TECHNOLOGY
How the unthinkable led to the unimaginable
When the novel coronavirus arrived in the UK, the Dudley Group NHS Foundation Trust advanced its IT by “four years in four months” to support clinicians and patients. Chief information officer Adam Thomas explains what it learned along the way.
The unthinkable happened in March, when we woke up to the reality of COVID-19. None of us should ever lose sight of the fact that there is an enormous, human cost to this disease that continues to this day. But the unimaginable happened because in preparing to confront the consequences of the pandemic, we realised that a lot of things that had seemed like big issues
were no longer major problems. Take virtual access to outpatient clinics, for instance. About six months before COVID arrived, I was in a meeting about whether we could do this and still deliver good care. It was an aspiration in the NHS Long-Term plan, but in that meeting it felt like it was a long way off. Then COVID-19 arrived; we rolled out the ‘Attend Anywhere’ platform in
four days, and that answered the question. We went from delivering 5% of outpatient appointments virtually to delivering 60% by video or phone call.
Challenges addressed That’s just one example. In many ways, the challenges we addressed during those early weeks of the coronavirus crisis were challenges we had identified before COVID-19 arrived. They included: providing better access to information for staff and patients, encouraging collaboration by moving from a transactional approach to a more flexible way of working, and integrating care across our pathways. However, before COVID-19, we were struggling with this agenda. It wasn’t just virtual access to outpatients. We had been discussing longitudinal records and population health management to the point that I’d stopped talking about ‘interoperability.’ The word had become a turn-off for the board and for our clinicians. Then the pandemic hit and for seven weeks we delivered digital improvements week on week.
Perhaps the most important aspect of this time was having a common goal. During the crisis, we were able to shift away from asking: ‘what is the IT issue here?’ to ‘what is the healthcare issue that IT can help to resolve?’ and that created a ‘pull’ effect. The question now is how to make this sustainable.
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Delivering at pace We undertook a lot of work on COVID-19 testing and we created an SMS service so staff could obtain negative results in a matter of hours, which built a lot of confidence. Meanwhile, we got people connected via laptops, signed them up to Microsoft Teams, and did a rapid piece of work on remote radiology so clinicians who needed access to images could have it. We created a flexible working environment in which we could track productivity. We soon realised that NHS staff members were working far too hard at home, so we created a support model to address that and put in some continuous professional development so people working from home could stay up to date.
MARCH 2021
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