Information and Communications Technology in the NHS Transforming the Patients Experience of Care European Commission Alasdair Liddell – Kings Fund 20.

Information and Communications Technology in the NHS

Transforming the Patient’s Experience of Care

European Commission

Alasdair Liddell – King’s Fund20th July 2010

Two studies

• Fathom Partners for OfCom (March 08):

– What will the health sector’s requirement for wireless spectrum be in 20 years’ time?

– Scenario planning project

– ofcom.org.uk/research/technology/research/sectorstudies/health/

• ?What If! Innovation for the King’s Fund (Nov 08):

– What are the barriers to delivering the ‘best’ scenario from the OfCom report, and how might they be overcome?

– kingsfund.org.uk/research/publications/technology_in_the.html

10 April 2023Alasdair Liddell Page 2

Definitions


• My focus today is consumer-facing technology

• Technology enables, but the real issue is innovation

• Innovation = invention, incubation, adoption, adaptation and diffusion

• The NHS is very good at invention but very poor at diffusion

• To realise the full benefits of technology, there almost always have to be fundamental changes in ways of working, roles and service models

• Healthcare is lagging behind other sectors in its use of consumer-facing technology

• There are significant economic, clinical and quality benefits from greater use of technology

• But there are also significant barriers to technology uptake in healthcare

• What needs to be done? Some ideas…

• But it’s difficult. What do you think?

Key Points

10 April 2023 Alasdair Liddell Page 4

Other sectors’ use of technology

• Shopping

• Banking

• Holidays, travel

• Entertainment

• Information

• Social networking

• iPod apps

• etc10 April 2023 Alasdair Liddell Page 5

Individual – anywhere Home

Ambulance

Hospital / GP surgery

1. Healthcare technology applications

Settings for ICT applications



Individual – Anywhere Applications


Theinterfacing

ofa patient’s

record and /or Body

AreaNetwork toequipmentassociated

with theambulanceor onwardsto a distant

location (e.g.

hospital)


Ambulance Setting Applications


Videoconferencing


Home Setting Applications



Hospital, Polyclinic, GP Surgery


Better clinical outcomes

Achieved through:

Increased patient engagement

Better continuity of care

Reduction in medical errors

Emphasis on prevention and healthy living

Health information web sites and devices (e.g. nutritional scanners) help consumers make better decisions about living healthily

Telecare and telehealth prevent unnecessary interventions

Improved patient experience

Improved access to information

Administrative and transaction tasks are easier

Monitoring and alarm devices can help people sustain an independent life at home

3. Key benefits

Benefits of technology adoption


Benefits to society

Improved health in society = more economically productive society

More efficient use of resources – benefits health service, patients and society

Enables care closer to home

Effective use of information and technology brings peace of mind to patients, family and carers

Meet challenges faced by the health sector

More demand for health services – changing demographics

Technology enables more efficient use of resources

Clinicians can treat a larger number of patients (e.g. videoconferencing, telecare)

3. Key benefits

Benefits of technology adoption


Product development

and marketing

Implement-ation

Use by consumers

Decision to purchase

Idea

Decision to develop

Decision to use

SuppliersCommissioners and consumers

4. Technology adoption process

Decision pathway for technology adoption

Clinicians and consumers


4 models for technology adoption

Consumer awareness and understanding

Consumer concerns

Consumer activism and empowerment

Demographic changes

Internal factors

Policy

Structures to encourage adoption

Procurement and decision making

Information sharing

Leadership

Resources: funding and

people

Trials and assessment

Decision to develop

Demand

4. Technology adoption process

Factors affecting technology adoption

External factors

Technology standardisation

Engagement between suppliers and NHS

Investment case

Funding

Supply

Decision to buy

Decision to use


5. Barriers to adoption


The barriers to adoption

• Lack of (the right kind of) national leadership

• Few incentives for clinicians and commissioners to adopt technology

• The NHS is difficult to sell to

• Costs and benefits fall in different places

• Procurement is often least cost, not best value

• The change management consequences are disruptive



Case study - Warfarin

• 1m people on long-term anticoagulation therapy

• Control of this therapy requires 4-6 weekly blood tests, and adjustments to dosage, requiring visits to hospitals or clinics

• A self-monitoring device has been on the market in the UK for 16 years, but only 18,000 are in use

• This means that 98% of the anti-coag population are submitting to hospital/clinic tests

• Self-monitoring is clinically more effective, more convenient, and probably cheaper



Why?

• Not enough focus on the total patient experience?

• Misguided reliance on ‘push’ strategies

– web-sites and other information sources aren’t sufficient to ensure diffusion

– There is no incentive for inventors to disseminate and sell-in their innovations

• “Pull’ strategies require system incentives to be in place

Our recommendations

• Leadership from the centre, and locally– Actively to encourage, support, enable and reward

– Technology needs to be integral to policy development

– Procurement procedures need to be changed

– More coordination between national agencies and budgets

• Convenience is an outcome – measure it!• Links with and advice to industry to help them make

the compelling case• Create consumer demand• Target the ‘most likely’ consumers first


NHS Financial Context

• The financial challenges facing the NHS may provide a stimulus for a more entrepreneurial approach to innovation

• Will the financial pressure be enough to motivate commissioners and clinicians to ‘pull’ innovations into their own care setting?

• Will the ‘system’ allow the necessary tolerance of failure that is an inevitable part of innovation?

• The key interfaces for maximum benefit are hospital/community, health/social care and patient/system


What do you think?

Alasdair Liddell

[email protected]


Information and Communications Technology in the NHS Transforming the Patients Experience of Care European Commission Alasdair Liddell – Kings Fund 20.

Documents

technology technology

alasdair liddellpage

demographics technology

technology uptake

communications technology

technology adoption

greater use of technology

use of consumer