​Cloud-first, mobile-first: Can this ambitious tech plan fix the NHS?

Cloud, artificial intelligence and voice-activated assistants all get a mention in new NHS tech vision.
Written by Steve Ranger, Global News Director

New rules for tech in the NHS are on the way. But without any more money, will they make much difference?

The NHS needs to create a modern technical infrastructure than it can use as the basis for investing in new digital services, according to a new plan that envisages a health service able to harness technologies, such as artificial intelligence and Amazon Alexa skills.

"A modern technical architecture for the health and care service has huge potential to deliver better services and to unlock our innovations," said Health and Social Care Secretary Matt Hancock. "We want this approach to empower the country's best innovators -- inside and outside the NHS,"

Patients assume the health service is a single entity, but it's actually made up of many different parts -- hospitals, GP surgeries, care homes, pharmacies, community care facilities, and more. All use different computer systems and standards, which makes it hard to share even basic information. Messages and records are often missed or lost, which means poor patient care, frustrated staff and wasted money, while people are frequently discharged from hospital without sufficient or accurate information about their care needs.

"We need to replace legacy architectural decisions to keep up with modern technology," said the Future of Healthcare policy paper published by the Department of Health and Social Care. "Interoperable, connected health information in other countries has shown cost- and time-saving benefits, including enhanced care co-ordination and a reduction in unnecessary diagnostic testing."

SEE: Exomedicine arrives: How labs in space could pave the way for healthcare breakthroughs on Earth (cover story PDF)

The report said that digital services should all be made available in modern browsers using open web standards -- this is standard for most organisations, but a novelty in the NHS.

Doing this would free up doctors to choose devices that meet their needs and open up the NHS ecosystem to more developers. It will also help as the NHS moves to a mobile-first approach, making services easily accessible from mobile phones, tablets and laptops.

The report also said the NHS should be internet-first -- adopting internet standards and protocols for networks and digital services -- and public-cloud first. Going cloud-first should cater for more resilient and larger-scale services with large amounts of data or unpredictable processing needs, while commodity services like word processing would be continually upgraded and improved, without the need for massive migration projects.

Alongside the vision piece is a more down-to-earth set of standards from NHS Digital that will formalise the way IT systems talk to each other, to allow digital services to be built across the NHS -- connecting details of a patient's hospital stay and GP care, for example. Any system failing to meet these standards will be phased out, the Department of Health and Social Care said.

A global centre of health tech?

The report sets out a number of examples of when it will know that the tech modernisation project has achieved its goals -- a healthy person using wearables and diet-tracking apps to co-ordinate with their GP about targeted preventative care, or someone with a long-term condition finding a variety of supportive apps and technologies to meet their needs, for example -- and that the UK is the global centre of health tech and is exporting expertise abroad.

It even hopes to progress so far that a developer with an idea for a digital health tool "will migrate to the UK because this is the best place to build it". Quite how another of the government's big ideas -- Brexit -- gets in the way of that one remains to be seen.

The ideas set out by the Health Secretary aren't policy yet: the idea is to consult with doctors and tech experts.

The report argues that by making better use of technology the NHS can manage the growing demand for services. However, the NHS has often lagged on investing in new technology for two reasons. First because large-scale IT projects in the health sector have often ended badly in the past; and second doctors would rather spend their limited funds on patient care. Setting standards but allowing healthcare organisations to decide what to buy themselves may tackle the first issue, but so far there's no additional funding for any of this.

According to one think tank, funding increases of four percent a year are required to improve NHS services over the medium term, with five percent needed in the short run: recently the government offered the NHS a 70th 'birthday present' of just 3.4 percent.


NHS IT: Using the open standards and the cloud to drive digital transformation
How one of the UK's largest NHS trusts is developing its own infrastructure to put patients at the centre of healthcare.

NHS IT: Can better use of tech give healthcare a shot in the arm?
Is improving tech the key to to making healthcare more efficient?

How smart contact lenses will help keep an eye on your health
Health tech: Researchers are working on combining sensors with off-the-shelf contact lenses for a range of medical applications.

DeepMind's AI spots early signs of eye disease
Initial results of DeepMind's partnership with Moorfield's Eye Hospital in London suggest that a scanning method that uses artificial intelligence could provide quicker diagnoses and help prevent sight loss.

Healthcare security nightmare: UK's NHS lost nearly 10K patient records last year (TechRepublic)
Despite having electronic record systems in place, 94% of NHS Trusts still use handwritten notes for patient record keeping, according to a report from Parliament Street.

This swallowable chip uses glowing bacteria to spot hidden illnesses
MIT researchers have created swallowable chips that can help identify blood in the gastrointestinal tract.

Government websites hijacked by cryptocurrency-mining malware (CNET)
Over 4,000 websites worldwide were affected by the malware.

Editorial standards