Richard Strong, managing director, EMEA, Allscripts, argues trusts boards should be “very positive” about the health tech response to the first wave of covid-19; but they need to act now to secure recent gains for the NHS reset.
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As we emerge from the first wave of the response to the coronavirus pandemic, there is a lot of talk about the “new normal”. I’m not a big fan of that phrase; it implies that we will be going back to the way things were with just a few changes, some of them for the worse.
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I prefer the idea of a “reset”; because it suggests that we can look back to what we were aspiring to achieve before covid-19 and use the best of our response to the pandemic to deliver on it.
In that context, it’s clear that there are some key tenets of the NHS long-term plan that are going to be important going forward. These include the aspiration for a more integrated health and care system that can wrap services around the patient and give individuals more say in their own health and wellbeing.
In IT terms, this translates into acute services that are supported by electronic patient records at a high level of digital maturity, into healthcare economies that can share information for population-level planning and delivery, and into digital communication with patients using the devices we all use in other areas of our lives.
Covid-19: a step change in health tech deployment
If we take the NHS long-term plan as a baseline, it’s clear that during covid-19 there was a rapid shift in some of the health tech required to deliver on it. There was a rapid roll-out of Microsoft Teams to support remote working and of platforms to support virtual clinics and consultations.
As a company, Allscripts also saw customers push ahead with planned deployments. Gloucestershire Hospitals NHS Foundation Trust “held its nerve” to go-live with the e-observations component of our Sunrise Acute Care EPR so it had full visibility of the covid, oxygen-use, and NEWS2 status of its patients.
While The Dudley Group NHS Foundation Trust accelerated its planned deployment of our dbMotion population health management platform to give its clinicians access to patient information from GP and other systems.
Sustaining the change: questions for boards
If we are going to sustain the “pivot to digital”, boards need to reflect on these developments. The roll-out of remote working and virtual clinics was driven from the centre, using time-limited free licences. Boards need to be asking whether they got the right tools and, if they did, how they can be efficiently integrated into clinical workflows.
Boards also need to be asking whether they have the systems they need to manage future covid peaks, so they can move out of reactive mode and think proactively about meeting NHS long-term plan commitments; which will mean asking whether there are systems in place to share information across their integrated care system and with patients.
Our “clinical wrap” approach and UK blueprint support this kind of thinking, because they enable trusts to retain their patient administration systems while adding the clinical functionality that is most important to them. We are doing the integration piece with Teams and virtual consultation platforms, and we can support information sharing across healthcare communities.
The Dudley Group has done that using dbMotion, while Gloucestershire Hospitals has worked with us to give GPs access to Sunrise from their desktops.
One obstacle is that we do not know how funding will work in the future. However, Allscripts has developed a subscription model that removes the need for capital funding, as well as a UK blueprint for implementation designed to remove legacy systems that don’t deliver clinically-engaging functionality and are expensive to run.
Now is the moment to be positive, but also to reflect
Over the past few months, we have seen a step-change in IT adoption across the NHS, which has in turn delivered a step-change in clinical engagement.
If I was sitting on a board now, I’d be feeling very positive about all this; but my advice to people who are sitting on boards is that they need to think now about how to secure those gains, stop barriers going up again, and have a plan to secure the systems that will make technology part of a new normal that is very much better than the old normal.
