NHS IT chiefs set the stage for a year of digital transformation as Digital Health Rewired returns to London
Brandon Cross Technologies
Justin Cross, MD at Brandon Cross Technologies is a highly experienced IT consultant and software developer. He shares his insights regarding how new technology can not only impact the NHS and private healthcare providers but how they can really make it work to their advantage.
Do you have a headache?
Most organisations face many challenges. People are often overstretched doing time consuming and repetitive tasks. Your IT systems should be making your day easier. But often they don’t do what you need them to do and they can become slow or unreliable. You need to be able to access information quickly and easily. You need to manage and schedule human and medical resources. You need to communicate quickly and efficiently.
Does this sound familiar? Probably, but IT departments are often overstretched just keeping existing systems running and up to date, making it difficult to deliver real change. But it can be done. At Brandon Cross our goal is to understand the headaches you are currently having and find timely and cost-effective solutions, creating the possibility for real transformational change.
What is “Digital Transformation”? A good starting point is the dictionary.
“Digital” – “Recording or storing information as a series of ones and zeros…”
“Transformation” – “a complete change in the appearance or character of something or someone, especially so that that thing or person is improved”
It is what you would naturally expect it to be, nothing more. You may be starting from non-digital systems – paper, forms, photographs – or from existing yet inadequate computer systems.
Scanning and storing information such as X-rays, medical records or other paper documents can be ‘transformational’ in that your ability to access it, transmit and reference it, can be made more efficient by orders of magnitude. Everyone, with appropriate authorisation, can access what is needed, when and wherever it is needed, and add additional information along the way; perhaps with an audit history of what was created or added, when, and by whom; as is often necessary for privacy, security and compliance purposes.
Even if you have already completed the digitisation process, there is still much to gain from newer enabling technologies. Older legacy systems and disparate, disconnected databases can be transformed into services which streamline your operations by bringing all the information you need together at the point of use. Previously fragmented information can be brought together, with new capabilities added, to be able to find, update and share information. Systems can be web enabled to work on any computer, laptop or tablet, removing your dependence on specific desktop configurations.
This process of transformation, if not done correctly, can be disruptive, requiring large budgets and teams, taking considerable time to implement and bring into routine use. This is not unusual, and causes unnecessary stress to all concerned, including front line workers, managers and budget holders; particularly in an already pressured environment. But it need not be that way.
Evolution vs. Revolution
Most off the shelf systems require transforming data from the old systems and transferring it to the new system. Consequently, old systems usually have to be decommissioned, staff have to be retrained, teething problems dealt with, potentially during live operation impacting staff and patients alike. Once completed and bedded down everything should be plane sailing; but that takes time. This can be the right strategy, but projects can be long, risky and complicated. You need to be very sure you have made the right choices in terms of technology and implementation partners.
An alternative approach is to create systems which can work with and alongside existing systems, so that your entire ecosystem doesn’t have to change overnight. Old systems continue to work, while new capabilities can streamline processes to improve productivity. Staff can be trained progressively, and any teething problems are easily managed. Furthermore, running pilot projects to test capabilities and gain feedback can be done allowing improvement and enhancement before rollout out of any new system across the organisation.
This approach has several benefits. Adoption of new technology is no longer disruptive. A new system doesn’t have to be able to do everything that your older system did on day one. Certain activities may continue to use the old system, at least for a while. This can significantly reduce the time-to-value; the time it takes to begin reaping the rewards the new system has to offer. Projects which might otherwise have taken years to deliver can yield benefits much sooner. Investment can be phased and managed, significantly reducing risk. This also provides greater flexibility to steer the course through an ever-changing technology landscape.
Opportunities in Technology
Technological advance is accelerating. This is both a blessing and a curse. The cutting edge provides us with capabilities which could not have been dreamt of, even just a few years ago. But we have to manage and compete, so we have to keep pace with the rate of change, discern the reality from the hype, decide when is the right time to adopt a new technology and, just as importantly, take the necessary steps to dispense with the old.
IoT (Internet of Things), Blockchain and Artificial Intelligence are things which are frequently referenced as suppliers attempt to present themselves as the most cutting-edge innovators. Each technology has its place and purpose, but you should not be using technology for the sake of it, but only to achieve the benefits and efficiencies required.
IoT is useful for logistics applications and smart home devices. In the context of healthcare wearable devices promise enormous potential, although to put it simply we are just talking about data collection devices – the main advance being portability and reduced size.
Blockchain enables an industry to work safe in the knowledge that shared data cannot be tampered with inappropriately by malevolent actors. It is very useful to ensure certificates, contracts and other records cannot be falsified; but only where there is no central, trusted authority to oversee it.
Artificial Intelligence is currently having a significant revival; largely due to advances in Machine Learning and the accessibility of the large computational power now available through modern hardware and cloud services. Artificial Intelligence and Machine Learning are often confused as being the same thing, when in fact AI is a much broader field. And, like any technology, one sized does not fit all and it’s important to understand the options available and to focus on the real-world benefits that can be delivered.
In general AI is poorly understood. This is in part due to the deeply technical nature of the technology and uncertainty about converting such cutting-edge technology into real world benefits. This is not helped by some ill-informed conversations in the media overstating its practical real-world capabilities and its potential for world domination! But what is it really?
Neither AI nor Machine Learning are particularly new. The term ‘Artificial Intelligence’ was first coined, by John McCarthy, way back in 1955! AI has a long history and many of the concepts from decades ago are still just as valid and applicable in today’s systems.
Machine Learning and ‘Deep Learning’ have progressed significantly. Borrowing ideas from neurobiology, these are about processing large sets of data in order to be able to match example inputs (e.g. images or an encoding of clinical symptoms) to known outputs (e.g. the positive identification of a cancer, or the classification of a disease from a set of symptoms). This can have significant benefits where large clinical data sets are available.
AI also includes other forms of ‘intelligence’, some of which we now take for granted such as language translation, number plate recognition, navigation, conversion of speech into text, or text to speech. AI can also be used for complex planning and problem-solving tasks, language comprehension, interactive dialogues and other tasks that require knowledge and reasoning. Such systems can all reduce the burden on human resources.
A particular sub-category of AI called ‘Expert Systems’ uses knowledge, often encoded as a set of rules, to allow a system to perform reasoning tasks and reach conclusions in specific areas of expertise. MYCIN was an early expert system developed in the 1970s at Stanford University, which encoded about 600 rules to allow it to identify bacterial infections and recommend antibiotics.
Modern AI systems are now used across many industries, to provide customer service solutions; solving customers problems either directly through the web or mobile Apps, via voice, or mediated by call centre agents ensuring every agent works consistently using the latest information.
Planning for Success
Any significant project will have numerous stakeholders, from chief executives and finance directors to auditors, clinical staff and IT managers, all bringing their own perspectives. It is crucial to having a full understanding of the environment in which a system is to work, including people and organisational units, policies, processes and procedures, and the technology already in use. It should also be borne in mind that these things are not static but change over time.
Large projects often fail because they take too long to deliver, by which time the requirements, environment or technology have changed. Systems therefore need to be delivered in stages and built to be more adaptable using multiple independent, loosely coupled components, rather than a single monolithic solution dependent on a single supplier.
Brandon Cross Technologies have the experience required to facilitate successful project delivery, which requires not only the ability to follow a process, but people skills, the ability to envisage alternative solutions, achieve compromise, and foresee, avoid and overcome technical obstacles. The technology is important, but the people and partners you work with are more important.
Contact us to find out more.