Archive | July 2013

The Integrated Digital Care Record – An Opportunity to Shine?

NHS England have recently released the “Safer Hospitals – Safer Wards” initiative which aims to outline the strategy for Trusts to move finally to greater Integrated Digital Care Records with a target date of 2018. Also mandated is the use of the NHS number on all patient records.

The National Programme has delivered some great advances for the NHS. For example, Choose and Book, the greater move to digitisation in primary care, the use of e-Prescribing,(though uptake has not been as expected), PACS, GP-GP records transfer and the use of N3 for the whole NHS and partner organisations. However the programme has not been without its challenges.

Lack of standardisation

A true integrated digital care record across all care boundaries has remained elusive and secondary care is still, in the main, a paper led beast. That is not to say there have not been some great innovations in the area, but overall it does lag behind the primary care sector. This new initiative, which has central funding available to the tune of £260m, will seek to redress this imbalance and put the UK in the driving seat of electronic patient records.

In the UK, we have a number of clinical systems suppliers who have all developed systems to provide electronic management – be that from the simple “PAS-style” patient information and diary management, to more complete EPR solutions where all clinical information is stored electronically, including certain workflows and other enhancements.

However, this array of providers leads to a very mixed picture across the NHS and has resulted in a situation where sharing of electronic records has been held back by lack of standardisation and in turn reduced the uptake of systems, due in part to confusion over best practice and successful implementations.

One local NHS Trust may have a full blown EPR and see clinicians using less paper and more electronic records, but fifteen minutes “up the road” another Trust may still be a running on a basic PAS with a number of non integrated healthcare systems which do not share information well, and the clinicians can only rely on paper records in the main.

This new initiative is the chance for Trusts to change this and become truly paper-light. Trusts may now work closely with various partners to be able to gain access to funding, and to standardise their approach and technologies. Trusts should be seeking to build solutions with a ‘selected’ number of suppliers, to gain the best of breed for what they require, to truly integrate their care records.

Legacy systems and increased storage needs
Systems suppliers will need to have the correct infrastructure on which to run these solutions, and storage and networking ability will be key to this. Infrastructure which is old and may cause bottlenecks in the system, which in turn, may quickly cause any software solution to fail.

A lack of forward planning for the increased needs of enterprise level storage and archiving, generated by new system adoption,  can lead to a reduced benefits realisation, and may cause clinicians to revert to paper records as information becomes difficult to manage/store/recover, and the take up of a new technical solution will be curtailed.

Looking at the issue of aged infrastructure in more detail, it is recognised that there has been a lack of investment in Trust ICT for the past several years. Many ICT departments have had to survive on limited budgets which have enabled them to “keep the lights on” (just, in some cases) but have not allowed them to benefit from advances in technology, or even to keep up with standard technology change.

The training aspect to such large scale implementation and change programme is vital to successful integration and adoption.  Trusts need to ensure ‘buy in’ by ensuring that their staff are correctly trained in any new electronic system or the benefits are often lost, or even worse, the systems negatively impact the clinical process having an overall detrimental effect on patient care.

Truly Integrated Digital Care Records are good for the patient. Diagnosis and treatment times will be reduce whilst patient safety will be improved. End result, better health outcomes and a greater level of patient satisfaction.

The launch of this initiative may well fill some ICT departments with sense of trepidation, due to the scale of the challenge, but it is great opportunity to deliver the benefits clinicians have been requesting for years and to achieve the main business goal, to provide safe and successful care for patients.  

This is Definitely an Opportunity to Shine!

The Strategic Business value of Unified Communications

If we look back through Economic history we see examples of how the use of technology could help organisations be more successful in their core business. The smart companies will recognise these as strategic opportunities that can make a real difference to their competitiveness.

Ford and the mass production line, it was the way the line was organised was the key to Henry Ford’s outstanding success, not just the car itself. In the oil industry, it was the transport of oil , Shell Transport and Trade was formed specifically to transport the output of their sister company, Royal Dutch. In both these examples we see companies recognising that their key business required them to have expertise in other areas.

With many companies today their strategic asset is not physical – but knowledge. It is their people that are the key to their success. Developing systems and processes that can harness this knowledge is the most important strategic competitive weapon business has today. And this is why Unified Communications and Collaboration (UCC) is so vital to business today. It is a technology that can be literally the foundation of a knowledge powerhouse. I have heard of many examples of how it can help customers achieve this strategic advantage here are a few examples…

– Enhance their market reach

It is possible to use Unified Communications (UC) Platform to underpin the communications, of a new start-up or for an established company in a new local market. How often do we see companies try to enter new markets over reach and over commit themselves before they know the conditions of a new local market? Using UC we can build a local presence with very low overheads, but have the appearance of being local. The company has a local presence, local telephone number but with almost no local infrastructure.

– Build centres of Excellence (COE’s ) with a physically disparate group of people

Companies know they get synergy by putting their best people together, they also know a physical re-location causes disruption and removes the local subject matter experts from their local ecosystem. Employees can resist re-location, as they have family ties that keep them in one locality. UCC can help companies strike a balance, use Collaboration Technologies to build a community and leverage the scale of a larger team, but ensure that the local talent pool is not drained in one local area, and keep individuals close to their local customers and communities.

– Get closer to their Customers and their Supply chain

Today we are really seeing a move towards not just Email as a way that companies can keep in touch, but secure channels of communication via Instant Messenger, Voice and Video. The expectation going forward will be that this will BE available, and it will be hard for companies to manage their customers effectively if these tools are not available. The use of public bureau services like, “WebEx”, “Goto Meeting” and “Skype” all demonstrate that this trend has already gathered a pace. A company with its own platform can save money and reduce costs by not being reliant on these public bureau services.

– Extranet

Extranet is a platform that can be used to communicate with partners and close business associates. When combined with UC Federation it can make a powerful collaboration tool for businesses that need to collaborate outside of their own direct organisation

The expectation going forward is that both B2B and B2C communications will become increasing multi-modal, so organisations need to start preparing for this now.

Twitter: @iainb0408

Is the move to the cloud as fickle as the British Summer?

Over the last few months there’s been a lot of press about software vendors moving their licensing models to a Software as a Service (SaaS, or once marketing have got hold of it, ‘cloud’) model.

Whilst the likes of Salesforce and Google have been selling their products as a service for many years, some of the traditional (perpetual licensed) vendors are testing the water too.

First we had Microsoft bringing their Office product suite to market as Office365,  then at the start of 2012, Adobe announced that they were only going to make the next generation of Creative Suite products available via their new ‘Creative Cloud’ offering.

Just like the weather, it seems Adobe may be changing its forecast, Chief Executive Shantanu Narayen said “While we will still continue to offer CS6 on a perpetual basis, the feedback from our community is important, and we are evaluating additional options that will help them with the transition. Our goal is to over-deliver on customer expectations, which we believe will make the entire community ultimately embrace CC  (Creative Cloud).” This is not an all out u-turn, but it does hint that customer feedback is getting through.

There are definite advantages to consuming apps via SaaS, but what is becoming clear is the switchfrom one model to the other could be made more palatable if the vendors had their customer’s interest at heart.

If a vendor has always sold their products as a service then there is little resistance, but for those vendors where customers have made past investments in perpetual licenses, then it is clear customers want choice as to how and when they embrace the cloud. Where vendors have given choice the full impact of these choices needs to be understood in terms of both migrating the technology and the longer term commercial impact.

Microsoft and Oracle announced on the 24th June 2013, that they will be partnering to enable customers to run Oracle software on Windows Server Hyper-V and in Windows Azure. Customers will be able to deploy Oracle software — including Java, Oracle Database and Oracle WebLogic Server — on Windows Server Hyper-V or in Windows Azure and receive full support from Oracle.

If two of the industries fiercest competitors can join together to offer customers flexibility and choice and other vendors are not, which one would you go to in this scenario? – or would you go to someone like CC?

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