Tech in the NHS: This is what needs to change first

Forget AI and VR; if the NHS wants to use tech to improve healthcare, it needs to start with something else.
Written by Mark Samuels, Contributor

How can technology help save the NHS? For Dr Sam Shah, director for digital development at NHS England, the answer is simple – embracing developments in consumer IT and emerging technology can boost operational efficiency and healthcare efficacy.

"We use technology every single day to undertake tasks in our daily lives – and in the NHS, we have an opportunity to use technology to not only undertake some of the basic transactions, like booking an appointment or looking at a record, but also to use technology over time as part of the process of delivering care," he says.

Shah was appointed to his role at NHS England in October 2017 and is working with suppliers and other partners to develop customer-centric services in the NHS. As well as leading digital development for the NHS, Shah – who spoke with ZDNet at the recent Big Data World event at Excel, London – also works as a clinician in primary care in Kent.

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This dual role gives him on-the-ground understanding of how technology is being used in primary and secondary care. Shah says most hospitals have plenty of equipment that's connected up in some way. The challenge is to bring these services together and develop integrated systems that boost healthcare.

"We have the benefit of 70 years of amazing work behind the scenes in the NHS, but we now need to think about how we bring technology into the lives of individuals, both in terms of providing benefits to the people who use our services and in terms of identifying people that might need help before they get near to hospitals and surgeries," says Shah.

But before the exciting innovation comes the dull-but-worthy infrastructure groundwork; a lack of connectivity between systems means interoperability must be an essential first priority. The adoption of open standards will allow the NHS to create digital services that are more useful for the people it serves.

"Why is it so difficult to access a health record or to make a booking for any service in the NHS? It shouldn't be this hard – and that's why we've got to create open standards and digital services that are meaningful for citizens and more consumer-centric," says Shah.

The NHS is attempting to move with the times. Hospitals have been banned from buying any more fax machines as part of a move towards digital services, and a new technology strategy for the NHS attempts to set central standards for vendors supplying the NHS, while encouraging local-level creativity across healthcare organisations. A new digital service for the NHS, known as NHSX, will help set national policy, technology standards and best-practice techniques around technology deployment, particularly around the use of open-source code. 

This year has also seen the release of two key reports that will guide the NHS' technology strategy for years to come: the Long Term Plan, which sets out the health service's policy for the next 10 years, with IT playing a central role; and the Topol Review, which details how staff should be prepped to be able to use all the new technologies that are emerging.

"In an omni-channel world, we should be able to put standards in place that allow innovators to connect up systems and allow empowered citizens to decide through their own devices what they share with the NHS, how they transmit their data, and how they make that information use more meaningful, so that they can help to create a responsible health service that meets their requirements," Shah says.

In many ways, it's possible to draw a parallel between the work the NHS is undertaking and the transformation efforts of CIOs in other sectors – in all cases, the implementation of digital services must relate to desired business outcomes. But in the NHS, the stakes are higher because it also means better healthcare processes – and treatment.

"It's like any industry: we need to improve the value exchange – and we need to do that for the patient and the clinician," says Shah. "If we can get the value exchange to be the highest level it can be, the other technology in time will flow. But let's at least get the basic infrastructure and connectivity right, and – at the same time – let's make the lives of the clinician and the citizen the most optimal they can be during that interaction."

Shah says it's important to recognise that a lot of the technology that will help transform healthcare in the long-term future – like artificial intelligence, virtual reality or even quantum computing – is being developed in other industries. Technologists working in the NHS tend to operate in a highly regulated environment, so getting to an implementation point tends to involve a lengthy testing and development process.

"Our best hope is to start with the basics – let's spend the next few years resolving issues and putting the standards in place," says Shah. "Once we get that platform in place, then we can start taking advantage of the benefits associated to emerging technologies."

Shah is extremely positive about the potential for digital to have a life-changing impact in the NHS, even if a series of concerns – such as integration, standards and openness, and an ongoing squeeze on funding while demand continues to increase – remain as potential barriers to transformation.

"Yes, it might be difficult and, yes, things are challenging, but we're all in it for the same reason: to provide the best possible outcome for our patients. With that lens in mind, if we all get together and focus on user need, we can exploit some of the best technology to make a difference," he says. 

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