HEALTHCARE PLANNING


pathways, but the bulk of patients will need to access a healthcare professional, and have some form of laboratory assessment (i.e. phlebotomy or analysis of another bodily fluid), before having some form of direct or indirect visual examination. So far we have taken account only of those in direct contact with the patient through their journey, and not those who may be analysing or reporting on these various tests. With this knowledge, however, we perhaps feel more comfortable about what needs co- locating.


Planners will need to factor in local needs and transport links to alternative services, but the basis for such decisions is becoming clear.


Shape: the future is digital as well as place-based Our modern facilities therefore need co-located services based on patient pathways, with great transport links and parking to support users and providers alike. However, connectivity


in a modern setting means more than transport links. Healthcare professionals and patients should be able to access and deliver services remotely where that creates convenience, efficiencies, or cost advantage, and still yields diagnostic or treatment goals. Connectivity not only allows healthcare data to be shared between a network of centres and hospitals, and the staff within them, but can also support the optimisation of provision across a geographical location, maximising the available resource. In specialities such as cross-sectional imaging, technology already exists for less experienced members of staff to operate equipment with more experienced staff monitoring and supporting remotely, which reduces staffing pressures. A precedence for remote reporting of a variety of tests has long been established in large swathes of healthcare, including – among others – ophthalmology, cardiology, and dermatology. Support mechanisms for inter-specialty colleagues already exist in the form of dedicated virtual multidisciplinary team meeting


Professor Terry Young


After sixteen and half years as a research engineer, divisional manager, and Business Development director, Terry Young became a Professor at Brunel University London for 17 years. He has a BSc in Electronic Engineering and Physics, and a PhD in laser spectroscopy, both from the University of Birmingham, and is a Fellow of the British Computer Society. His research has been in health technology, health services, and information systems. He has taught information system management, project management, and e-Business. His awards include the


Operational Research Society’s Griffiths Medal 2021, for analysing the return simulation methods offer when used to improve healthcare services. Prof. Young set up Datchet Consulting in 2018 to support innovation on the borders of academia, health, and industry.


Steve Powell


Steve Powell MBChB, MRCS, FRCR, MBA, enjoyed a highly successful career as a Consultant Interventional Radiologist with a particular interest in complex venous interventions, culminating in him leading a large teaching hospital department as Clinical director. He was President of the Vascular Access Society of Britain and Ireland, European Training lead for AngioJet thrombectomy, a member of the editorial board of the Journal of Vascular Access, and a member of the European Renal Best Practice Guideline group. Following his Clinical director role, he moved into healthcare management, initially developing an NHS Trust’s strategy, and subsequently supporting the development of the outline business case for the merger of two large teaching hospitals. He became director of Accelerator, ‘the home for business’ on the Liverpool Health Campus, supporting technology adoption in healthcare settings, before leaving the NHS in 2017 to lead a diagnostic company, resulting in the establishment of the service’s first Community Diagnostic Centre, with an initial 10-year contract with the NHS in the South-West of England. Currently leading healthcare consultancy, SKP Advisory Services, he has supported clients ranging from start-ups to government departments. He is Chairman at a healthcare-orientated software company, CEO of AI Sight, and a trustee at the Grade I listed St George’s Hall, Liverpool.


30 Health Estate Journal April 2023


software, which could easily be adopted to create a virtual ‘big, centralised’ centre around a smaller, more remote, physical centre.


AI and ‘smart’ algorithms With connectivity and transferable healthcare data come the opportunity to enhance our healthcare professionals with artificial intelligence and their practice with smart algorithms. The rapid rise of AI means that repetitive, but critical, tasks can be performed by computers, enabling those making diagnoses and treatment decisions to do so more quickly. Predictive algorithms can set appropriate follow-up appointments based on personalised data pertaining to risk, rather than convention, reducing the costs of healthcare provision, and supporting those most at risk. Similar algorithms can scour individuals’ healthcare data to highlight potential risks or concerns not yet considered. In adopting these advancements, we


must balance their improvements in healthcare delivery with the requirement for compassion expected from our caring profession. Gestures of reassurance or empathy are still difficult to emulate in a digital environment, and it is in these situations where we deliver sometimes life-changing news. Digital also enables digitally literate patients to move huge elements of their care onto the web: making appointments, collecting results, and conducting some appointments from home. The difficulty facing us right now is how few of the hardest-to-reach patients are ‘digital natives’, or have access to appropriate digital technologies.


Conclusions


Designing healthcare facilities remains a challenging occupation. There are tensions between the expectations of users and providers. There are barriers to adoption of new ways of working and new technologies. With digital developments come data security concerns, and yet much of our lives are shared online. With remoteness from large central facilities comes concerns around isolation that could be overcome with numerous digital solutions. In order to meet the future needs of service-users, access to differing specialties should not be sequential, but rather – by clustering on the basis of pathways – more slick. We must exploit the (over-used) Big Data to target, predict, and prevent. Connectivity should be the foundation to future healthcare development. And so our facility has developed into a


physical location with digitally empowered professionals able to treat us effectively, efficiently, and locally, with the benefits of digital co-location with a larger centralised facility. Digital really disrupts the old paradox, enlarging the comfort zone for patients and staff.


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