TECHNOLOGY
In our hospitals, we reconfigured our physical space and worked with Allscripts to make sure that our Sunrise electronic patient record was configured to support the triage and treatment of acutely unwell patients and that their COVID-19 statuses could be displayed on tracking boards. We accelerated a project to roll out our information sharing and population health management platform, the Allscripts dbMotion Solution. After all that talk about population health management, we had been working on a three- to six-month deployment programme but suddenly we were able to deliver it in a matter of weeks. We pulled medications information from the EMIS system that our GPs use into the platform, and we added laboratory and radiology information and documents from Trust systems, so it was all accessible to clinicians at the touch of a ‘blue button’ in context, all within the EPR.
Facilitators for progress
The facilitators for progress were threefold. As an acute Trust, we found ourselves oper- ating in a changed funding structure. There was money available from the Government and a streamlined approach for getting approval to spend it. We had strong working relationships with suppliers, who were offering free access to their products, extra licences and enhanced support. We had a strong, common goal, which supported teams and enabled us to drive forward projects like the dbMotion roll out. 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.
Learning lessons on what to stop, keep up and start
The question now is how to make this sustainable. If one of the reasons we have been able to make progress is that we have had a common purpose, then how do we keep up momentum day-to-day, when we don’t have a common enemy like COVID to provide one?
Our plan is to draw on the lessons that we learned during the pandemic, and to identify what we want to start, keep doing and stop. So, we are going to stop talking about ‘IT issues’ and we are going to stop talking tech jargon like ‘interoperability.’ We are going to stop trying to define the solution from the outset, only to find that it does not do what people wanted it to do. And we are going to stop making perfection the enemy of the good. Instead, we are going to keep talking about operational and clinical needs and how technology can address them. We are going to continue with
MARCH 2021
agile development processes. Aligned with that, we are going to be looking to maintain confidence at board level, so we can continue to use board-level leadership to guide the way the organisation moves forward in this space. But we are going to start developing a new cohort of clinical leaders who have stepped out of the organisation. We also want to build patient and citizen
advocacy, because while we weren’t always able to include all stakeholders as we moved at pace during COVID, the patient voice will be critical as we develop our local integrated care system. To support that, we will be rolling out Allscripts Care Director. With this solution, we can create care plans that professionals can share and act on across our pathways. We will use it to develop new digital services for patients and use the NHS App as a front-end, and build products behind them, so they get a consistent experience of any service that they use. We will look to build even stronger relationships with suppliers, because our experience during COVID reinforced what I have always thought: we should be collegiate and collaborative. We should be working in partnership to share both risks and efficiency, quality and safety benefits.
No new normal We should never forget the human cost of the unthinkable coronavirus pandemic, but we should also never forget that it allowed us to make previously unimaginable
advances with technology. People are starting to talk about a ‘new normal,’ we do not want to go back to our ‘old normal.’ We need to review what happened and establish what worked and what didn’t so we can embed new ways of working. At the same time, we need to start looking at really exciting ideas, like AI in imaging, digital pathology and process automation where that makes sense.
I recently concluded a webinar with a Brian Eno quote: “Repetition is a form of change.” While this is true, it is not the form of change that we can continue to accept. We need to adapt and move forward. CSJ
About the Author
Adam Thomas is the CIO, at the Dudley Group NHS Foundation Trust. A graduate of Aston University, Adam qualified as a pharmacist and proceeded to undertake post-graduate qualifications in clinical pharmacy and independent prescribing, sustaining a clinical commitment in medical oncology at The Dudley Group since 2010. After leading a number of healthcare IT projects, he took a career move to IT in 2016 where, as part of the senior leadership team, he has delivered a programme of digital transformation and enhancement, including the Trust’s strategic electronic patient record (EPR), Sunrise.
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