INNOVATION
partnership with the life sciences industry. We are determined to make the UK the best place in the world to develop new drugs and other products that can transform the health of patients. “The report provides us with a strong basis to make the right decisions about how the health system can be adapted to meet the challenges of the future, attract inward investment, grow the thriving life science industry and use innovation to improve patient outcomes and tackle the financial pressures on the NHS.” Patients are central to the review. Under the recommendations of the review, they are offered a greater say in determining what
A new strategic commercial unit should be created within NHS England to enter into commercial dialogue.
innovations are important to them, so that real experiences of conditions such as diabetes or cancer can be used to shape priorities for new drugs, techniques and treatments. The Government will now consider the proposals and respond more fully in due course, mindful of the need to ensure affordability.
Commenting on the publication of the
Accelerated Access Review, Aisling Burnand, CEO, Association of Medical Research Charities, said: “We welcome the publication of the Accelerated Access Review and its recommendations for getting the best technologies for patients more quickly. We know patients and their families want early and fast access to new life-changing and life-enhancing innovations. The review offers
Initiatives to accelerate innovation to the frontline are welcome, but details around funding, technology assessments and integration need ironing out to make rapid health transformation a reality, says IMS MAXIMS chief clinical information officer and chief medical officer Professor Michael Thick.
Service transformation: resolving the digital paradox The Government’s latest proposals for
digital health, the Accelerated Access Review (AAR), intends to shorten the time between bench to bedside innovation, and is an encouraging step for technology adoption. The review shows promise and offers valid solutions. It makes a strong case for collaboration between suppliers and the NHS to enable end user design from the outset, which in the past has been a challenge. The collaboration must happen much earlier too; a critical factor for clinical engagement and uptake in technology solutions. Simply layering new products onto existing pathways, the review notes, is also no longer viable. Like any review of this kind, the devil is in the detail. While accelerating adoption of technology is welcomed, important questions remain around integration, assessments funding and the bigger digital picture that will determine how much of a good thing the review will be for the paperless agenda.
From isolation to integration
The AAR is right to highlight that innovations such as patient-facing apps should be encouraged, but we need to address how this fits into the broader transformation agenda for healthcare providers. It is now widely accepted that the adoption of mobile working is part of the future, but standalone, patient-facing apps that do not share data and knowledge with an enterprise solution presents a significant challenge for managing the care pathway. It is also important not to omit apps developed for healthcare professionals, which, when integrated into an enterprise-wide solution deliver significant benefits to the patient, professional and hospital.
Getting value from apps in the delivery of care requires a highly co-ordinated view, both in clinical and organisational terms. A myriad of self-contained, non-reporting apps makes holistic and informed care virtually impossible. There are certain functions that undoubtedly a small standalone app would be able to support quite quickly in a hospital environment, but if we are to transform – rather than tinker around the edges – there must be integration with the electronic patient record (EPR). Interoperability and the use of agreed open standards are essential if we are to benefit from these innovations. Moreover, if apps are to be assessed for effectiveness, this should be done in the context of the enterprise-wide solution, not in isolation. They also need to include the very people that have the duty to care. NHS England CEO Simon Stevens previously announced funding for apps that would have a positive impact on patient health and care delivery. The next step, and secret to acceleration in this instance, has to be a rapid pathway to get suitable applications in front of the people that will assess and evaluate these apps.
The bigger digital picture
Sustainability and Transformation Plans (STPs), Local Digital Roadmaps and the National Information Board’s 10 domains and 33 programmes are shaping the digital agenda at scale and increasing pace. But how does the AAR fit in with these national and local priorities, particularly as there is increasing uncertainty around capital funding? Where will investment come from for the plans set out in the AAR? It is clear that the digital paradox remains firm; to save money and transform services, the NHS must be ‘digital by
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default’, but in order to deploy digital services, organisations must invest. Taunton and Somerset NHS Foundation
Trust has embraced the ‘digital by default’ approach. It has laid solid digital foundations with the deployment of an open source EPR, that enables clinical decision support, ePrescribing, medicine management and more. Through the Global Digital Exemplar (GDE) programme, the Trust is accelerating its adoption of mobile working, giving due consideration to how this will impact its staff and digitally-enabled patients along a care pathway. We are currently working with the
Trust to deploy a range of mobile clinical functions to enable e-observations for conditions such as sepsis, which will enable faster delivery of healthcare, a more efficient way of working for the clinician, and a much safer journey for the patient, with enhanced quality and experience. Taunton and Somerset is a digitally ambitious NHS Trust, with a firm grasp on the importance of interoperability and standards for shared care. With mental health, ambulance and community Trusts in line to join acute hospitals in the GDE programme, NHS frameworks for technology adoption such as the AAR must look at the bigger picture, that incorporates an increasingly digital patient, while also ensuring that the wider health and care economy can benefit from such innovation. If the AAR gives us the platform to speed up digital adoption, then the GDE programme can be the spring board to deliver integrated care. Therefore, further commitment both in spirit and resource from the Government would go a long way to solving the digital paradox.
MARCH 2017
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