most expensive mistakes you can make and ensure you engage the right people for the design of your organisational culture as you grow. For Market and Customer Analysis, focus is critical when growing a business but narrowing down markets or sectors can sometimes stop progress for business owners who are conflicted by numerous choices. So prioritise markets, sectors and customers, and design in metrics that will help you see how your choices are making a difference and ensure you are able to quickly assess when to change direction. Business Development - once your strategy and messaging are where you want them to be, reaching the right potential customers quickly and efficiently is vital. Use contacts, strong networks (like those of Healthcare World) to ensure you’re getting to the right customers. Throughout the life cycle of any business, all these elements will be required, and never more so than now, as we live through a situation which is delivering a complex and fast changing landscape for our businesses, people and ideas. emma.sheldon@healthcareworld.com

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Healthcare consultancy for the future We are a unique, forward thinking and specialist global health consultancy focused on healthy populations. Together with our clients we are influencing the factors which affect health outcomes – both in terms of preventative measures and healthcare interventions. Our experts connect thinking between health and infrastructure to embed health considerations in other sectors which affect health outcomes. In all our work, we take a digital first approach. We offer a broad range of skills and expertise to support clients design, plan, implement and evaluate their healthcare services. Our services include:

• • • • • • • • • • •

Design of new models of care Data simulation, analysis and evidence led consulting Clinical pathway design Operating model design Capacity planning and modelling Operational excellence and efficiency improvements Digital innovation in both services and facilities Business case and feasibility study development Estate masterplanning Impact assessments Infrastructure delivery

Opening opportunities with connected thinking. richard.cantlay@mottmac.com mottmac.com

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17/01/2022 20:27

healthcare world series

The Evolution of Healthcare Infrastructure Healthcare World’s expert panel delivers a vision for the future

ne of the challenges of healthcare is the fact that for the last 100 years or more, the development of infrastructure has been the solution to any healthcare problem. Within months of the pandemic being recognised, enormous Nightingale hospitals were built in the UK that were never used. The pandemic shambles and the parallel acceleration of digital health has shown that the theatre in which healthcare is performed is going to be the home and the means will be digital. The Healthcare World Series debated this new development with leaders in this field who are spearheading the ‘revolution’:

Richard Cantlay, Head of Healthcare at Mott MacDonald, Elliott Engers of digital solutions Infinity Health, data guru Simon Swift of Methods Analytics, Carly Caton of lawyers Bevan Brittan and infrastructure specialist Barry Francis. The balance between prevention and intervention Reducing the healthcare demand at source by maintaining a population’s health is one way of approaching the subject, according to Richard Cantlay. He quoted statistics showing that global deaths from noncommunicable diseases are now around 60

per cent, and are linked to diet, air quality, exercise and other issues. “We need a whole system approach to wellbeing, not the current system that sees maintaining a population’s health as the healthcare sector’s problem to deal with,” he said. He went on to illustrate how built environment projects can also put

Richard Cantlay Head of Healthcare Mott MacDonald

“We need a whole system approach to wellbeing, not the current system that sees maintaining a population’s health as the healthcare sector’s problem to deal with”

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HW SERIES Infrastructure Session

backlog of patients following the pandemic. In addition, there aren’t enough people to staff them or sufficient training to upskill them. “This is a problem that we have to look at more fundamentally,” he stated. “It’s about using the infrastructure and the staff that we already have more effectively. And technology has to be the answer to that.” Infinity’s software can be used to create a virtual ward that allows staff to monitor a larger cohort of patients remotely and more efficiently. “We’re seeing a big uptick in the demand for setting up virtual wards,” he added. “The beauty of digital infrastructure is that it scales better and in a way where you can generate data that organisations can use to better assign and prioritise cases. Predictions around cases and demand will become more accurate and resources can be developed to meet that demand.” The consensus among the panel was that the wrong infrastructure can be worse than no infrastructure because of the lack of staffing and low uptake. Moving away from the hospitalcentric health system

healthcare at the centre of its thinking, by reducing pollution or improving air quality through better building materials. By changing the lens with which we view healthcare, we can redefine the word ‘infrastructure’ so that it becomes a balance of digital and built infrastructure, and we can look at the subject in the round by including prevention as well. PPP expert Barry Francis agreed with Richard that the default position is often to build a hospital as a physical structure to show that something is being done about healthcare. “Hospitals sound sometimes as the solution to delivering something which can’t be delivered,” he said. “The huge advantage about these projects is they make people think about what is actually required and illustrate the risks. But if we’re moving towards a more systemic approach, then PPP will still have a part to play.” Carly Caton agreed that changes are happening apace, and had already begun before the pandemic hit. “The system and

Barry Francis Infrastructure Specialist Barry Francis Consultancy

“If we’re moving towards a more systemic approach, then PPP will still have a part to play” the hospital system has been the same for decades,” she said. “We think about medical innovation or digital innovation, but we also need to have organisational innovation and system change innovation as well.” The rise of the hospital at home Elliott Engers of Infinity Health felt that it isn’t possible to build the amount of hospitals that are required to deal with the

There was agreement that the shift from healthcare to health and wellbeing will take place within the next ten years. As a result there is a lack of clarity around how hospital infrastructure may be used on a daily basis in the future, felt Carly Caton. For Elliott Engers, the key point in new hospitals has to be the incorporations of modes of communication from the start. The last mile of healthcare requires large numbers of staff coming together to exchange information face to face, so the digital infrastructure has to be up to standard and fit for purpose. Following the pandemic, outpatient departments are now full to capacity and this is where digital solutions could halve the waiting rooms as consultations could be conducted virtually. Moving on from this, Barry Francis made the point that to build a hospital with empty beds makes no financial sense. He also highlighted the growing role by insurers in minimising healthcare costs, so diagnosing and treating in the community makes sense as a result. He went on to ask how you finance a project with a much greater emphasis on the digital rather than the physical. If the aim is to keep people out of hospital, then for Richard Cantlay the combination of design and operational practices is key. “Keep the higher acute 33

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facilities for those that absolutely need to be there because it’s much more efficient and it’s a much better patient experience,” he said. “It delivers better health outcomes and is just one reason why we need to move away from this hospital-centric health care system.” Hospital-acquired infections were another important reason cited for keeping people away from hospitals. During COVID, Infinity Health implemented a lateral flow testing system for frontline staff and the data highlighted which areas were at risk in a hospital. “It’s key that as we as we start to implement solutions such as virtual wards or patient-initiated follow up, which now puts the onus on patients taking more responsibility for their health, that we have checks and

balances and ways of identifying where patients aren’t engaged or where there’s additional clinical risk. I think it’s imperative that any new models of care take that into consideration,” he added.

Carly Caton Partner Bevan Brittan

“We think about medical innovation or digital innovation, but we also need to have organisational innovation and system change innovation as well”

Richard Cantlay highlighted the issues facing certain countries where technology is not as advanced or where connection problems often occur. Simon Swift agreed, saying; “I’ve worked in East Africa and in Southeast Asia, where many doctors aren’t in hospitals. But patients can speak to somebody and leapfrog an entire phase of healthcare infrastructure. We have to avoid ideology and focus on pragmatically delivering for all of the population, using whatever tools are most effective.” Using digital solutions to mitigate the impact of infrastructure The panel agreed that digital health is a really confusing picture. There are millions of products and it’s hard to understand how they can come together to create a coherent healthcare system.

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surrounded by semi-permanent, modular, rapid deployable buildings to create more adaptability. Such a view would enable buildings to be transferred from one state to another, as opposed to a building that will exist for 60 years with only some amounts of adaptability flexibility built in. Simon Swift was keen to show how using data to model population health would serve hospitals of the future so there would be more efficient use of facilities and staff. “We can solve many things with data and thus understand how to shape our health care service optimally in terms of physical infrastructure, digital infrastructure and workforce,” he said. Conclusion While Simon Swift felt that healthcare infrastructure won’t change dramatically in the next 10 or 20 years, Richard Cantlay felt the important issue is the balance between prevention and intervention. Elliott Engers considered the benefits of digital are so clear and scalable that he would be

amazed if there isn’t an enormous uptake of digital solutions to mitigate admissions into hospitals. In emerging economies, Barry Francis felt there is a real opportunity to leapfrog to digital solutions if countries take the risk. For Carly Caton, the key driver for the future would be a more integrated system with perverse financial incentives removed, thus allowing patients to receive more care at home and enabling more flexible physical infrastructure to be built. In short, the panel’s vision consists of the integration of digital and physical infrastructure, with an engaged population that monitors health and wellbeing and only accesses acute facilities where strictly necessary. It may take a while to get there, but we’re already heading that way. Find out more healthcare world series

www.healthcareworld.com/ healthcare-world-series/

For Richard Cantlay, there are four solution areas that focus on maintaining the health and wellbeing of the population: • Digital solutions for prevention, allowing individuals to be able to have better ownership of their own health and wellbeing • Digital solutions to gain better insights into the health of the population, which then facilitates better infrastructure planning • All non-building infrastructure such as digital and physical • Building infrastructure that enables digital to make the flow and the efficiency within the built infrastructure better As a result, he felt we should start to view the physical state as a blend of permanent, high acuity facilities, perhaps 35

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Can digital really solve the workforce problem? Jyoti Mehan of Health Care First considers how digital can tackle the workforce issue within healthcare

e hear a lot about digital solutions in healthcare, and the fact that these may be the panacea to our problems. As we well know, healthcare is facing an enormous workforce problem, which was sharply thrust into focus by the pandemic. While those of us in the healthcare sector were becoming increasingly aware of the workforce

problem prior to this, the past two years have comprehensively demonstrated the gravity of the issue we are facing. But right now, there is a real feeling that digital, and technology, can solve the workforce problem. We have heard so many instances of digital enabling the workforce to be more efficient, such as fully-connected patient management systems, technologies

that enable patients to take charge of their own healthcare when applicable, and many more. These solutions have been embraced with open arms, and for good reason. Technology is just such an incredibly important field in healthcare - and there’s no way to deny the power and capability for change that it has. Without the benefits of the developments in digital health which we have already experienced, we would really be in a bad place right now. However, if we look at technology, and digital innovation at large, healthcare is really lagging behind in its own digital revolution. For instance, if we look to consumer technology - the iPhone was only released in 2007, yet now it’s incredibly rare to find someone who doesn’t own a smartphone.

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WORKFORCE Health Care First

Jyoti Mehan CEO Health Care First

“The way forward is to integrate technology into digital pathways - not necessarily always digitalfirst, but focusing on the right care, at the right time, by the right medium”

Internet banking and fintech have taken massive strides - banking applications have come such a long way now that it’s hard to find a reason to go to the bank in person. Even physical cash is becoming scarcer - retailers nowadays are able to utilise online and cardbased payment services which have made a profound impact on both the customer and the businesses themselves. The digital innovations which have occurred in these sectors have changed their industries so much so that right now, they are almost unrecognisable from how they were just ten years ago. Using the best of both worlds So, we have to ask, why is healthcare falling behind? There is no doubt there is so much that

can be digitalised in health care and ensuring the integration of tech is fundamental to realising its benefits. But what is all too easy to forget, especially in comparison to industries such as retail and banking, is that we are not dealing with money and commercial goods; but with people receiving care. These industries particularly engage with highly repeatable tasks, often transactions, that don’t pose as much direct risk to life. As such, the slow pace of digital uptake in healthcare is somewhat necessary - while new technologies can be easily implemented in other sectors, within healthcare, there must necessarily be a stronger and safer methodology. There is also the age-old issue of computers vs humans. Computers are

undeniably better than humans at many things, information storage, calculation easily repeatable processes that require data. In the age of AI, there are so many factors that can even be predicted and reliably built upon - algorithms are already incredibly smart, and they show no signs of slowing down soon. But, we can forget how nuanced people are. We haven’t yet built anything that even closely replicates the human brain - the ability to understand small gestures from patients that can’t easily be picked up by a computer, being able to touch, feel, hear, and empathise with a patient is fundamental to developing the best care package, and always will be. We can never forget that as we age, we need more care, and even though our children are the next generation and digitally native, the process of ageing hasn’t changed. We naturally become less able to see, hear, hold things, as well as our cognition slowing - and however advanced digital gets, being able to access care with the support of real people will not, and cannot change. Digital exclusion isn’t unique to us now - as digital develops, digital exclusion will remain. Digital providers should look at solving the problem of comorbidity and complexity of care requirements in way that releases time to care - not replace it altogether. Technology needs to get even smarter if really wants to help solve the workforce problem - and part of that is solving the easy jobs, the low hanging fruit - but also by making it easier for clinicians to actually do the job that they are skilled at, and that we as patients value. Contact Information

www.healthcarefirst.co.uk

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Breaking the mould The future of healthcare is beyond the walls of the hospital, says Elliott Engers, CEO, Infinity Health

raditional approaches to healthcare have centred on face-to-face interactions between patients and clinical staff. When patients need treatment, it makes sense to bring them into a hospital setting, where the equipment, medicine, and expertise they need are in one place and can be accessed easily. But healthcare costs are rising, the complexity of patients’ health needs is increasing, and we are facing a global shortage of healthcare staff which is set to reach 18m by 2030 – 20 per cent of the workforce needed. Layered onto this, healthcare systems are reeling from the impact of the pandemic. In the UK alone, the number of patients waiting for their first outpatient appointment has reached more than 10 per cent of the population, while the workforce crisis is predicted to be a key limiting factor in dealing with the rising backlog of care. Healthcare cannot cope with the demand; the model of providing healthcare within the walls of hospitals simply isn’t working anymore. Changing how we deliver healthcare Healthcare has been slow to adopt new ways of working in the past, but digital solutions are vital to tackling the issue of overstretched healthcare systems and increasing demand. I believe that we need to make significant changes to the way we deliver care, and expand the borders of healthcare operations. Only see patients when needed The UK is an example of how a healthcare system can reduce demand on hospitals through transformation of outpatient pathways. Two thirds of NHS outpatient appointments are taken up by outpatient reviews, many of which are unnecessary. The Patient Initiated Follow-Up (PIFU) programme has been introduced to reduce the overall number of outpatients appointments and free up clinical time. Instead of routine follow-up appointments being automatically booked, patients can

decide if they would like an appointment and request it themselves. Infinity Health is currently part of a national PIFU pilot, where clinical and management teams use our platform to manage PIFU and understand the full picture of their waiting lists. The platform integrates with existing systems to allow hospitals to prioritise patients that need to be seen. Increase coverage with the same staff Another way acute hospitals can adapt their services is through virtual wards, where a multidisciplinary team delivers high quality hospital care at home. This can help to “unblock” beds, by reducing unnecessary admissions and length of stay in hospital. Infinity Health is focused on enabling multi-disciplinary teams to remotely monitor and coordinate care for patients in their homes, providing frontline staff with the tools they need to share their caseload and manage their tasks in real-time. One of our virtual wards implementations has increased capacity to see patients by as much as 55 per cent without additional staff, so it is clear the right digital solutions can make a meaningful difference. Integration with assessment forms and monitoring devices means that patients can be monitored remotely via Infinity while they wait for care, which is also an advantage for staying in touch with patients on PIFU pathways. Increase efficiency in hospitals There will always be patients who need hospital care, and for them, receiving the right treatment and investigations, at the

Elliott Engers CEO Infinity Health

“The model of providing healthcare within the walls of hospitals simply isn’t working anymore”

right time, in the right order, is crucial. It’s vital to patient flow, ensuring patients are admitted and discharged when appropriate and reducing bed blocking. This is another area Infinity is focusing on. Using our digital task management platform, staff can access and add to a realtime log of all outstanding, completed, and pending tasks for each patient, direct from

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DIGITAL HEALTH Infinity Health

the point of care. They can see what needs go be done, for whom, and ensure tasks are completed in the right order, by the right person. A recent evaluation at one Infinity site showed a saving of an average of 91 minutes per person per shift, and staff reported feeling more organised and in control as a result.

The future of healthcare is here Hospitals will always be an important part of ensuring patients get the care they need, but they are not the only way to do so safely. The vision of a world where healthcare delivery is safe and efficient, and where the workforce’s time is used most effectively, is

already within reach. Our job is to ensure we can all benefit from the digital solutions that make this possible. Contact Information

https://infinity.health

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Fabian Sutch-Daggett

NEWS

Website Editor

COVID pandemic hits women’s mental health hardest, new research shows New research shows the impact the pandemic has had on Britons’ mental, financial, and social wellbeing The COVID pandemic has hit women’s mental health harder than men, according to independent research on behalf of Circle Health Group, the UK’s largest private hospital group. Almost half of the women surveyed (44 per cent) said the pandemic has negatively affected their mental health, compared to 32 per cent of men. Notably, there was not a single mental health symptom where more men said they were suffering than women. Compared to men, women suffered particularly when it came to social anxiety, difficulty sleeping, and lack of concentration. Key drivers of women’s mental health problems compared to men were limitations on social life and family concerns. Women also thought life is more unlikely to return to how it was pre-pandemic compared to men, fewer said they felt safe at going back to work than men, and a smaller proportion said they felt comfortable socialising in public or private places. “The pandemic has taken a serious toll on a lot of people and the burdens have been particularly heavy on women. Even though we all became experts at Zoom meetings, only half of women say they took the time to talk to family or friends about

the problems they were having – and far fewer spoke to a medical professional or therapist,” says Amanda Dorkes, an Executive Director at Circle Health Group. “Lots of people made lifestyle changes like changing diet or taking up new hobbies. These are great and can really help, but if you’re struggling it’s crucial you find a friendly ear as it can make all the difference to how you’re feeling.” “There was a lot of talk at the height of the pandemic about how working habits would be unrecognisable when it came to an end,” says David Cooper, Chief People Officer at Circle Health Group. “But it seems we’re creatures of habit, and most people are already comfortable and feeling safe about getting back to the office. Employers should take a lot of credit for this, both in terms of the effort they’re putting into making the office a safe place to go and getting that message across. “But, at the same time, they shouldn’t forget that for many people a hybrid model of working from home with a few days a week in the office has become the new normal. Demand for safety measures is still high, with five out of six people saying they expect employers to take steps to make them feel comfortable, should they get back behind their desks full time.” The poll also found:

• An age divide: • Younger Britons (aged 18-34) are much more optimistic about life returning to the way it was before the pandemic than those in older age brackets – 47 per cent of 18-34 y/o vs 41 per cent 3554 y/o vs 28 per cent of 55+ y/o. • The same group also had the largest proportion who said the pandemic had had a positive impact on their mental health. • Medical concerns: • The pandemic has left 4/5 people worried about how quickly they can access professional medical advice if needed. • 1/4 people are more likely to turn to private healthcare for procedures than they were before the pandemic, with the majority (58 per cent) of respondents saying they were not confident they would get prompt access to NHS treatment if they needed it. • Willingness to get into the office: • Workers are ready to head back to the office, with 70 per cent saying they felt safe returning to work • Three out of four (76 per cent) said they are comfortable being back in the office. • However, they seem keener than their bosses, with just 24 per cent of respondents saying employers expect them back in the office. • Some employees have different expectations for returning to the office, including the 1/20 who expect to be allowed to bring pets in to make them comfortable in the office.

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NEWS

AdviseInc named SME of The Year at the British Data Awards 2022 AdviseInc, a company that utilises AI data analysis to help organisations save money through spend analysis and price benchmarking, has won the SME of the year award at the British Data Awards 2022 Hosted at the prestigious Lansdown Club in London, nearly 160 companies entered the award, with AdviseInc taking home the win. “It’s great to receive recognition for the hard work our team puts in, day in day out, for our healthcare customers. We share a common passion to help the NHS make sense of the

billions of pounds it spends on goods and services, helping to improve efficiency and drive down costs across the board,” says Mat Oram, CEO and Co-Founder of AdviseInc. The SME of The Year award recognises the organisations that are using data to help build a ‘new possible’ while powering

Monkeypox risk to global public health is ‘moderate’ says WHO

“The situation is evolving rapidly and WHO expects that there will be more cases identified as surveillance expands in nonendemic countries, as well as in countries known to be endemic who have not recently been reporting cases,” says WHO. Monkeypox is a viral zoonosis (a virus transmitted to humans from animals) with symptoms very similar to those seen in the past in smallpox patients, although it is clinically much less severe. The more dangerous pathogen of smallpox, Variola Major, had a fatality rate of 30 per cent, according to the CDC. Through a vaccination campaign the smallpox virus was eliminated, with the WHO declaring smallpox as eradicated in 1980. The monkeypox virus is transmitted from one person to another by close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding. The incubation period of monkeypox is

The multi-country outbreak has been reported in more than 23 member states where the virus is not endemic Since 13 May 2022, monkeypox has been reported in 23 nations where the virus is not endemic. The vast majority of reported cases so far have no established travel links to an endemic area and have presented through primary care or sexual health services. “The identification of confirmed and suspected cases of monkeypox with no direct travel links to an endemic area is atypical,” said WHO in a press statement. As monkeypox is a very rare disease, one case of monkeypox in a non-endemic country is considered an outbreak. The sudden appearance of monkeypox simultaneously in several non-endemic countries suggests that there may have been undetected transmission for some time as well as recent amplifying events. As of 26 May, a cumulative total of 257 laboratory confirmed cases and around 120 suspected cases have been reported to WHO, and no deaths have been reported.

the economy through data innovation. Amongst the finalists for the award included Corndel, Effini, Good-Loop, Local Data Company, Metapraxis, Software Solved, and The Data Shed. Run by Predatech, the British Data Awards help to discover and celebrate the organisations that are passionate about data, no matter their size, with firms taking part including FTSE 100 giants, tech unicorns, innovative start-ups, public sector bodies, not-for-profit organisations, and many more. “We recently celebrated our eighth anniversary, and this award allows us to truly appreciate everything we have achieved over the years,” says Mat. “With some exciting new projects on the horizon, the future is bright for AdviseInc, and I am looking forward to working with our customers and partners to build a better, more sustainable NHS. Thank you to everyone who has been with us on our journey and supported us along the way.” usually from 6 to 13 days but can range from 5 to 21 days. “Historically, vaccination against smallpox had been shown to be cross-protective against monkeypox. However, immunity from smallpox vaccination will be limited to older persons since populations worldwide under the age of 40 or 50 years no longer benefit from the protection afforded by prior smallpox vaccination programmes,” says WHO. While one smallpox vaccine (MVA-BN) and one specific treatment (tecovirimat) were approved for monkeypox in different countries, in 2019 and 2022 respectively, these countermeasures are not yet widely available in most countries and not at all in some. “Currently, the overall public health risk at global level is assessed as moderate considering this is the first time that monkeypox cases and clusters are reported concurrently in widely disparate WHO geographical areas, and without known epidemiological links to non-endemic countries in West or Central Africa,” says WHO. The public health risk could become high if this virus exploits the opportunity to establish itself as a human pathogen and spreads to groups at higher risk of severe disease such as young children and immunosuppressed persons; a large part of the population is vulnerable to the monkeypox virus, as the smallpox vaccination, which confers some cross-protection, has been discontinued since 1980 or earlier in some countries. 41

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Mobile maternity transport service set to expand across Tanzania as new $10m investment launches The mobile ‘m-mama’ service that provides emergency transport for pregnant and postpartum women will now be scaled up to cover more than 50 per cent of the national population across 15 regions Starting from 2022, the expanded m-mama programme in Tanzania is expected to transport more than 300,000 women, empower more than 1,400 community transport drivers and could save more than 9,000 lives. Launched in 2013, m-mama is a tailor-made service offering emergency transport to assist pregnant and postpartum women during medical emergencies including obstruction labour, in addition to neonatal patients who need to get to a hospital or treatment centre. The m-mama solution has already contributed to a reduction of 38 per cent in maternal deaths and 45 per cent in perinatal deaths in the Shinyanga region alone, supporting the Tanzanian

government’s strategy to tackle maternal and newborn mortality in the country. The programme was co-created by Vodacom Tanzania Foundation, Vodafone Foundation and the Government of Tanzania and was successfully piloted in 6 Tanzanian districts including Shinyanga and Sengerema. “This simple platform has enabled over 12,000 women and babies in one region to access emergency medical care. Over 200 community drivers have enabled this urgent transport for moments when an ambulance is not immediately available. Now with the support of the Tanzanian government, the m-mama programme will be integrated as a government-backed service, supplementing the ambulance service that will provide much-needed emergency transport for

more than half of the population of the country. Our ambition in time is to expand this platform further to other countries where a simple community driver system platform supplementing the ambulance service can save lives,” said Andrew Dunnett, Vodafone Foundation Director. The m-mama service uses a centralised ‘Dispatch and Control’ system for managing emergency transportation, optimising the use of government ambulances supplemented with community drivers. m-mama is built on simple, robust technology that can be practically used in rural and semi-rural settings. In the pilot phase, which ran from 2013 to 2022, the programme reached over 10,455 women and 2,200 newborns with over 200 drivers registered and trained as community taxis. With full government endorsement, both Foundations have committed to invest $10m USD over six years to roll out the programme, guided by a steering committee from Tanzania’s Ministry of Health and public health delivery agency PO-RALG. Over the next six years, the government will increase its funding and the programme will be fully integrated into the healthcare system by 2027. “At Vodacom, our purpose is to build better futures and create productive societies. Core to this is the belief that technology must help bridge divides and improve equitable access to services. We believe that technology coupled with the country’s enabling environment and political will has the potential to support African nations to realise transformation in healthcare, agriculture, education, financial services and other priority sectors,” said Vodacom Group CEO Shameel Joosub at an event to launch the new programme. “Too many pregnant women, women in childbirth and newborns die each year from largely preventable causes. For nine years, we have been working with the Government to develop a practical, sustainable and scalable solution to reduce maternal and newborn deaths in the country. We have built a system that strengthens health care delivery and connects the community and lower-level health facilities to responsive emergency transport,” said Vodacom Tanzania’s Managing Director, Sitholizwe Mdlalose.

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NEWS

Revolutionary radiation measurement technique could transform cancer treatment A medical device pioneer has secured a patent for the latest version of its technology which can provide accurate measurements of radiation inside a patient’s body using strings of tiny glass beads, an approach set to transform radiotherapy treatments across a range of cancers Currently, radiation oncologists prescribe a level of radiation that balances the targeting of a tumour with the tolerance of surrounding healthy parts of the patient’s body. Radiation levels are monitored from outside of a patient’s body with a substantial margin for error of +/- 10 per cent. The technology uses strings of up to 300 glass beads, each 1mm thick and 1.7mm in diameter, which are inserted

into the patient’s body around the area being targeted with radiation. The glass beads have natural impurities that trap energy which confines the free electrons created when matter is ionised by radiation. The beads are then heated to around 350°C, releasing stored energy in the form of light, which is proportional to the absorbed radiation. This light is then measured to determine the

amount of radiation being transmitted to an area of the body. Known as DoseMapper, the technology enables oncologists to fine tune radiation doses by building highly accurate models of radiation exposure using hundreds of measurement points from inside the body. It can reduce the error margin to less than +/- 5 per cent, substantially decreasing the risks of overexposure to radiation, which occurs during as many as a quarter of radiotherapy treatments. TRUEinvivo, the developer of the technology, was founded by Dr Shakardokht Jafari, who is also Chief Technology Officer. Dr Jafari was inspired to transform cancer treatment after her own father passed away from cancer and, as a breast cancer survivor, she is acutely aware of the impact of radiotherapy on patients’ quality of life. “Radiotherapy is a vital treatment in the fight against cancer, but can prove a blunt tool with radiation levels hard to measure and accurately target,’ she says. “Our technology has the potential to transform radiation treatments by dramatically reducing unnecessary radiation exposure and increasing tumour control probability. We are excited to refine the technology further and increase adoption to improve welfare and health outcomes for patients undergoing cancer treatments.” So far, the company has received more than £414,000 in funding from Innovate UK including a £170,000 grant from the Sustainable Innovation Fund, which the company used to commence preclinical testing. They developed software to automate the detection of beads in patients’ CT scan images, and built a stringing machine to automate production of the threads of beads. DOSEmapper technology is currently in use at The Clatterbridge Cancer Centre NHS Foundation Trust in Liverpool and the surrounding areas, with further hospital partnerships ongoing as part of pre-clinical trial work. TRUEinvivo’s ambitions are to expand its manufacturing process in the UK and grow its operations across Europe, as well as gain regulatory approval to expand into the US and Asia-Pacific region. “What Dr Jafari and the TRUEinvivo team have achieved is nothing short of incredible,” says Jonny Voon, Head of the Sustainable Innovation Fund at Innovate UK. “TRUEinvivo’s technology has the potential to transform radiotherapy and we are proud to have supported them to help make the team’s ambitions a reality.” 43

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$197,000, compared with the global average of $812,000 (across all sectors in the survey) • Of those organisations that paid the ransom, only 2 per cent got all their data back • 61 per cent of attacks resulted in encryption, 4 per cent less than the global average (65 per cent)

Ransomware attacks on healthcare organisations increased 94 per cent in 2021 A new survey, “The State of Ransomware in Healthcare 2022” has shown a large increase in ransomware attacks on healthcare organisations The study displayed a 94 per cent increase in ransomware attacks on the organisations that took part in the survey. In 2021, 66 per cent of healthcare organisations were hit, compared to 34 per cent the previous year, showing big increases year-on-year. “Ransomware in the healthcare space is more nuanced than other industries in terms of both protection and recovery,” said John Shier, a senior security expert at Sophos, who commissioned the survey. “The data that healthcare organisations harness is extremely sensitive and valuable, which makes it very attractive to attackers. In addition, the need for efficient and widespread access to this type of data – so that healthcare professionals can provide proper care – means that typical two-factor authentication and zero trust defence tactics aren’t always feasible.” While these attacks may be on the rise, healthcare organisations are getting better at dealing with the aftermath of ransomware

attacks, according to the survey data. The report shows that 99 per cent of those healthcare organisations hit by ransomware got at least some of their data back after cybercriminals encrypted it during the attacks. Additional ransomware findings for the healthcare sector include: • Healthcare organisations had the second-highest average ransomware recovery costs with $1.85m, taking one week on average to recover from an attack • 67 per cent of healthcare organisations think cyberattacks are more complex based on their experience of how cyberattacks changed over the last year; the healthcare sector had the highest percentage • While healthcare organisations pay the ransom most often (61 per cent), they’re paying the lowest average ransoms,

“Healthcare organisations are particularly vulnerable, and when hit, they may opt to pay a ransom to keep pertinent, often lifesaving, patient data accessible. Due to these unique factors, healthcare organisations need to expand their antiransomware defences by combining security technology with human-led threat hunting to defend against today’s advanced cyberattackers,” says John. More healthcare organisations (78 per cent) are now opting for cyber insurance, but 93 per cent of healthcare organisations with insurance coverage report finding it more difficult to get policy coverage in the last year. With ransomware being the single largest driver of insurance claims, 51 per cent reported the level of cybersecurity needed to qualify is higher, putting a strain on healthcare organisations with lower budgets and less technical resources available. In the light of the survey findings, experts from Sophos recommend the following best practices for all organisations across all sectors: • Install and maintain high-quality defences across all points in the organisation’s environment. Review security controls regularly and make sure they continue to meet the organisation’s needs • Harden the IT environment by searching for and closing key security gaps: unpatched devices, unprotected machines and open Remote Desktop Protocol ports. Extended Detection and Response (XDR) solutions are ideal for helping to close these gaps • Make backups, and practice restoring from them so that the organisation can get back up and running as soon as possible, with minimum disruption • Proactively hunt for threats to identify and stop adversaries before they can execute their attack – if the team lacks the time or skills to do this in house, outsource to a Managed Detection and Response (MDR) specialist • Prepare for the worst. Know what to do if a cyber incident occurs and keep the plan updated

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STANDARDS ACS

Ensuring clinical excellence Josie Winter, Clinical Operations Director of Advanced Clinical Solutions, explains how to help hospitals reach and secure clinical excellence

tandards are a very difficult issue to tackle in the hospital sector. In the UK we are very lucky - we have one set of rules, and one set of regulations to follow. While ensuring that you are up to standard can be a long and difficult process but identifying the issues is a much simpler part of the process, thanks to institutions such as the JCI and the CQC. Yet in international markets, especially so in emerging healthcare sectors, this is often not the case. There can be multiple

versions of standards and regulations, or none at all, or frequent changes - making it a minefield for providers to get their care settings and hospitals truly up to scratch. All too often, governors can be unsure if they need to follow the JCI standards, or the UK or US standards, or their own local standards - and trying to do all of these is a sure recipe for failure if you don’t have a plan. Sometimes, it’s easier to adhere to local and national standards - lining these up with your patient needs and care, and ensuring that the clinical setting (whether it be a hospital, a clinic or a practice), truly meets

the local and regional patient need. Equally, sometimes it’s best to tackle the issue by striving for a JCI or a UK-standard hospital avoiding the issues of regional and national differences, and having a pretty concrete goal in mind. Neither of these decisions holds more merit than the other - it all depends on what your needs are. We can help you discover what these are, and realise the vision of achieving these standards. Advanced Clinical Solutions (ACS) is a team of highly trained healthcare professionals whoare experts in patient safety, regulatory compliance and quality improvements. Having experience in both the NHS and private healthcare organisations including a large corporate med-tech organisation, ACS has developed and delivered hundreds of clinical audits and quality improvement plans. We apply our extensive knowledge across a number of services, adopting a ‘seek first to understand’ approach to best serve our clients different demands, needs, wants 45

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and desires. Since attending Arab Health 2022 in Dubai, the impact of technology has become apparent to me, and I can see how shared resources could be achieved with an international guidance system in place. Achieving enhanced patient safety through learning Some of our customers include nursing and care homes, private acute care and private clinics, universities and educational institutions, GP services, and legal and insurance providers, and in all these sectors we identify many key areas to target when bringing standards up to par, including: • Preparing and suggesting audit levels (regulatory compliance) • Exceeding standards for infection prevention and control • Training to enable you to retrain new employees (train the trainer) • Leadership and coaching (as required) • Free updates and our latest information

I’m proud to say we’ve worked on several projects to ensure this goal, from film studios to local health authorities and beyond. In our experience, the key is always to review risk dynamically and make sure your standards are not just up to code but even better. One of the best ways to do this is by sharing our networks - it can be sharing a business card at an event or even connecting on a social platform (visit us on LinkedIn). This will help us all progress as a community and effect global change. Sharing knowledge internationally Our goal is to further develop compliance at an international level, and we can achieve this collectively by learning and indeed improving from our global partners. As part of our brand ethos, it is vital that the patient should be, and always is, our number one priority.

Following the impact of the pandemic and borders across many countries being reopened we’ve also learnt that the value of global reach is incredibly important. Being based in the UK with the ability to travel, we have learned the reach of the digital landscape, and we know by collaborating effectively there is a real opportunity to affect change. The most important piece in the jigsaw puzzle is the patient, who is at the heart of our work. By adopting compliant practices through clinical governance, education, learning and quality improvement, we can enhance patient outcome and ensure better environments for everyone. Contact Information

www.advancedclinicalsolution.co.uk

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WEBINAR’S 2022

Upcoming Healthcare World Series Events Digital and Data in the Kingdom of Saudi Arabia June 9th 10.00AM BST In the second in our series of debates highlighting healthcare opportunities in KSA we will examine the evolution of digital healthcare and the use of data in the Kingdom.

Entering the UK Healthcare Market July 5th 12.00PM BST The UK NHS is the worlds only truly free at the point of delivery healthcare system and represents a great opportunity for manufacturers and suppliers from around the world. But this, so say, single payor system is unlike any other in terms of its regulatory, procurement and purchasing structure. In this session we will here from NHS leaders and experienced suppliers to the NHS to help understand how overseas suppliers can enter the market.

Saudi Vision 2030 – An Ambitious Infrastructure Programme July 28th 10.00AM BST In our final virtual session on healthcare opportunities in the Kingdom before our trade mission in September we look at the healthcare building programme in the Kingdom and their ambitions to make Saudi a world leading healthcare system.

The USA – Land of Opportunity? September 2022 (Date & Time TBC) The USA has a health system unlike any other and virtually limitless scale. Its insurance led payor system though is unlike any other; it has one off the toughest regulatory regimes in the world and its size and geographical scale can make it a daunting market to conquor. In this session we will here from regulatory experts, payors and providers from the USA providing insight on how to approach a market which is equally challenging and rewarding.

Head to healthcareworld.com/healthcare-world-series to register for the above session and for more information

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Delivering capacity through digital Health Education England’s action learning programme enables individuals to consider workforce planning issues, say Partnerships Managers Finola Preston and Aleksandra Conversano

ast year, deep in the midst of the COVID-19 pandemic, healthcare capacity was in a dire place. Never before in living memory has there been such a stress on our health systems, and even now, we are really feeling the impact of the workforce problem. In an effort to recognise this issue, the WHO designated the year of 2021 as the ‘International Year of the Health and Care Workers’. This project was vital in highlighting the urgent need to invest in health workers, ensuring their health, jobs, economic opportunity and equity throughout the world.

As such, HEE worked in collaboration with WHO to develop the next generation of system leaders, creating the ‘Workforce Planning and Leadership Development Programme’, comprised of a series of four seminars and seven Action Learning Sets, presented by leaders in the field of workforce planning. These seminars are accessible and open to all, and only require registration. So far, two of these seminars have taken place, with more coming later this year. These ‘Action Learning Sets’ are comprised of 60 participants from seven low and

middle-income countries around the globe, bringing together future influencers and leaders from all corners of the social, economic, and political spheres. “You can’t fix a problem with a tool from the same shed that created the problem,” says Goran Stevanovski, the Chief Medical Education Officer in the Medical Faculty, Skopje, and member of the North Macedonia Action Learning Set. “There are many different people: lawyers, MBAs, MAs, people with varied backgrounds and positions. They are looking at the world in a different way, each bringing something to the table, which is enriching.” Action learning enables individuals to consider real-life workforce planning issues specific to each participating country and encourages them to work together to co-develop solutions. Led by experienced facilitators from the University of Salford, the sessions empower participants to act as advocates for a strategic approach to health workforce planning.

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EDUCATION Health Education England

their experiences and share common tools and practices they utilise daily to address these challenges. A solution to your challenges?

“No one is solving this problem for us as this problem requires too many institutions to solve. Instead, we are learning how to tackle it,” says Goran. This type of technical collaboration focuses on bringing in external best practice, but also building capacity and confidence in the ability of countries to solve their own issues.

Ged Byrne MBE Director of Global Engagement HEE

“Despite the challenges of COVID-19, a digital model has allowed us to deliver a global programme meeting the needs of seven countries”

Highlighting best practice One of these seminars: ‘State of Shock: the role of workforce planning in responding to shocks in demand for health and care’, brought together experts from Australia, England, the Kingdom of Saudi Arabia, Peru, and South Africa. It focused on the challenges of responding to short-term ‘shocks’ to healthcare, such as COVID, at the same time as the existence of longer-term trends. More than 400 people dialled into the discussion and a further 2,000 have watched it online subsequently. Seminars three and four are scheduled to take place in July and October 2022 respectively. These will focus on the challenge of ensuring sufficient health professionals – nurses, doctors and other qualified health and care workers – as well as how countries may maximise the contribution of supporting workforces. International speakers will present on

Discussing the success of the programme so far, Ged Byrne, Director of Global Health Partnerships at HEE, commented: “These digital sessions have highlighted the importance of collaborative and strategic workforce planning. Both HEE and WHO are excited to see how attendees apply their shared ideas, reflections and solutions to their challenges. Despite the challenges of COVID-19, a digital model has allowed us to deliver a global programme meeting the needs of seven countries.” Further information on the YHCW programme, including recordings of the first two seminars, is available on the HEE website. HEE is undertaking a thorough evaluation of the programme to demonstrate its impact on each country involved and participants will present their reflections at the end of the year. HEE and WHO are currently planning a second round of this programme, building on the successes and learning from this first cohort. “You feel yourself committed at the end of the day. The sessions are programmed in a way that first they give the ease of expressing themselves and talking about the problems, and then the way they put the questions. It is in an open way that you can have the freedom to express and explain and participate within the team with the chance for everyone to talk,” says Dr Vincent Saliba, who attended the sessions. “It is a very interesting and good approach, because at the end everyone has to address how they are going to tackle a part of the problem, so it keeps you preoccupied and committed towards your work and this is what makes it personal.” If you would like to find out more about year two of the progamme, register your interest to join, or think HEE could support you in your capacity building needs, please get in touch with us at TCC@hee.nhs.uk. We look forward to hearing from you! Contact Information

TCC@hee.nhs.uk www.hee.nhs.uk

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A digital prescription for making healthcare better Digitalisation is key to unlocking a more holistic systems approach and the delivery of better health services and patient outcomes, write Mott MaDonald’s Digital Healthcare Lead Abhi Shekar and Global Lead for Social Outcomes Kerry Scott

aving a video consultation with your doctor is one of the contemporary trends in modern healthcare that has become standard practice during the pandemic. In the years ahead we will see more routine healthcare management conducted outside the four walls of a hospital, while technology will also make it commonplace for people with conditions which previously required hospitalisation to be remotely monitored and treated in the comfort of their own homes. The delivery of healthcare will change – it must. When the direct impacts of COVID-19 recede, healthcare systems will still need to be strengthened in response to ongoing challenges: the complex needs of growing, ageing populations, financial pressures, chronic staff shortages, and higher patient expectations. The ultimate goal is to move away from the current reactive ‘one size fits all’ model towards more preventative and personalised healthcare. This is the pathway to radical improvement of patient outcomes and quality of care. A key enabler of this transformation will be digitalisation which means far more than just automating processes, cutting paperwork and increasing efficiency. It is about using tools, technologies and data to rethink and reinvent the way we plan, design and deliver health infrastructure and services. Addressing the causes of poor health A hospital should no longer be considered as a stand-alone facility at the centre of the healthcare service, but rather as one part of a city’s wider health ecosystem. Systems thinking is critical to co-ordinate societywide efforts to improve the wellbeing and resilience of communities by addressing the causes of poor health, not just the consequences. Healthcare planning needs to be linked to housing, employment and other

socioeconomic determinants of health. If healthcare provision is coordinated with other sectors – transport, business, industry, education and leisure – holistic, society-wide policies and interventions can be developed that widen access to health services and recreation, improve air quality and green spaces, and promote healthier, more active lifestyles. What will help make this possible is smarter, integrated infrastructure, enabled by 5G networks which allow data to be exchanged, subject to consent, between actors in different sectors – between health improvement agencies, local government and schools, for example, so they can collaborate and develop joint responses, which are evidence-based, to address growing health challenges such as obesity and diabetes. Improving the patient journey Historically, hospitals were essentially designed to be a one-stop shop meeting every healthcare need. In the past, they have been the only option for people seeking treatment or support. In the future, with a digitally enabled healthcare system – supporting the transition towards

Kerry Scott Global Lead for Social Outcomes Mott MacDonald

“Digitalisation will drive greater transparency and access of patient data, increasing people’s knowledge and confidence, and empowering them to become active partners in the management of their health and wellbeing”

more preventative care, and more treatment delivered in the community and remotely – hospitals will become one of several options. This will prompt a rethink of how buildings are designed and services organised, giving us an opportunity to consider how to address inequality and promote social inclusion. A ‘good’ patient journey looks different for different sets of people. Age, socioeconomic status, ethnicity and physical ability all influence how people interact with healthcare. Future provision will need to better reflect this, and can do so if patient and social outcomes are embedded into the design and delivery of infrastructure and services from the outset. Digitalisation will drive greater transparency and access of patient data, increasing people’s knowledge and confidence, and empowering them to become active partners in the management of their health and wellbeing.

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INFRASTRUCTURE Mott MacDonald

Better data, better outcomes Better sharing of data between acute and primary care sectors, and beyond to social care providers, is essential to provide personalised healthcare. By building up a complete picture of the medical history and needs of individual patients, clinicians and practitioners will be able to tailor treatment and interventions to meet those needs. With better data, managers will have greater insight into how their organisation is performing and can make informed and timely decisions. This is crucial to making more efficient use of capacity and putting staff and resources in the right places to meet demand, all of which will enable an improvement in health outcomes. And the provision of more information can also help people to improve their own health. Digitalisation will drive greater transparency and access of patient data, increasing people’s knowledge

and confidence, and empowering them to become active partners in the management of their health and wellbeing. Those that do are more likely to adopt healthier behaviours, leading to better clinical outcomes and lower rates of hospitalisations. Equal access to health Providing more services outside hospitals and closer to home will make it easier for people to access health services when and how they want to, and to deliver services based on local needs. Telemedicine and virtual services will be attractive to many groups including younger people, working adults, and those who live in hard-to-reach places or without the ability to use private transport. But those without digital devices or connectivity, or without the ability or confidence to use technology, are less

likely to benefit from virtual consultations, so there will always be a requirement for face-to-face appointments. Digitalisation can be the means to address health equity and improving access, but if not deployed correctly could widen disparities in health systems. The future introduction of technologies, therefore, should be characterised by increased choice of, and interaction with, healthcare, not by the replacement of one system with another, so that no-one is left behind. There must always be equity of access to infrastructure and services. If we abide by this principle, digitalisation of healthcare will benefit everyone. Contact Information

www.mottmac.com

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TECHNOLOGY Snomed

The global language of healthcare SNOMED International CEO, Don Sweete talks to Healthcare World about SNOMED CT, SNOMED International and its global, thriving community

NOMED international is an organisation committed to maintaining and growing our global expertise in healthcare terminology, ensuring that SNOMED CT is the common language for clinical terms globally and contributed to by clinical, standards and industry partners worldwide. SNOMED CT is the most comprehensive, multilingual, clinical healthcare terminology in the world and is a resource with scientifically validated clinical content. It allows for the consistent representation of clinical content in electronic health records, such as clinical information systems, health data and analytics platforms, and interoperability solutions. It is developed collaboratively to ensure it meets the diverse needs and expectations of clinicians and other stakeholders worldwide. Adopting a “hub” approach, SNOMED CT is also mapped to many other international

standards and adaptable to each country’s requirements. In fact, once a country or designated authority becomes a Member, anyone within those borders can access and use SNOMED CT and its related products and services, both for non-commercial and commercial purposes, without prejudice. Q: Who is responsible for SNOMED CT? A: SNOMED International is the organisation that drives the maintenance and the evolution of SNOMED CT. A non-profit, Member-driven organisation, SNOMED International plays an essential role in improving the health of humankind by determining standards for a codified language representing groups of clinical terms. SNOMED CT enables healthcare information to be exchanged globally for the benefit of patients/citizens, care providers and other stakeholders.

For the past 20 years now, SNOMED International, or IHTSDO as it was previously named, has produced the SNOMED CT International Edition. Striving to determine the best global standards for health terminologies, the organisation engages with the global healthcare community on many fronts, and from many angles to improve SNOMED CT so that it best serves the clinical information needs of a diverse range of stakeholders. Originally developed by the US College of American Pathologists, the organisation we know today exists due to a global coalition of 9 charter Members, 5 from Europe, that identified the significant need of clinical terminology in the world’s electronic health records, creating a mechanism to assure equal access to it from its participating Members. Q: So, who uses SNOMED CT? A: Broadly speaking, there is more than just one health stakeholder invested in the use of SNOMED CT. Across policymakers to Members, care providers, collaboration partners, researchers and knowledge producers, vendors, and even patients and citizens -- each part of this stakeholder ecosystem plays a role in the use and 53

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outcomes realisation of SNOMED CT, preserving a delicate balance among the stakeholders. SNOMED International now has 42 Members spread across the globe with the most recent Member countries including Germany and the United Arab Emirates joining in 2021, and Thailand in early 2022. In fact, 22 of SNOMED International’s Members are based in the European region and last year, a foundation for broadened European use of SNOMED CT via a grant programme offered by the European Union was put into place. Specifically, the European Union agreed to provide a grant of 60 per cent of the annual SNOMED CT Membership license fee to EU Member States with the goal of making it easier for those countries to use SNOMED CT and to further interoperability globally. This funding is available to all European Member States through the European Health and Digital Executive Agency until 2027, a decision that

signifies the commitment that governments and international regions are making to solve for health information interoperability. Beyond traditional membership, the organisation also delivers SNOMED CT to more than 30,000 affiliates globally and SNOMED CT now serves approximately one-third of the global population across 80+ countries. Q: What value does SNOMED CT offer its users and health systems around the world? A: The pathway to realising the full value of SNOMED CT is when it is embedded in a computer system, typically a clinical information system, a health data & analytics platform, or an interoperability solution. The logic is that SNOMED CT improves the information quality in these systems, and when coupled with other features, increases the adoption and satisfaction of its users.

The extensive use of clinical information systems, health data & analytics platforms and interoperability solutions, which is at an all-time high, leads to the achievement of key benefits. In this case, better health and improved patient outcomes, as re ected in our vision.

Don Sweete CEO SNOMED International

“SNOMED CT enables healthcare information to be exchanged globally for the benefit of patients/ citizens, care providers and other stakeholders”

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TECHNOLOGY Snomed

once annually, 3 Freesets, 7 Reference Sets and 5+ international maps to its global community. A range of collaborations, agreements and partnerships with organisations and associations such as WHO, GMDNA, MedDRA, European Union, ERA, DICOM, IHE, ICN, and Inserm, to name a few, truly signify the role of the organisation as a terminology hub. SNOMED CT education, implementation and product support, open-source tooling, translation support, and dedicated global customer service make up a good share of the organisation’s services offerings. And, for our Members, each embarking on a journey and tackling it in their different ways, you can’t understate the value that a global community levers in terms of best practices and lessons learned. Q: What’s next for SNOMED CT and the SNOMED International community?

SNOMED CT delivers different benefits to each of its unique stakeholders. It supports care providers, patients/citizens along with researchers and knowledge producers to create data, information, evidence and knowledge. From that, care providers, patients/citizens, and policy makers use and share the data, information, evidence and knowledge to effect action, making improvements to patient outcomes and health system value. Completing the ecosystem, SNOMED CT supports vendors, implementers, collaboration partners and Members to support all stakeholders by enhancing SNOMED CT and deploying it globally. Q: How do different adopters use SNOMED CT? A: As I mentioned, having SNOMED CT-coded data embedded in any type of electronic

health record or interoperability solution is necessary for SNOMED CT to function. Keeping that in mind, using SNOMED CT for data entry and integration sets a foundation for many other uses. These include clinical information sharing, as well as a range of analytics functions to support point of care, population and management purposes. Another key area where SNOMED CT delivers benefits is conducting clinical, laboratory and scientific research. Q: What SNOMED CT services does the organisation offer its Members? A: In addition to maintenance, quality assurance and the monthly release of the SNOMED CT International Edition, SNOMED International also delivers its stakeholders a multitude of other products and services. Over the course of the year, SNOMED International delivers the Global Patient Set

A: There are a few interesting items on the horizon for our global community, which may also be of particular interest to the European community. Towards the end of 2021, SNOMED International shared its intention to extend the core of SNOMED CT’s structured clinical terminology to deliver an open, standalone terminology in support of the scope of content within the International Patient Summary (IPS) for non-Members. A beta release out for public comment, the organisation will make this available before the end of 2022. To get a representative picture of the global SNOMED CT effort underway, the players can take in some excellent education resources. I recommend attending this year’s SNOMED CT Expo, September 29-30, Lisbon, Portugal and online. Registration opens on 15 June. Representatives from the SNOMED International team are ready to talk about this and more. Whether you are a current Member or affiliate, or looking to better understand how SNOMED CT fits into your digital health landscape, I encourage you to visit Booth #240 over the course of the HIMSS European Health Conference & Exhibition. Contact Information

www.snomed.org

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Changing times Healthcare can be transformed through change management, says Linea CEO Ian Chambers

ealth and social care organisations have faced operational challenges for several years as a result of budgetary constraints and a demanding push for continual efficiency gains. The onset of the COVID-19 pandemic further amplified these historic issues, resulting in significant caseloads and backlogs, creating workflow challenges and strain within teams. The cessation of elective service provision at the height of the pandemic has meant that in many countries more than 10 per cent of the population are awaiting treatment. Care providers are having to tackle these backlogs while working within budgets that were set three years earlier without the realities of the pandemic in mind, resulting in increased spending and reduced governance.

Similarly, their workforces are often not large enough to cope with these challenges, leading to staff exhaustion and the need for further expenditure resulting from overtime, shift premia and temporary resource.

In-depth activity modelling supported by workforce optimisation can identify the best configuration of services to gain the maximum utility from scarce resources. In addition, these activities can form the foundation of critical incident planning so that business continuity can be assured. Furthermore, seeking different models of care is essential in overcoming the various patient and staff challenges. One such possibility is a greater adoption of community-based care as it provides many

Accelerating recovery Despite all this, by taking the opportunity to re-align services as part of the post COVID renewal programme, recovery can be accelerated. Health economies can create extra capacity (buildings and workforce) in a manner that is least disruptive for service users by separating work into discrete locations, still easily accessible to the local population, but able to act as ‘hot’ and ‘cold’ sites in an emergency, such as a pandemic.

Ian Chambers CEO Linea

“Seeking different models of care is essential in overcoming the various patient and staff challenges”

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CHANGE MANAGEMENT Linea

operational understanding and sound financial planning. • Helping healthcare organisations develop a more agile and flexible organisational culture, adept at quickly understanding and resolving complex problems through periods of unprecedented challenge. • Creating a plan for managing workforce capacity and expanding the resource pool to meet demand, considering the need to avoid overworking frontline staff and the longer-term impact of Brexit on the free movement of international labour.

benefits to patients while reducing pressure on acute care hospitals and minimising healthcare costs for service commissioners. Options include Hospitals at Home, Virtual Wards, acute remote monitoring and anticipatory care or complex care with high risk of deterioration. Our agile approach to problem solving and workforce solutions through the creation of new roles and different working patterns has demonstrated that waiting lists can be swiftly reduced and activity increased, while the long-term strategy is developed and agreed. The holy grail of a patient pathway which facilitates a seamless journey from primary care to secondary or tertiary care could be within sight if the strategic direction is established now. Creating transformational systems At Linea, we have years of experience delivering change management support for the health and social care sector and appreciate the unique challenges they face. We believe every organisation has

infinite potential, and provide the tailored guidance and hand-on support required to deliver a sustainable model of care for the communities served. Healthcare change management is vital at a time when organisations are facing unprecedented challenges, resulting in leaders juggling multi-dimensional problems through the need to do more with less. We know these difficult & complex challenges can be overcome which is why we work closely with organisations to deliver effective change management solutions which address the root-causes of these problems. These include: • Developing a coherent approach to backlog management by maximising existing utilisation, enhancing productivity and identifying additional ways to create new capacity by ‘sweating assets’ while developing innovative working processes to transform culture. • Bringing spending cultures and unsustainable expenditure back under control through a careful balance of

By providing strategic guidance and business transformation, we help healthcare organisations redesign and improve processes, ensuring they are truly patient-centric. By guiding teams through a significant and carefully balanced programme of system and organisational transformation, we resolve problems, to create a solid foundation for future growth and ongoing stability. It comes down to understanding the issues and then utilising our expertise and significant resources to work through problems and create sustainable solutions. In doing so, we aim to drive patient-centric care and organisational sustainability by carefully balancing finance, performance and quality dilemmas. We’re well aware of the complex challenges our clients face, and by providing strategic insight and increased operational/clinical capability, we assist in improving accessibility, maximising outcomes and enhancing care quality. We also help clients eliminate the staff shortages that compromise sustainable demand management and first-class patient care. I’m delighted to say we have an excellent track record of sustainable improvement in healthcare. By working together in partnership with our clients, we transfer knowledge and build capability to ensure organisational self-sufficiency and improve staff work/life balance, ultimately building a sustainable healthcare system for future generations. Contact Information

info@linea.net www.linea.net

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03/06/2022 10:19

Notes from a Modern GP

Dr Patrick Wynn

The NHS staffing crisis is not insurmountable, says Dr Patrick Wynn of Health Care First

e seem to have a world in in near apocalypse right now as we lurch from crisis to crisis. Only a year or two ago we had Parliament in turmoil over Brexit which paled into insignificance when the Global Pandemic came along. And just as we seem to be getting over COVID, there is a war in Europe. All of this puts our own problems into perspective, but it has impacted on our day-to-day clinical service in many ways. We now find ourselves with a major staffing crisis throughout the NHS. This is not just a lack of doctors which we always seem to focus on, but cuts through all ranks and roles. We don’t have enough staff available to pick the phone up when patients ring. This means long waiting times and we all know how frustrating it is sitting on hold, especially when you are unwell and have urgent needs. Consequently, when callers do get through they are understandably annoyed and some will vent this on the receptionist they speak to, all of which is understandable but only makes the job of call handling harder and more stressful. This means we have yet more difficulty recruiting and retaining staff and, when combined with record low rates of unemployment, the problem gets worse. So many of our staff join the service because they genuinely want to help and do good, but who could blame someone for leaving if they are faced with an

earful of angry callers day after day when they could stack shelves in the local supermarket for the same money? We rely heavily on specialist nurses who are highly trained to offer expert knowledge on specific disease areas and deal with all manner of urgent medical issues. These nurses are highly experienced and time-served before they take on extra responsibilities, but now we find the next generation are loath to engage with the extra training because they find it too academic and over-onerous. They simply stay at the same grade and do not attempt to progress their careers, and without the next generation of specialist nurses, we are facing a crisis of provision. We have introduced many new roles such as clinical pharmacists who deal with medication enquiries and can prescribe when required, and we are using specialist staff without the need to go through a GP or nurse. For example, you can now speak directly to an

“Not only do we need to address staff numbers and training, but we also need to innovate and change working practice”

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COLUMN Dr Patrick Wynn

NHS Physiotherapist without a referral. We have the funding to provide frontline mental health practitioners which is a desperately needed service but guess whatwe can’t recruit! Pension reform has meant that many older doctors are better off retiring and the increasing pressure in the system is making more and more doctors leave for nonPrimary Care jobs. The expansion of medical schools has in part happened, but it takes upward of 10 years to turn a high school leaver into a GP so the impact will take time to be realised. Is there a solution? What can we do to remedy this situation? Public sector pay rises have fallen way behind the private sector, but with a chronically underfunded service, is it right to take finance away from services to increase pay, or as a nation are we prepared to simply pay more for our NHS? This is in the hands of politicians and not something we can control directly or in the short term. We can use agency staff or outsource services - I’m sure everyone is aware of online consultations with private providers such as Babylon. These providers can offer an excellent service whether privately or NHS funded, but at the end of the day they rely on the same diminishing reserve of specialist staff. Likewise with agency workers. In our district there has been funding to assist Primary Care with additional staff which has been used to hire agency staff - the irony is our own staff leave our service to work for higher rates of pay under the scheme with no net increase in service, just an increase in cost!

I believe we need a combination of many things. We need to improve pay without doubt, but that is not the most important factor in my mind. To improve our recruitment and retention we need to make the job more attractive all round. We need to improve working conditions in terms of relieving pressures and stress and in supporting the emotional needs that so easily get forgotten when working under pressure. With enough staff, support and funding, working in Primary Care could be the pleasure it once was. Not only do we need to address staff numbers and training, but we also need to innovate and change working practice. The use of allied health professionals at the front line of service is one such opportunity we are already working on, but we need to go further with the use of online, phone-based apps and Artificial Intelligence solutions. This is just around the corner and can’t come too soon for me. In my experience most NHS staff go to work for far more altruistic gain - to do good and help people. It sounds like a cliché, but it is true. On Sunday this week I was at the scene of a cardiac arrest giving chest compressions to an unconscious man who came round and started talking. He is now doing well in Coronary Care at the hospital and we are expecting a full recovery. Try and beat that for job satisfaction! Contact Information

www.healthcarefirst.co.uk

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ince the introduction of a Federal law specifically regulating patient health data in 2019, the United Arab Emirates (UAE) has promulgated the concept of data localisation, with restrictions upon health data sent outside the country. This is an important consideration for any international health provider undertaking digital health projects in the UAE.

ICT Health Law Federal Law No.2 of 2019 on the use of information and communications technology (ICT) in health fields in the UAE (ICT Health Law) introduced national regulations to allow the Ministry of Health and Prevention (MOHAP) to collect and analyse health data at a state level in the UAE.

One of the most impactful provisions of the ICT Health Law was that it mandated that health information and data related to services provided in the UAE could only be processed, generated, or transferred outside of the UAE in cases prescribed by virtue of a decision issued by a local Emirate health authority, in coordination with MOHAP. This restriction on the movement of health data was problematic for healthcare providers whose services involve the movement of health data across borders, such as, where local healthcare providers had entered into partnership with other international partners, either for second opinion services, or as regards data analytics, insurance claims processing, or other data processing activities.

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LEGAL Al Tamimi

Andrea Tithecott Partner and Head of Healthcare & Life Sciences Practice Al Tamimi

“The Resolution expressly provides for 10 circumstances wherein the transfer of health information and data outside of the UAE may be permissible”

However, the Resolution expressly provides for 10 circumstances wherein the transfer of health information and data outside of the UAE may be permissible. Those 10 exemptions are as follows:

Despite MOHAP alluding to allowances for data transfers being permitted by local health authorities, no such resolutions were passed for a period of nearly two years, with some considerable ‘grey areas’ and lack of transparency as to how to go about seeking approval on a case-by-case basis. Resolution 51 In response to requests from the healthcare community for clarity on this issue, MOHAP took steps to address the situation. In April of 2021, Ministerial Resolution No 51 of 2021 concerning Federal Law No.2 of 2019 on the use of Information and Communication Technology in Health Fields and

Executive Regulation (Resolution 51) introduced several clarifications and exceptions to the data localisation restriction in ICT Health Law. Providing Definitions to Terms and Phrases The Resolution 51 defines the phrase “health services provided within the [UAE]” as “any health work or procedure carried out by a health facility operating within the [UAE], whether it is within the scope of diagnosis, prevention, treatment, rehabilitation or health monitoring.” The Permissible Cases Generally, the default position remains that health information and data may not be stored or transferred outside of the UAE.

1. Overseas Treatment: The information and data is of patients being treated outside of the UAE, within the limits of the necessary treatments and procedures. 2. Overseas Laboratories: The information and data is related to samples that are sent to laboratories outside of the UAE. 3. Scientific Research: The information and data is used within the framework of scientific research, in compliance with the laws of the UAE. 4. Insurance: The information and data is required by insurance institutions and claims management institutions within the scope of their procedures. 5. Organisations Cooperating with the UAE government: The information and data is requested by competent organisations that cooperate with the UAE. 6. Personal Medical Devices and Wearables: The information and data is in simple medical devices and tools used by the public, based on personal use, and entails the recording of some simple medical data for the patient. 7. Drug Safety: The information and data is related to the prevention, treatment, or diagnosis of a patient that may cause side, reverse, or negative reactions. 8. Transfers Approved by a Health Entity: The information and data is related to any other health information and data that a health entity agrees to transfer or store outside of the UAE 61

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(subject to some further considerations related to public security, public interest, and public health). 9. Telemedicine: The information and data is used within the scope of providing telehealth services. 10. Specific Formal Patient Requests: The health entity keeping the information and data of a specific person receives an official request from that person or their legal representative for a transfer for use outside of the UAE. Additional Conditions for Rendering the Exemptions Permissible In addition, the Resolution states that certain conditions must be fulfilled in order to render the aforementioned cases listed in exemptions 1, 2, 5 and 7 above fully permissible. Those conditions are as follows: • Written consent of the recipient of the health service or his legal representative must be obtained; • Only the concerned person or entity shall be authorised to access the data and information; • Data and information related to the relevant health condition of the concerned patient will only be to the extent needed to use such data and information for its intended purposes; and • Data and information shall be encrypted before being sent, using the best encryption standards. In addition to these controls, a copy of the relevant health information and data must be kept and stored inside the UAE, as well as documentation of consent for the transfer or storage outside of the UAE for the exemptions in clauses 5, 7, 8 and 10 above. The health data and information listed in exemptions 3 and 5 are subject to the following controls: • No identifiable information about the patient may be transferred; • Only the concerned entity may access the data and information; • The data must be encrypted using the best encryption standards before it is sent; and • Data and information shall be transferred using media of the highest security standards.

Exemption 3 maintains an additional control requiring that the sharing of data and information must be made for the purpose of scientific research only, and not be used for purposes other than the research being carried out. Insurance Context Health data and information transferred under exemption 4 are subject to the following controls: • The insurance institutions and claims management institutions must be operating in the UAE; • All data and information must be stored inside the UAE;

• No identifiable data about the patient may be transferred; • Written consent of the recipient of the health service shall be granted; • The data and information shall not be completely transferred; • The insurance policy number may be sent for processing only if part of the request is concerned with processing claims outside of the UAE; and • The data and information shall be encrypted using the best encryption standards before being sent, and will be transferred using media that adopt the highest security standards. A patient who comes to the UAE on a visitor visa may transfer their health

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LEGAL Al Tamimi

data and information outside of the UAE at their request or for the purpose of fulfilling the health insurance requirements. Resolution 51 and permissible transfers – one year on We are now one year having passed since Resolution 51 was brought into force. The question is, has Resolution 51 fixed the problem? Does it allow sufficient flexibility for data transfers when there is a legitimate justification? The jury remains firmly out on this question. Unless a transfer squarely falls within a listed exemption under Resolution 51, the exemption does not

apply and a further approval is needed from a local Emirate health authority. Unfortunately, neither health authority in Dubai or in Abu Dhabi has published any guidance or a clear process for making an application for approval. It is a matter of approaching the regulator on a case-by-case basis and arguing the case for a one-off approval. This is an undesirable situation, but despite further protestations from stakeholders engaged in digital health projects requiring trans-border movement of health data, MOHAP does not appear to be mobilising on this topic or considering widening the goal posts.

Conclusion While Resolution 51 provides welcome guidance on when health data may be transferred outside of the UAE, the exemptions remain limited and subject to particular controls. Accordingly, any business that wishes to rely on any of the exceptions must ensure proper comprehension and compliance with the exception and its conditions. Contact Information

www.tamimi.com

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omplaints are never something that we really want to hear - but they are vital to ensuring the level of care and continued development within health organisations. Without patient feedback, even organisations at the forefront of innovation may fall short of realising what their patients actually need. It is imperative that complaints are not only acknowledged and acted upon, but also that they are

interacted with in the best manner possible - and AI may play a pivotal role in this. For reference, complaints to the UK NHS by patients or families are incredibly common, with the NHS receiving more than 175,000 complaints about its services every year - this translates into more than 3,300 per week. Our partner NHS trust (University Hospitals of Leicester NHS Trust) alone receives 4,500 complaints or concerns per year. Allied to this, the cost of litigation is

steadily increasing - £2bn to the wider NHS and £22m to UHL alone, annually. Looking at the issue elsewhere in the world, in 2010, a report by the Harvard Business School placed the cost of medical malpractice in the USA at $55.6bn, increasing the cost of care by an estimated 5 per cent. The vast majority of this, though not entirely, originates with a patient complaint. Yet despite this wealth of information which is presented to us, these complaints are not always used to understand systemic or specific problems in care organisations, disregarding the rich information that they contain. While some complaints may provide very little information to learn from, many provide a very comprehensive analysis of our care systems from the most important perspective - the patient. The sheer volume of complaints causes significant problems in the way

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TECHNOLOGY Methods Analytics

that people have raised, causing further distress and cost to hospitals and staff time • Perhaps most worryingly, hospitals cannot maximise the learning from past experiences • In turn, this means mistakes are repeated and patient care does not improve. The solution – how can AI help?

that complaints are managed and, most importantly, learnt from by hospitals and care facilities. Having to manually analyse and process these complaints is incredibly labour-intensive and takes considerable time. As complaints can be very long and emotive, analysing them, responding to them and learning from them objectively, can be difficult. Human beings are not good at synthesising information from large numbers of narrative sources as primacy and latency effects overwhelm us. Human beings, even with the best intentions, also get bored. As several high-profile reports to the British Government have found, this means: • Already distressed patients and families frequently suffer delays • Many complaint responses do not address all the key issues or questions

To tackle this problem, we’re using a combination of automation and a branch of AI known as Natural Language Processing (NLP) to focus on this problem and enable healthcare providers to derive real value from complaints, both immediately for the complainer but more broadly for the organisation and future patients. NLP is a branch of artificial intelligence that allows computers to interpret human language by “reading” and then analysing large blocks of unstructured text. Put simply, the system processes the data into a format in which it can be understood, then classifies it, and identifies the underlying issues in the complaint - this is known as topic modelling. Although this system is still in development, it is based on previous work which we have successfully deployed for organisations such as the UK Health Regulator, the Care Quality Commission and the UK Ministry of Defence. Our aim is by using the AI system, we can address and enable complainants to be better served, and for organisations to use the rich patient feedback to mitigate future risk, targeting these key areas: 1) Reassuring patients and relatives a.

A faster, more complete, and more accurate response to the issues raised in their complaints. Automation equals speed and appropriate workflows in this instance, so the complaint gets to the right person to respond to the complainant quickly. There is a lot of evidence that speed is a major factor in resolving complaints simply, as people feel listened to. b. Reassurance that all the issues raised are being identified and patterns are being viewed by senior leaders. Not always, of course, but often when you speak to complainants the term used is ‘we want to make sure it doesn’t happen to someone else’, so having a clear pathway

and a fast process gives the signal you are listening and acting. 2) Helping hospitals a.

Accurately identifying key problem areas in near real-time so mitigation can be put in place. This is about risk: clinical risk and executive risk. Executives who do not have strong process in place to manage complaints have an unmanaged risk. That is not good governance. b. Improving the efficiency of complaint management resulting in: i. Improved experience for patients and relatives, reducing the onward effects of the complaint in staff time to manage the issue and potential later litigation ii. Reduced burden on staff of responding to the risk now and through the process iii. Reduced time clinical staff spend dealing with complaints, thereby allowing them to focus on clinical care. c. Focusing quality improvement efforts where they are needed most, thereby improving patient outcomes. d. Potentially reducing both the number of complaints going forwards, as risks are better understood and mitigations can be put in place and therefore litigation costs, by improving learning from complaints and by improving patient satisfaction with the complaints process. Conclusion Key to note is that although it makes the human’s task much faster, easier and more objective, it does not remove the human oversight of what is obviously a sensitive area. “AI in healthcare” usually conjures up images of robots on the wards or using computers to read CT scans. However, healthcare is so much more complex than this, and many of the ways in which AI will improve care and improve efficiency are in “back-room” tasks. Although less “glamorous”, they are no less important for both the patient and the hospital. Contact Information

www.methodsanalytics.co.uk

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elemedicine has advanced considerably over the past decade, not least because we live in a connected world. From GP consultations through to kerb-side intervention and care, that technology has developed to such an extent lives are potentially being saved and hospital conveyance is possibly reduced, demonstrates that the care pathway is evolving.

But there’s a fly in the ointment – our connected world has gaps where no, or very limited connectivity exists. Of the many advantages telemedicine has delivered, such as remote diagnostics and consultation, the most promising effect is the increase in more and more treatments being delivered away from traditional settings. The COVID-19 pandemic has accelerated this widespread use of remote GP consultations, which has

been a major benefit for the majority of patients who are now routinely accustomed to this model of care. While this has reduced the burden for many, particularly the older generation who may struggle with the logistics or indeed expense of getting to their named surgery, it has also helped ease the pressures on GP surgeries. The fly in the ointment But what about the digital divide, or emergency care in remote areas? Or treating those who are harder to find and of no fixed abode? It’s here where the technology needs robust connectivity to ensure the transfer of data, or remote diagnoses and treatments can be fulfilled. There’s a raft of video platforms such as ExStream and even wearable devices using

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DIGITAL Telemedicine

of satellite and cellular communications to form an ecosystem that underpins all other technology. With the introduction of Elon Musk’s low earth orbit (LEO) satellites, the opportunities for new connectivity has increased exponentially, making our connected worlds less fragmented. Some 20 years ago, we at Excelerate Technology were delivering satellite broadband connectivity for our emergency services clients when, for instance, there was no broadband infrastructure – or the terrestrial infrastructure was not fit for purpose. Back then, our cellular networks were also extremely unreliable or simply couldn’t offer the bandwidth required to overcome limits on data packet size or volumes of traffic. Now, while broadband has greater coverage and we largely rely on a 4G / 5G cellular network, satellite is still the most effective way to guarantee reaching the parts other channels can’t get anywhere near. Connecting the dots

Skype or WhatsApp, which are nowadays widely deployed. What isn’t so widely reported, however, is that for all this to work seamlessly at say, a road traffic collision (RTC), is the requirement for robust and resilient connectivity. How is that data, in whichever guise it’s shared or delivered, transmitted if there is no terrestrial infrastructure, and has been compromised or as is often the case, contended due to the sheer amount of traffic vying for bandwidth? It is this problem that must be addressed. Without resilient and secure connectivity, even the best technology available on the market becomes redundant. This challenge is indeed significant, but through advancements in connectivity technology, we are witnessing significant strides forward, where barriers such as ‘not spots’ are being overcome through robust and ubiquitous ‘hybrid connectivity’ – a bonding

So how does this all knit together? By way of example, we have recently embarked upon a €5.7m initiative, co-funded by the European Space Agency (ESA), ARTES 5G Strategic Programme Line (SPL) and the UK Space Agency (UKSA), to create the prototype for pioneering an always connected, cloud-based digital ambulance of the future. Participating partners are working closely with the NHS to deliver ambulances that are always linked via 4G, 5G and satellite. This technology will enable a whole range of applications to work in concert with each other to substantially improve patient experiences while transforming the way ambulance services deliver ‘see and treat’ care. Crucially, it will function as a remote consultation room giving paramedics access to medical records, and specialist clinicians access to patients to provide treatment en-route to hospitals. Having the added assurance of a robust hybrid connectivity ecosystem is the final piece of the jigsaw. And this is how the ‘fly in the ointment’ can be avoided – no matter where an ambulance or crew may be. First responders and healthcare professionals will be able to provide most of the care to patients without unnecessary conveyance to emergency departments, while providing a whole range of new on-the-spot services

Simon Hill Chief Technical Officer Excelerate Technology

“The time has come to harness hybrid connectivity, because the technology we have available to us today can deliver so much more than just a faceto-face consultation, it’s instrumental in accelerating patients’ access to healthcare”

such as investigative procedures, tests and greater use of technology to enable specialists located remotely to treat patients immediately through telemedicine. Crucially, there should also be easy access to a range of diagnostics from phlebotomy, electrocardiogram and spirometry to more complex diagnostics like MRI and endoscopy, without having to bring patients into hospitals. This could revolutionise NHS care. Moreover, healthcare professionals are now finding and treating vulnerable groups who are harder to locate, or for whatever reason may be more susceptible to illnesses such as Hepatitis C, TB and more latterly, COVID-19. While this has been talked about as the future of healthcare for some time, it is with us now. The time has come to harness hybrid connectivity, because the technology we have available to us today can deliver so much more than just a face-to-face consultation, it’s instrumental in accelerating patients’ access to healthcare while at the same time reducing the inflow of patients through conventional hospital triage. Telemedicine is no longer just about remote GP services; it goes to the heart of community healthcare provision at both primary and secondary healthcare levels and for this reason it is not compromised by weak conventional connectivity infrastructure. Hybrid connectivity is the future. Contact Information

www.excelerate-group.com

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ometimes you don’t need to set out trying to fix all the wrongs in the world. An unachievable vision is all too often a pitfall for startups and big businesses alike. Occasionally it is the simplest of problems that requires a solution and achieving it can be tremendously beneficial not only for the company but also for the customers (in this case, patients). Moises Barbera Ramos, a 23-year-old scientist and entrepreneur from Spain, identified an orthopaedic surgery solution that nobody else had recognised. Although he wasn’t the first to recognise the problem, he was the first to see how it could be solved by AI. His company Drill Surgeries

is a young and vibrant startup in the medical device sector, driven to improve how Intramedullary Nailing surgeries are performed worldwide. His innovative tool facilitates how surgeons achieve distal enclosure/locking during the surgery, reducing time and X-ray impact on patients and medical staff. His success is no doubt due to his incredibly impressive portfolio at such a young age – an MSc in Physics at the University of Liverpool was followed by an internship CERN, the home of the Large Hadron Collider, developing algorithms for big data analysis. Then came JP Morgan Chase where he worked on programs to

enable quicker execution of trades, and XJTLU in China, working on hand-tracking mechanisms for driverless cars. Identifying the problem However, Moises is no stranger to healthcare. His father was a salesman for medical devices, and he fondly recalls joining his Dad at work, venturing from hospital to hospital back home in Valencia, unconsciously absorbing the issues and challenges within the sector. So healthcare is in his blood. Within orthopaedics, a process called ‘intramedullary nailing’ has been used for a very long time. Invented by Gerhard Küntscher during World War II for treating femur fractures, this procedure enabled patients to resume their activities quickly, sometimes in only a few weeks, as opposed to the months of inactivity that a plaster cast would necessitate.

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TECHNOLOGY Drill Surgeries

Moises Barbera Ramos CEO & Co-Founder Drill Surgeries

“Our software runs on a mixed reality headset that recognises the environment and the surgery taking place, builds 3D models and provides hands-free guidance during the surgery”

Arnau de Villanova, Spain, who had recently performed one of these surgeries. Very simply, there is a nail with two holes on each end; you fix one end to the bone, and the other end to the bone, and that is it,” says Moises. “The problem is that these holes are very small, and to see where they are in the patient requires many X-rays to keep track of them - which makes the process much longer. We began to wonder if there could be a way to locate these holes faster, and without radiation. So we started looking at ways of using programming and code to assist surgeons with this type of medicine, therefore eliminating the need for radiation. That was the spark of the idea and he is now our Principal Advisor and leading the current trials in Spain.” Since then, intramedullary nails have been in constant use. They are no longer restricted only to breaks of the femur, but have been adopted for usage in other fractures, such as the arms. As they share the load with the bone itself, patients are able to be active and use their broken appendage far quicker - resulting in less risk of muscle atrophy, and a much quicker recovery time. However, this procedure is not simple. Performing it requires pre-operation X-rays, followed by a long invasive surgery, and post-operation X-rays - exposing the patient to a sizeable amount of radiation. While Moises realises that it isn’t possible to eliminate the need for the surgery - he’s a scientist, not a wizard - he understood that he could in fact reduce the need for the patient to undergo so many X-rays, reducing the patient’s exposure to unnecessary and harmful radiation. “Back in 2018, I was speaking to Dr. Javier Coloma, an orthopaedic surgeon at Hospital

Identifying the need Following this, Moises spent months developing his program to solve this issue. He spoke to many surgeons from around the world, first in the UK and in Spain, then as far afield as Australia and Switzerland, asking if they faced this issue, and if they believed that this solution could work. “All of them faced the same problem. It’s a really simple procedure, but they have to spend ages taking X-rays because they need to know where these tiny holes are, and there wasn’t any other way to do it,” says Moises. Other companies and innovators in the field have attempted to fix this issue before. Techniques such as ultrasound and electromagnetic approaches had been posited as the fix for this procedure, but they were not successful - meaning that surgeons had to continue to rely on X-rays. Yet, Moises wasn’t going to tackle the problem with these solutions - he was going to use AI.

“I realised that we could use computing to solve this issue. We started with some mathematical equations - this was the basic proof of principle,” he says. “We continued by building on top to create an augmented reality interface. Our software runs on a mixed reality headset that recognises the environment and the surgery taking place, builds 3D models and provides hands-free guidance during the surgery. “So, say this procedure is being performed on the patient’s leg - the program recognises the procedure that is being performed, and the surgeon can see everything that’s going on in the patient’s leg without needing to use radiation.” “Additionally, we also aim to reduce operating time, we’ve tested this in mannequins with promising results, potentially up to 75 per cent less time and up to 60 per cent less radiation. We have also filed a patent so our technology is patent-pending at the UK IP office.” Despite his youth, Moises has impressive supporters among business and academia, including the University of Liverpool and Liverpool John Moores University, Santander X and the European Union European Regional Development Fund. He has already won several awards, including Entrepreneur of the Year 2022 from EducateNorth and Tata Varsity Pitch 2021 for Most Disrupting Business 2021. This product has already received the support of many institutions, including international hospitals, but Moises is determined to get his product out there. “At the moment we are raising our first round of investment, so we can welcome shareholders into the company to help us shape the business. Through economical support, and through sharing expertise in the area, we can get this prototype ready for trials in a big way this year.” Patients are already experiencing a palpable benefit from this program - all stemming from a desire to fix the simple issue of finding very small holes. What this does prove, however, is that even if you are only fixing a small problem, you can vastly improve the quality of life for a patient. Contact Information

contact@drillsurgeries.com www.drillsurgeries.com

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03/06/2022 10:21

What’s your score? Romano Toscano, CEO and Founder of MyLifeKit discusses the launch of VioScore

s the world takes stock following the devastating impact of COVID-19, MyLifeKit Founder Romano Toscano believes a holistic overview of a person’s lifestyle wellbeing is essential. MyLifeKit’s new venture VioScore hopes to provide just that via a numerical expression to identify risk. “Our vision is to use accessible information and technology to create a ‘VioScore’ Society, leading to better lives for everyone,” says Toscano. VioScore has been created to provide individuals with an overview of, notably, their insurability derived from information gathered about their lifestyle choices. Since 1979, financial decisions have been based upon a credit score that in Toscano’s view doesn’t reflect the full reality.

“This limited view on a person’s insurability is unfair, and often based on only partial information of an individual’s life,” he says. He feels that the current system is unable to provide a comprehensive risk profile of one’s lifestyle and therefore leads to disadvantageous insurance policies and biased financial restrictions. A comprehensive score VioScore will merge health-related data and credit-related data to offer users a numerical expression of their life based on their physiological needs, health, and financial wellbeing. VioScore will evaluate potential risks posed by unhealthy lifestyles and present solutions to improve it.

The service also has applications within the healthcare sector by allowing providing healthcare professionals deeper insight into a patient’s lifestyle. It can also be applied in the insurance and banking sector, to help consumers with better access to credit and insurance coverage, as enabled by a positive VioScore, similar to the way in which traditional credit scores usually work.

Romano Toscano CEO & Founder MyLifeKit

“Numerical signifiers have surged in popularity in recent years, and yet there is no offering which combines credit and health analysis into one simple score. VioScore will answer that need”

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DIGITAL HEALTH VioScore

More than 5m UK citizens have ‘thin’ or non-existent credit scores and almost a third of them are under 30. Those who have little to no history of handling credit are classed as unscorable or rejectable. Having a sparse record is no reflection of a consumer’s financial situation or risk. Furthermore, a bad credit score can impact an individual’s insurability indefinitely. VioScore for healthcare VioScore regularly calculates an individual’s score based on many aspects such as health, credit, surrounding factors, environmental aspects, global trends and other factors, supported by data inputs and artificial intelligence. The result will allow people to take control of their life situation by comparing their score to benchmarks and by providing individual advice on how to improve the score and henceforth improve their lives. Collaboration with general practitioners will allow seamless VioScore sharing between patients and healthcare providers, leading to greater insight into patients’ lives allowing general practitioners to provide better health care, early issue identification, and preventative medicine recommendations.

It will lead to an improvement in job satisfaction by enabling general practitioners to practise at the top of their licence. It will also create an improvement in the economics, efficiency, and effectiveness of medical care processes, leading to a healthier patient base and increasing patient retention. VioScore can help reduce the imbalance between the demand for, and capacity in, general practice. Working with inhouse experienced counsel to provide the best GDPR and data protection, “VioScore will revolutionise the decision-making process for insurance firms,” states Toscano. “For example, in the USA it is not allowed to take medical data into a credit decision. We provide the indicators but for the USA we wouldn’t want to give that data away. The control should always be with the client- they should be the ultimate controller of their data. We call it ‘giving AI back to the people’.” So, what’s the score? With the rise in popularity of monitoring services such as fitness apps and smart technologies, enriched data can be accessed to create a complete overview of an individual’s lifestyle.

A recent report by IQVIA has found that there are more than 350,000 digital health apps available, with over 90,000 being introduced in 2021 alone. Across the pond, the US predicts there will be over 86 million users of health and fitness apps this year, and more than 100 million active Apple Watch users. These statistics show the willingness of people to keep track of their wellness through health, fitness, and financial monitoring. “Numerical signifiers have surged in popularity in recent years, and yet there is no offering which combines credit and health analysis into one simple score. VioScore will answer that need” says Toscano. The level of data available through a combination of these mobile apps will allow VioScore to create a profile of a user’s lifestyle, based upon their behaviours. This user profile will be translated into a number, which will replace the credit score with a more fair, reliable, and well-rounded risk analysis of an individual’s habits. This number, in turn, will provide banks, insurance companies, mortgage brokers and comparison sites a ‘smart’ and accurate dataset reflective of multidimensional variables which are not currently considered. By using VioScore, individuals will be able to check in on their lifestyle wellness as easily as they do their daily step count or sleep patterns. Essentially, users will receive benefits such as insurance premiums and financial deals, and the way an individual’s financial risk profile is calculated will be reformed. “Our product will bring multiple benefits, not only in boosting personal health awareness, but also flagging potentially unhealthy lifestyles, thus bringing a revolutionary approach to medical prevention, by spotting , and even catching diseases and life-threatening illnesses ahead,” says Toscano. “An individual’s credit score starts at the moment of application for credit. VioScore starts when you are born. It should be a holistic overview of someone’s life.” Contact Information

www.myvioscore.com

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How AI is transforming procurement in healthcare Vamstar CEO Praful Mehta explains how AI is altering the procurement process for the better

he field of artificial intelligence (AI) has made great strides in recent years, with the technology making its way into industries as diverse as manufacturing and hospitality. The next frontier is procurement and supply chain management in the healthcare industry, with AI set to transform the way companies source their materials and streamline the operations of their equipment. Some

Praful Mehta CEO Vamstar

“Today’s advanced technology enables a machine learning-based approach to streamline decision making”

experts predict that within five years AI will be responsible for over $300bn in annual savings, for the healthcare industry alone. Procurement Processes Just a few years ago, procurement and sourcing teams were mostly focused on negotiating contracts and maintaining relationships with suppliers. Today, these professionals are tasked with improving both their organisation’s procurement processes and their vendor networks. They are using machine learning and artificial intelligence to streamline processes and improve outcomes. For example, AI technology is being used to analyse transaction data, so patterns can quickly be identified, trends in spending can be monitored and more

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ARTIFICIAL INTELLIGENCE Vamstar

informed decisions about future purchases can be made. Other professionals rely on machine learning algorithms to understand how procurement team members view different vendors. Armed with that knowledge, they can ensure that purchasing managers get more personalised recommendations when they buy new products or services. Real-Time Decision Making Machines can assist humans in making better decisions. Supply chains are rife with variables, risks, and uncertainties - that’s what makes them exciting.

use real-time monitoring solutions to track hospital staff, patient treatment, etc. The data collected by these solutions is fed directly into AI algorithms, allowing hospitals to get insights that help improve care and reduce costs. In some cases - such as diagnosing patients - AI can help doctors more accurately pinpoint an ailment or condition and prescribe a better treatment plan for a patient. In other instances (e.g. pharmaceutical procurement), intelligent predictive analytics are used to determine when it is best to restock drugs, based on how much is left in stock and how often people need them. Data Management

Praful Mehta CEO Vamstar

“Through machine learning, neural networks are able to quickly analyse large amounts of data and recognise patterns or flags indicative of criminal behaviour” In situations where there are multiple factors to consider and limited time to do so, machine learning can provide a huge advantage. Today’s advanced technology enables a machine learningbased approach to streamline decision making and improve the effectiveness of procurement processes. Here are some specific ways machine learning is transforming procurement today: • Real-time analysis: advanced analytics allow for real-time predictions about supplier performance and risk assessment. • Better forecasting: machine learning algorithms can predict demand more accurately than humans by analysing historical data, market trends, and other inputs. Data Collection In recent years, AI and machine learning have revolutionised data collection, especially in healthcare. Hospitals can

Even with relatively small volumes of data, machine learning requires significant computational power and large amounts of data to create algorithms. You need to figure out a way to collect that data quickly and organise it, so your algorithms can learn from it. If you’re gathering medical equipment and pharmaceutical products from a variety of suppliers, for example, you need a system that will: • Work on any device (and in any language), • Collect information from all parties involved in acquiring supplies and be able to store that information long-term as well as in real-time, • Process requests as they come in without slowing down or hindering your other business processes. Fraud Detection A study by LexisNexis Risk Solutions found that pharma companies lose an average of $8.6m per year from fraudulent activity (e.g. kickbacks, misrepresenting patient eligibility). Fraudulent activity in pharma procurement can be hard to detect with traditional methods, such as a department’s own in-house processes and monitoring, because criminals go to great lengths to conceal their behaviour; using stolen identities, fake documentation, etc. One way to improve fraud detection is through an artificial intelligence program called neural network analysis. Through machine learning, neural networks are able to quickly analyse large amounts of data and recognise patterns or flags indicative of criminal behaviour. For instance, a company

that used a neural network to scan millions of invoices for signs of fraud, identified over 1,000 instances where invoice information did not match what was on file at corporate headquarters. This led to a nearly 50 per cent reduction in overall chargeback rates, within just six months. Bid Analysis By analysing large amounts of data, artificial intelligence can be used to determine which suppliers are best positioned to execute certain orders, as well as forecast and predict trends in procurement spending. Instead of having to wait days or weeks for a response from an RFP or bid analysis – sometimes not getting a response at all – companies can immediately start working with providers that were determined by AI to be optimal. With AI, companies have more time and resources available for other areas of their business, as bids are not analysed manually. B2B Trade Intelligence When applied to business-to-business (B2B) sales and marketing, artificial intelligence technology can help to develop deeper insights into your customers’ wants and needs. A machine learning algorithm can analyse thousands of variables related to prospective clients, showing what they have bought from other businesses in the past, how their spending patterns change over time, and what kinds of new products or services they are looking for. Conclusion All in all, there is a lot of room for error in the utilisation of AI in procurement; companies considering using such technologies should be aware that not all datasets are created equal. Machine learning works best when given large amounts of detailed information about individual consumers, and could struggle to provide an advantage from limited amounts of data. That said, provided that businesses make a commitment to using AI both now and in the long-term through managing their data correctly, the benefit of AI can be truly limitless. Contact Information www.vamstar.io

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n 2017, 18.5 per cent of the UK population was over the age of 65 and 2.5 per cent were over the age of 85. By 2050 nearly one in five people in developing countries will be over 60. Health needs and expectations of this group will be significantly different than those of previous generations. At the same time, chronic and lifestyle-related diseases are on the rise, and healthcare services are struggling to keep up with the consequent accelerating demand. In the UK, the 2019 NHS Long Term Plan has called for action on prevention and a focus upon mainstream digitally-enabled care. The aim is to deliver a ‘new look’ service, embedded within communities. This could range from assisted living, self-care, tele-care, and tele-medicine within a single housing unit, to multiple units supported by social care services, nurses, doctors, physiotherapists,

occupational health visitors, psychiatric nurses, and local pharmacists. Technology and communication networks can help alleviate overburdened healthcare systems by providing clinical tele-health and tele-care services to people on demand. Companies such as Amazon, Google, and Microsoft are already establishing their digital presence within

Richard Mazuch Director of Design Research and Innovation IBI Group

“New spaces must be flexible and agile to adapt to ‘ageless’, ‘multigenerational’, and ‘multi-morbidity’ scenarios”

our homes and it’s not hard to imagine this infrastructure enhanced by tele-healthcare services. With high definition video telehealthcare systems, doctors and nurses will be able to hold virtual consultations with patients or remote from hospitals in a “virtual ward” scenario. Already, there are successful examples of real-time clinical tele-health services such as tele-mental health, tele-audiology, and tele-nursing that use monitoring sensors to capture and transmit physiological data. This shift will also see a rise in salutogenesis, an approach that focuses on factors that support human health and wellbeing not only within the community, but also in the homes of tomorrow. In order to best design the home care services of tomorrow, the ageing process, body systems maturity, human physiology, and sensory receptors must be understood alongside the comprehension of related medical issues, morbidity levels, and salutogenic needs. However, to address the health and wellbeing issues of today and tomorrow, traditional perceptions of what constitutes “home” will have to be dismantled, reinvented, and reconstructed. These new spaces must be flexible and agile to adapt to ‘ageless’, ‘multigenerational’, and ‘multimorbidity’ scenarios. Ergonomic and anthropometric data can be used to help design a supportive home with fabrics, finishes, equipment, and devices designed to accommodate the ageing body – and its predicted postures,

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INFRASTRUCTURE IBI

Ergonomic and anthropometric data helps the next generation of elders to age in place

movements, weight, size, properties, and cognitive abilities. Design tools such as virtual reality, augmented reality, and a ‘sense-sensitive’ approach will help ensure successful design outcomes. Assistive design and technology interventions do not have be disruptive or expensive. Correcting diurnal temperatures, colourways, bedside dimmers, bed inclination, amber illumination, bed/WC orientation, and biophilic design (using natural resources to create a sense of harmony between modern architecture and the natural world) are all examples of lowbarrier interventions.

Alternative solutions are available as well, though they tend to be more costly. Examples of these include medical bedheads, sensory doors, body driers, robotics, thermal responsive shower heads and tiles, smart floors, LED WC seats, smart oxygen delivery, night-time hydrants, LED pillows, axo suits or exoskeletons, Toto WC/Bidets or water-spraying shower toilets, ODE emitters and Tomek fittings. While there are many challenges facing healthcare systems, today’s rapid technological advances offer us a solution to provide new and innovative forms of healthcare services that can improve what’s currently available. If we embrace today’s challenges and deconstruct, reconstruct, and reboot them with a focus on health and well-being, the homes of the future could well alleviate the pressures that our current healthcare systems are struggling with. Contact Information

Digital tools enable healthcare services to be more personal and socially-minded.

richard.mazuch@ibigroup.com www.ibigroup.com

Richard Mazuch, Director of Design Research and Innovation with IBI Group, is an architect and designer. An authority on healthcare, Richard provides profound insight into designing for global trends, patient groups and clinical provision. Richard has worked on healthcare projects in Hong Kong, Brazil, Oman, UAE, and Australia. Elected as a World Architecture Jury member, he is a University lecturer/examiner and speaker at International Conferences. Richard has worked extensively with the NHS, contributing to Health Building Notes, Health Technical Memorandum, NHS guidelines for ‘Evidence-based Design Healthcare Environments’, and co-author of three NHS Paediatric Guideline documents. Sense sensitive design, emotional mapping, and the design prescription are a few of the models that Richard has successfully pioneered.

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orking for a charity hospital is quite unlike working anywhere else. Mainly because we fundraise £3.4m every year to provide extra services for our patients and

residents, who are often with us for a long time, so this becomes their home. Our patients must come first and so capital projects that directly impact their care are naturally prioritised. Although we have made some

significant investments in infrastructure over the last few years, we have never managed to make the leap, until recently, from using paper-based records and work processes. We had to get an EPR platform that was the right fit for our organisation. EPR projects are notorious for overspends and delays – something that we, and many other organisations, know all too well. Even at RHN, over the past 20 years, there had already been two separate attempts to digitise patient records. So, in spite of our clear

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TECHNOLOGY PatientSource

Toby Roberts Associate Director of Information & Technology Royal Hospital for Neuro-disability

“PatientSource understood us, and we understood them; we were as important to them as they were to us”

willingness to move away from paper, you can forgive our trepidation for attempting the switch for the third time. But, eventually, we did. You see, at the RHN, our patients have complex needs: many of them unable to communicate or speak, and many of them are on significantly more medication than your average hospital patient, with staff managing between 30-40,000 drug interactions per month. And while incidences of drug errors are generally very, very low, any incident is one too many.

So, we turned to PatientSource. The fact of the matter was, we simply couldn’t afford a bigger-name solution. And so, despite being a fairly young SME, PatientSource was a less risky option for us. The initial outlay was cheaper, and it didn’t require any extra specialist hardware or apps – all it required was a web browser. But aside from cost-savings, we also realised that there were more benefits of working with an SME, benefits we hadn’t previously accounted for. Number one: they genuinely cared.

From the beginning, PatientSource worked closely with our team at the RHN to ensure its technology met all of our specific requirements – many of which were unique due to the complex needs of our patients. They also provided full training, and they were even on-hand to provide support in the week that the system went live on the wards (physically moving into the hospital). To be physically there, showing staff how to use the system, and creating bespoke functionality based on the feedback they were receiving, on the frontline of care, would simply not have happened with a ‘big’ EPR provider. PatientSource understood us, and we understood them; we were as important to them as they were to us – and that made for the perfect partnership. But what about the results? Well, unsurprisingly, they’ve been positive too. In fact, within just one month, we noticed the positive impact of the PatientSource e-prescribing module, with prescription errors reduced by 83 per cent (from six incidents in April 2018 down to one during April 2019). So why is there such reluctance elsewhere to take a punt on ‘unproven’ suppliers? Well: “You won’t be sacked for buying EPIC or Cerner”, so the old trope goes. But while this may be true, by ignoring SMEs, you’re only limiting your digital potential. So many SMEs have so much to offer and, from our experience, you won’t be disappointed. Contact Information

www.patientsource.co.uk

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Creating next generation health insurance Meeting the needs of today’s society can be achieved through organisational agility, says Aron Thompson at PA Consulting

ith people wanting to stay healthier for longer, society is demanding that health insurers play their part in this effort. Customers expect their insurer to collaborate with them in staying healthy, addressing their medical needs in new ways, and engaging them using a variety of new channels. This gives health insurers an opportunity to devise novel, preventative products and services made available through modern technologies to become a healthcare partner to their customers. The prize is worth it. Helping customers make positive life choices to prevent long-term, chronic illness offers insurers a substantial opportunity to grow and diversify their customer base to improve

underwriting profit while also reduce operating costs as customers transition to digital channels. All of which will have a positive impact on an insurer’s combined operating ratio while mitigating the risk of disruption through new market entrants and disintermediation. Organisational agility In creating next generation health insurance, insurers will need to challenge themselves to re-imagine how they engage customers from the beginning to the end of the product lifecycle. They will also have to look at how they contend with the challenge from digital disruptors and how they create an end-to-end digital and agile

operating model that enables them to deliver relevant products to market faster. We refer to this paradigm as organisational agility. Some research carried out by PA Consulting shows that there are 5 key characteristics of insurers who have successfully created end-to-end digital and agile operating models. These insurers: 1. Centre on their customers: By bringing customers into the new product and service development process (e.g. personalised product pricing and coverage terms or new customer acquisition or service channels) they can harvest and respond to customer feedback in a direct and inclusive way. Customer centricity makes it much easier to trial new innovations and prove their value, pivoting ruthlessly away from products and services customers do not want. 2. Focus on speeding up time to value: Simple measures, such as lead time to market, ensure focus on simplifying

CONSULTING PA Consulting

collective agreement as to why they want to change in a unanimous, unshakeable, and tangible way. They must then create the conditions of success from the outset. Ensuring your company has the right culture of curiosity for agility to blossom, lining up supporters and determining how you are going to measure and communicate progress is key. Without these factors success will be unachievable. Meeting the needs of today’s society

Aron Thompson Agility and Financial Services expert PA Consulting

“Customers expect their insurer to collaborate with them in staying healthy”

processes which get in the way of speed in delivery. Breaking work down into smaller achievable parts helps people focus on what is most urgent and important, thereby delivering quick and simple solutions which meet customers’ needs and can then be enhanced in an iterative and incremental way. 3. Design for simplicity: Align people, process and technology around the value the insurer delivers through virtual long lived delivery teams, not around what employees do within

specific functions (e.g. distribution, marketing or technology). 4. Build to evolve: They recognise that a learning-based, evolutionary insurer is the key to success. They create an environment where people work in alert, responsive and dynamic teams, able to adapt to changing competitor activity and customer needs, while also learning from their own internal data points. 5. Liberate their people: They offer a clear and inspiring sense of purpose to create a sense of inclusion and commitment. They publicly recognise and reward people who step outside their organisational boundaries to collaborate with others to get the job done, making them the leaders of tomorrow. Achieving maturity in these characteristics takes time; organisational agility is a journey not a destination. Leaders must start by building unanimous top team commitment, so they are in

Creating organisational agility touches many functions and internal capabilities. There will be times when making design compromises seems like the right thing to do in the interests of speed of change, compromising with colleagues on the extent of the re-design and its corresponding operating model. However, this can often result in watering down critical elements which leads to fragmentation and inefficiency. Finally, accepting that tomorrow’s leaders will be different to today’s will help break down traditional habits and fiefdoms and embrace bright pioneers of your future success. These will be the leaders to evolve your business to create the next generation of health insurance. There are some insurers embracing organisational agility that have seen the benefits first hand. For example, a leading global health insurer identified that its customers wanted preventative healthcare, wellbeing and health management. It set out an end-to-end digital and agile operating model, which considered 4 key lenses – customer experience, technology, delivery and operations. This is helping them to deliver a £25m per annum net profit uplift. Insurers who recognise organisational agility as a keystone to creating next generation health insurance will achieve two outcomes. Firstly, they will put valuable products and services more rapidly in the hands of their customers. Secondly, they will evolve their business to be simpler and more effective, thus able to rapidly meet the changing needs of their customers and society. Contact Information

www.paconsulting.com/agile

Opinionated

Steve Gardner Managing Director

Joining the dots

s I write this piece, I’m contemplating my trip to Helsinki for HIMSS22 Europe. It’s a city I have never visited, and perhaps may not have done, but thanks to the conference I’m about to get to know it. Finland is already miles ahead of other countries in their vision for healthcare, and it has plenty to show us in terms of digitisation and interoperability. These two concepts lie at the heart of the future of healthcare - a digitally integrated, global healthcare system that connects us all. It’s our first time as media partners at HIMSS - I had hoped to be in Orlando in March but COVID had other ideas. I’m really looking forward to a packed programme of sessions talking about the ways in which digital healthcare can be used, implemented and delivered. I’ve written before about the need to change the point of delivery of healthcare from the healthcare facility to the home and through digital channels. The establishment of Accountable Care Organisations (ACOs) in various health 80

economies and Integrated Care Boards in the UK are examples of moving in the right direction. Taking the power out of the hands of individual institutions or large hospitals and putting the funding within the remit of a body that looks holistically across the health system makes absolute sense. But in established health economies this comes with challenges; there is an existing order, the big general hospital is used to ruling the roost. A move towards smaller and more specialised infrastructure with proper funding diverted to digital solutions, population health management and a cross system in a data-led delivery model will likely be met with resistance. From the theorist perspective, it’s interesting to play ‘fantasy health systems’ and imagine how we would build a new, modern, digitally connected health system from the ground up. Or you can go to the Kingdom of Saudi Arabia and actually do it. Vision 2030 has been around for a while, but it’s now really starting to move and the development of the 21 regional health

‘clusters’ in the country has proved to be a watershed moment. The clusters are the ACOs and they have been empowered to bring together a public health system which will integrate across its region, building an interconnected set of facilities with common data infrastructure, integrated digital and personal care records, true population health management and the right funding to do it all. As a colleague in the UK said to me the other day, it’s like they’re building a brand new NHS from the ground up. The progress they have already made is remarkable and after years of discussion and exploration they now really seem to be motoring in terms of delivering the most ambitious and fascinating programme of healthcare reform anywhere in the world right now. Saudi seems to be the hottest opportunity on the planet in healthcare right now and Healthcare World is expecting to spend a lot of time there in the next 12 months.

You wouldn’t spend 10 times more than you had to on something simple… Would you? Because this is happening in our hospitals, every day. AdviseInc bring transparency and clarity to spend in the healthcare system. Using the latest tools we give every hospital the ability to understand pricing and control once hidden costs. AdviseInc, make sense.

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To Solve. For Good.

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Healthcare World Magazine | Issue Five

Articles inside

Tomorrow’s Home: A Salutogenic Role in Health Management

Putting faith in an SME

How AI is transforming procurement in healthcare

What’s your score?

Fixing the little things

UAE health data localisation in 2022

Notes from a Modern GP

The value of patient feedback

Telemedicine, connectivity and the fly in the ointment

Changing times

The global language of healthcare

A digital prescription for making

Delivering capacity through digital

Ensuring clinical excellence

The Evolution of Healthcare Infrastructure

Time to consult

Breaking the mould

The need for standardising healthcare recruitment in the digital age

News

Can digital really solve the workforce problem?

The International Affiliate Network

Collaborating for Digital Solutions

The next generation of health and care technology: HIMSS22 Europe

Patient identity management and the future of consumer-driven healthcare

Finding hidden value in the data

Building intelligent hospitals

Radar Healthcare rolled out across the UAE in 90 locations

The ultimate end-to-end pathway

HIMSS 2022 Europe - Leading the digital health debate

Editor’s Welcome