Dr Bahman Nedjat-Shokouhi, chief executive and co-founder of Medefer, talks about how the health service can increase flexibility within the workforce through technology
For a national grid-style model to be successful, hospital IT teams must find a way of integrating data and creating unified workflows
The COVID-19 pandemic has highlighted the opportunities digitalisation can bring.
From electronic prescribing records (EPRs) and virtual wards, to artificial intelligence (AI); investment in these technologies is helping to alleviate clinical pressures, improve efficiencies, and, most importantly, provide better care for patients.
Modern healthcare systems simply cannot operate without a complete overhaul of their systems – and finding the right solutions, and partners, to work with will be critical to successful digital transformation.
While progress has been made in tackling the UK’s waiting lists, there is still a long way to go to get the healthcare system back on track.
We saw earlier this year that the UK Government has outlined a plan for digital health and social care, aiming to build solid digital foundations for the long-term sustainability of health and social care – a step in the right direction as the NHS continues to battle the backlog and face new challenges.
And, with the introduction of Integrated Care Systems (ICSs), the NHS has an opportunity to adopt a ‘national grid’ model.
Just like with electricity, multiple hospitals will be asked to work together.
Virtual solutions can connect an entire ICS, or region, with hospitals effectively becoming the power stations.
This model could be utilised where specialist care is distributed from clinics with more capacity to hospitals with larger waiting lists, not only increasing capacity within the NHS, but also enabling patients access to specialist care faster.
If you look back at the way the NHS has evolved – trusts all over the country adopt various systems and technologies at different pace and times, so it is difficult to have a single approach that can be adopted nationwide.
Alongside this, interoperability is an issue as many systems were not originally designed to work together, particularly when constructed and provided by different vendors.
Nowadays, a lot of the healthcare data have standards, and many systems do not match those standards.
Virtual solutions can connect an entire ICS, or region, with hospitals effectively becoming the power stations
For something like a national grid model to be successful, hospital IT teams need to find a way of integrating that data and creating unified workflows. There also needs to be clear understanding of basic infrastructure to pinpoint what needs upgrading.
Another challenge is governance.
Prior to the pandemic, the NHS was hesitant to partner with private providers and allow them to run clinical services, due to obvious issues with data protection and clinical governance.
But, while the pandemic made it necessary for the NHS to be more collaborative with a wide variety of partners, there remains hesitancy for those same reasons.
Additionally, given that the healthcare sector is highly regulated, there is an issue of how to manage the safety of doctors using these virtual services from home or another non-clinical setting. Therefore, a governed process involving national hospitals and consultants is needed for virtual services to be successful and compliant.
The benefits of digital transformation in healthcare are only truly achieved when there is seamless integration between digital and physical care.
There are technologies out there that are transforming the way outpatient care is delivered.
Some are focusing on the initial triage of the referral, providing advice to the GP.
And, at Medefer, we have introduced a novel approach for outpatient care.
Using technology to remove inefficiencies and to make consultants more productive, over 70% of patients can be managed safely without the need for physical outpatient clinics. This, in turn, frees up much-needed physical capacity so patients who cannot be managed remotely can be seen in person, much faster.
The traditional model of an outpatient centre involves consultants spending a lot of their time in clinics managing patients through in-person appointments.
With the continued pressure on clinical capacity, virtual services are crucial in alleviating this issue by making better use of previously-lost time.
Firstly, consultants can manage patients remotely, in different geographic regions, without needing to spend time travelling.
For something like a national grid model to be successful, hospital IT teams need to find a way of integrating that data and creating unified workflows. There also needs to be clear understanding of basic infrastructure to pinpoint what needs upgrading
Secondly, consultants can utilise small pockets of time that, until now, they were not able to use to deliver care – for example while travelling or inbetween face-to-face appointments.
This approach increases the overall clinical capacity available to healthcare systems.
A key part of the new Digital Health Bill is to improve the experience and impact of people using services, as well as to prevent people’s health and social care needs from escalating.
In addition to providing much-needed additional clinical capacity, the Medefer platform is already beginning to address issues like health inequalities by offering specialist care access to communities in more-isolated or rural regions.
An example of how a national-grid-type approach could work is shown by our partnership with the North East London Integrated Care System – NEL ICS, formerly known as Barking, Havering, and Redbridge Clinical Commissioning Group.
This partnership began long before the pandemic, when the trust was facing significant waiting lists for its gastroenterology department, and so it enlisted Medefer to help alleviate the backlog and transform the care pathway.
We built a gastroenterology virtual hospital to help manage outpatient services throughout the pandemic.
Through the platform, review times were reduced to 36 hours, which is a considerable difference compared to the national average of a 13-week wait for an initial consultation.
Patients who needed more-urgent care were upgraded to two-week treatment pathways, and those who did not need further support received advice and next steps virtually, removing the need for an in-person appointment.
By working closely with all the stakeholders to manage patient pathways, the waiting list has been reduced to less than five weeks, helping to improve clinical capacity and patient care.
As the NHS continues to work tirelessly to tackle the backlog and futureproof the health system, it is important that it finds the right partnerships and technological investments
Importantly, despite lockdown and hospital closures during the pandemic, patients were still able to access specialist healthcare, contrasting with much of the rest of the country.
This is demonstrated by the fact that Barking, Havering and Redbridge University Hospital NHS Trust has been the only hospital in the country without significant waiting lists in gastroenterology.
As the NHS continues to work tirelessly to tackle the backlog and futureproof the health system, it is important that it finds the right partnerships and technological investments.
Modern, digital-savvy healthcare systems that are patient-focused must adopt new and agile approaches to ensure the future of care.
By embracing systems that can change the model of care, and improve patient-doctor interactions, it will not only help solve workforce issues and improve patient care, but also secure the long-term future of the health system