Thousands of NHS professionals have downloaded the Hospify messaging app to securely communicate with each other and patients during Covid-19, and a new Web App will support remote coordination for many more.

The Hospify mobile app became the very first clinical messaging app to be approved for the official NHS Apps library by NHS Digital in early March 2020, shortly before the Covid-19 outbreak. Since then it has been downloaded by thousands of healthcare professionals looking for a simple, convenient communications tool that doesn’t compromise data compliance rules in the way that consumer messaging applications do.

The company has now launched the Hospify ‘Web App’, a browser-based version of its service that will support many more health and care scenarios, including that of GPs and pharmacists needing to share prescription information about and with individual patients. The Web App makes Hospify accessible across multiple devices, allowing users to send messages via their phone and then pick up the conversation back at their desk on a PC or laptop, for example.

Pharmacists and GPs, particularly those servicing communities in rural or geographically dispersed areas, have faced major communication challenges during Covid-19. The need to reduce physical footfall to prevent the spread of the virus has made it far more difficult for patients to get their prescriptions, with some GP surgeries reliant on physical prescription tickets and even fax machines as the only form of remote transmission.

As GPs and pharmacies prepare for the winter flu season, Hospify will allow clinicians and patients to exchange patient identifiable data while remaining firmly within data compliance guidelines. Clinicians and pharmacies subscribing to the Hospify Web App can also access conversations on desktop and laptop, store their messages in the cloud and download information to the patient record while maintaining those same rigorous standards.

James Flint, the co-founder and CEO of Hospify, said: “The release of our Web App completes our platform and allows us to provide the NHS, care providers and patients with easy-to-use, cost-effective technology that works in many healthcare situations and at all scales, including at a regional level.

“We have always had a particular focus on assisting communications between healthcare institutions, not just within them, and so we’re particularly pleased to see the take-up of the Web App by networks of GP surgeries and pharmacies, which have a particularly pressing need for this kind of simple but effective communication tool.”

The Hospify Mobile App and Web App are paired with an online tool, the Hospify Hub, that is now in use at more than 200 hospitals and other health and care sites throughout the UK. The Hub allows healthcare administrators to set up and coordinate teams of Hospify users and coordinate large scale use of the communications platform.

NHS vascular surgeon Neville Dastur, co-founder and chief technology officer at Hospify, said: “The new Hospify Web App can add value for a huge range of clinical scenarios and settings. These include managing ambulance transfers, managing conversations across a surgery or clinic and for being used as a mechanism for keeping track of evolving clinical conversations over several weeks or months.

“In addition, it could be the means to connect many thousands of staff across hospitals, social care, in other parts of the health ecosystem and, importantly, their patients.”

Hospify has continued to hit headlines in recent months following an organic growth in the use of the technology through the NHS Apps Library, where it remains the only general messaging app to have been approved for use by both patients and clinicians. NHS Wales, Devon CCG and many individual NHS trusts including London North West University Healthcare NHS Trust, County Durham & Darlington NHS Trust, Lincolnshire Community NHS Trust, Maidstone & Tunbridge Wells NHS Trust and South Tyneside NHS Trust have also all signed off the app for use by their employees.

Healthcare organisations wishing to deploy Hospify’s technology at scale can now procure the platform through a number of national frameworks – notably NHSX’s new Clinical Communication Tools framework and Spark, the technology innovation marketplace dynamic purchasing system (DPS) launched by the Crown Commercial Service during the Covid-19 pandemic.

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European digital health VC Heal Capital is at the forefront of the investment, backed by Germany’s private health insurers. It is the VC’s first investment following the Berlin-based fund’s launch in 2019. Also participating in the round are Philips Health Technology Venture Fund and current investor EQT Ventures.

Siilo is now the largest medical network in Europe with more than a quarter of a million healthcare professionals. Each month, more than 20 million messages are exchanged in more than 16,500 clinical chat groups or directly between users. Siilo Connect is used for secure departmental collaboration within renowned academic institutions such as East Lancashire Hospitals NHS Trust, Erasmus Medical Centre Rotterdam and Berlin-based Charité.

With the investment, Siilo will continue to expand its product offering to better support case-based collaboration and knowledge-sharing on its platform, as well as increase network growth across Europe, specifically across the UK and Ireland as well as, DACH, BENELUX. The company will also be hiring talent in areas such as product development and customer success.

“Communication is key in every organisation. Siilo has a strong vision in making healthcare professionals fall in love with their intuitive solution to promote it in a bottom-up approach,” said Dr. Christian Weiss, General Partner at Heal Capital. “Siilo’s messenger can be a true game changer in digitising the healthcare sector.”

Siilo was founded in 2016 by former surgery resident Joost Bruggeman (CEO) and Arvind Rao (CFO). Having experienced the fragmented healthcare system and outdated methods of communication — such as fax, pagers, and landlines — firsthand, Joost recognised the need for a secure, easy-to-use messaging app designed specifically for healthcare professionals. Bruggeman was recently named by Sifted as one of 80 European founders and companies shaping the post-pandemic world.

Joost Bruggeman, co-founder and CEO at Siilo said: “We believe there is a massive opportunity for healthcare to operate as a collaborative network. We started by connecting professionals treating individual patients, but during the acute phase of the pandemic, we’ve also been able to play a critical role in connecting different levels of healthcare to facilitate faster decision-making and information-sharing. With Siilo, frontline care workers, public health officials, and everyone in between are able to practice medicine together.

 We’re only just starting to uncover the different ways technology can facilitate collaboration and simplify workflows in healthcare, and we’re excited to increase our product offering and member network with the support of our newest investors, who bring a wealth of insights and experience around scaling innovative healthcare solutions.”

The Siilo Messenger app is free for individuals and teams to coordinate patient care, expand their professional network, and significantly reduce time-to-decision by exchanging best practices. Siilo Connect is the company’s subscription service for hospitals, care organisations, and medical associations where administrators can facilitate staff-wide collaboration on patient cases, discuss internal policies, and consult with external specialists, all while maintaining organisational compliance.

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Communication Challenge

The rapid evolution of technology, not least robotics, is inspiring the next generation of ergonomic design to better understand the human / technology interaction. Within the OR, the development of 3D imagery, precise robotics, even protective garments with in-built air supply, are changing not only the type of procedures that can be considered but also the processes and the need for effective interaction between multi-skilled teams. From situational awareness to decision making, teamwork and coping with stress, in an increasingly technology dominated OR, team members’ cognitive and social skills are recognised to contribute to safe and efficient task performance.

However, as surgical teams are increasingly reporting, while the innovation is compelling, technology led procedures are raising challenges – not least with the quality and timing of essential team communication. With a growing reliance on data, imagery, graphics and cameras, individuals are rarely looking at each other or even directly at the patient. Indeed, many individuals are moving around within, but also in and out of, the OR. Not only are they blind to the progress of the procedure, but they can also struggle to share essential information with the rest of the team. Furthermore, as technology takes an increasingly dominant role, there is a risk that clinical teams feel they have only a supportive role and potentially lose engagement.

For many Trusts, additional challenges are created in medical environments that are still in transition between paper based and electronic records, a situation that is proven to create new problems that can lead to mistakes.  From the ability to verify information to fostering teamwork, ensuring people share the right information at the right time and reinforcing situational awareness, effective communication is essential to the safe utilisation of technology innovation.

Effective Human Machine Interaction

To create and retain a calm, stress free environment, growing numbers of surgical teams are now exploring the value of high quality wireless headsets that enable every team member to be part of the procedure from beginning to end. Using one channel, the lightweight headsets provide simple, effective communication where every team member is part of the process and can quietly comment, provide essential insight from the imagery or data, or request information when required.

Linking up every team member via headsets, from the initial pre-op discussion to the end of the procedure, fosters an essential level of collaboration.  It enables effective, unambiguous speech between multiple specialists during a highly complex procedure. It supports training by empowering junior doctors, for example, to ask questions without feeling they are interrupting the procedure. And it can be used to keep everyone engaged during the routine, increasingly high-throughput procedures, such as joint replacement.

Evolving Ergonomics

The quality of communication has a direct implication on risk, safety and patient well-being – but it also provides a vital platform for successful utilisation of technology. Overcoming communication barriers is the foundation for ORs to embrace the evolution in human / technology interaction – including the maximising the social and personal skills including situation awareness, decision making, teamwork and coping with stress. When the communication works, the rest of the new OR ergonomics can fall into place.

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Matt Hancock insists that doctors must abandon pagers by 2021 and instead use smart phones and apps to communicate. The risks of using consumer messaging tools for this purpose have been identified, but despite contravening strict regulations around the use of WhatsApp, Facebook Messenger, Snapchat and similar platforms, they are used extensively by smartphone-carrying doctors and nurses to communicate while at work.

An integrated approach to delivering healthcare is key to improving patient experience and outcomes, and is the main driver behind the extensive use of messaging tools in the sector. The benefits of being able to easily look up and connect with other clinicians and support staff securely in real-time can be seen across the board from hospital wards to community nursing and mental health units. With this in mind, it’s easy to see the need for an application that is designed in line with the specific compliance and security requirements of the NHS.

Surgeon and IT developer Neville Dastur comments, “The ability to coordinate colleagues and quickly source expert opinions from your smartphone is invaluable. Healthcare teams are working more collaboratively than ever before but it’s also important to know that what you’re sending is secure, maintains patient confidentiality, and complies with the right regulations. While the use of WhatsApp isn’t sanctioned, it’s convenient and people will continue to use it if other options aren’t made available.”

Having experienced the situation first hand, Dastur decided to create his own app with the help of former technology journalist and digital product manager James Flint. Together they designed a messaging service – Hospify – that would give healthcare professionals the convenience of the apps they found so useful, but with the built-in security and compliance that would allow them to communicate freely without compromising patient information or their own privacy.

“After years of reading and publishing stories about badly managed and over-priced NHS IT projects,” says Flint, “I decided to stop moaning and try and actually do something about it. Neville’s unique combination of clinical and technical skills meshed really well with my experience of building digital platforms in the mainstream media. We then worked with the team at DCSL Software to refine the technology and build out an architecture that would keep all sensitive data encrypted and safe in the users’ phones instead of on insecure servers that are vulnerable to all kinds of cyberattacks.”

According to Dastur, the latest headline-grabbing hack “was a result of a side line attack on the VoIP (Voice over Internet Protocol) library in WhatsApp. The platform clearly uses some of its users’ data for marketing purposes and following the latest attacks it seems it leaves phones on which it is installed vulnerable to being read by hostile software. At Hospify we are absolutely strict in not allowing any access to data in this way, so we haven’t had to make the security compromises that WhatsApp has.”

Ill-served by inefficient, out-dated communication, over 600,000 NHS professionals are currently using consumer messaging services like WhatsApp to supplement communication. But the arrival of GDPR regulations in May 2018 rendered healthcare institutions whose employees use these consumer tools to handle patient identifiable data liable for fines of up to 4% of their annual turnover.

Hospify is a GDPR and NHS IG-compliant messaging service designed to remove this liability both in the UK and in Europe. Available for free in the Apple and Android app stores, Hospify puts a simple, affordable solution directly into the hands of healthcare professionals and patients. In short, Hospify is a compliant, trusted healthcare messaging app that anyone can use.

The free version of Hospify is already being used at more than 60 hospitals around the UK including Birmingham Community NHS Trust, Frimley Park NHS Trust, and University Hospitals North Midlands. Hospify is also backed by Innovate UK, Wayra Velocity Health (in partnership with Telefonica and MSD Pharmaceutical), and the UNISON Health and Managers in Partnership Unions.

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The joint effort between the award-winning provider of digital health transformation programmes and leading provider of interoperable, cloud-based, clinical data exchange technology, comes against a backdrop of the NHS being urged to move away from outdated communications technologies.

In recent months, health and social care secretary Matt Hancock has urged the NHS to “axe the fax”, “purge the pager”, and drop letters for email in patient communications, while issuing a tech vision for the development of IT in the NHS that puts a premium on flexible, cloud-based services.

“The current methods by which clinical and sometimes urgent information is exchanged in the NHS have come in for increasing scrutiny as concerns have grown that they are antiquated and expensive,” said Shane Tickell, chief executive of IMS MAXIMS.

“Recognising the shortcomings of some of the current systems in use, Matt Hancock has called on NHS organisations to plan for the introduction of modern, secure communications solutions. Our partnership with Secure Exchange Solutions, a leader in this field, is a direct response to that challenge.”

IMS MAXIMS and SES will immediately make available a simple, secure and seamless communication solution that is already delivering superior security and performance to thousands of healthcare providers and millions of administrators and patients in the US.

This solution is called SES DIRECT, which provides a variety of methods to connect to its secure data exchange platform, including SMTP and POP3 email clients (such as Microsoft Outlook and Apple’s iPhone email). 

It comes with robust directory services, end-to-end message encryption, and easy integration options with healthcare applications including: electronic patient record systems, patient portals, clinical data repositories, patient health applications and GP systems.

“SES DIRECT is based on the DirectTrust framework, which supports secure, interoperable health information exchange at 140,000 organisations and nearly 2 million secure Direct endpoints,” said Dan Kazzaxz, the founder and chief executive of SES.

“The flexible and easy incorporation into existing applications and workflows allows for easy replacement of email systems, fax machines and pagers. We are delighted to partner with IMS MAXIMS to bring these proven solutions to the NHS community.”

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If only Matt Hancock had reached out to the NHS frontline more extensively, he might have realised the importance of the technology he is hoping to ban. You see, the pager is a stalwart of global healthcare for one reason – it really does serve a purpose.

I remember being handed my first pager as a surgeon. Above all else, it signified that I was working in real frontline care, where I could support colleagues and patients wherever and whenever they needed me. And so, having learned first-hand the importance of pagers in healthcare, it came as little surprise to see the negative reaction elicited by Hancock’s announcement of the ban.

The pager is outdated, no doubt. But there are many reasons why pagers are still used by health and care professionals today – they have longer battery lives than mobile phones and, even without Wi-Fi or mobile signal, the pager works by running on dedicated radio-frequency networks, which are more reliable and proven to better penetrate thick hospital walls.

However, none of this is to say that the pager is flawless. Quite the opposite. There are a number of circumstances in which health and care professionals should consider replacing pagers with ‘WhatsApp-style’ alternatives, especially non-urgent care situations – as is point of the government ban.

But here too lies the problem. According to the Department for Health and Social Care, NHS trusts will be allowed to keep some pagers for ‘emergency’ situations, such as when ‘wifi fails or when other forms of communication are unavailable’. However, the governments understanding of what warrants an ‘emergency’ differs greatly to that of the people on the frontline.

Even when a hospital infrastructure is robust enough to support fast and reliable Wi-Fi – which could take years – there may still be a need for pagers in clinical emergencies and matters of life and death.

Indeed, thinking back to my time as a surgeon – despite becoming increasingly reliant on my mobile to communicate low-risk alerts, share detailed patient information and overcome the inefficient barriers within clinical teams or across organisational boundaries – all the while, I still relied on my pager.

And that got me thinking, WhatsApp-style messaging solutions were never intended to replace pagers – they were intended to replace WhatsApp. And for good reason: it’s simply a matter of time before a major WhatsApp confidentiality break – at least, a public one – and this is something we should be trying, desperately to avoid.

WhatsApp is insecure, limited in functionality and unfit for purpose, but its use is pervasive; a recent study by BMJ innovations revealed that 97% of healthcare professionals routinely use unofficial and – often – insecure web-based messaging apps to share private medical data and patient information without consent, despite the fact 68% of the aforementioned expressed concerns over sharing information in this way.

But despite their concerns, healthcare professionals continue to use WhatsApp because it makes their jobs easier. With time so precious on hospital wards and with healthcare professionals under more pressure than ever before – amidst the problems faced by an ageing population and the critical nature of the NHS staffing crisis – are they really going to stop to consider whether or not their phone is GDPR compliant or whether it adheres to the latest Information Governance Toolkit? No. They’re going to use an instant messaging service that is efficient and useful in practice.

But times are changing. And for the sake of the empowerment of their clinical workforce and their own GDPR compliance, it is now up to health and care professionals to find a system that replicates the efficiency and functionality of WhatsApp, and that doesn’t put patient confidentiality on the line.

If we look to countries like the Netherlands and Germany, secure healthcare messaging solutions are already in use amongst more than 140,000 health and care professionals, alongside a limited number of emergency pagers, and driven by grassroots demand. And this is an approach that the UK should consider more seriously. More often than not, we don’t need to ban things innovate – we just need to show people better alternatives.

And so, while Matt Hancock’s announcement is right in so many ways, it is his approach that has upset so many. Not only is there no funding and a limited strategy, but the blanket ban of pagers serves as yet another example of the disjoint between policymakers and those actually providing patient-care – evocative of a deeper-rooted problem seeded within the NHS.

The author is Joost Bruggeman, a former doctor and surgeon and co-founder of Siilo, a Netherlands-based start-up that’s one of the fastest growing European healthcare communication platform providers (a Forbes Top 5 Start-Up to Watch)

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A first for Ireland, the national deployment across 5 sites will standardise and modernise the way the hospitals order and view diagnostics tests and treatment services.

MAXIMS OCS will provide a set of simplified and unified digital workflows that replaces the reliance on paper and several order comms systems, to improve patient safety and productivity. Staff from any of the hospitals will be able to order and view results instantly, on or off-site, and avoid the delays and errors experienced with the current ways of working.

MAXIMS OCS will be deployed across all hospitals in the group, with links to pathology, radiology, endoscopy, oncology and cardiology departments, and outreach services such as physiotherapy and cardiac rehabilitation. Integrating with the hospitals’ laboratory and radiology solutions, it will offer staff a single point of access to the patient’s medical record.

The rollout forms part of Bon Secours’s 2020 strategy, which aims to build an integrated healthcare system to deliver advanced medicine and exceptional care through the delivery of 20 key strategic initiatives.

Commenting on the good news, Lynn Guthrie, Director of Strategy, Performance and Information, said: “This is a game changer for us – an OCS rollout of this magnitude has never been done in our organisation before, or in Ireland. It’s going to dramatically improve the care we offer our patients, as our staff have faster access to more accurate information from any of our 5 sites.

“Given the project’s complexity, we needed a partner that had the depth and breadth of experience to advise and support us along the way. The technical and clinical knowledge that has been demonstrated by IMS MAXIMS gives us great confidence in its achievability in our desired timeframe.”

Shane Tickell, CEO, IMS MAXIMS, added: “Bon Secours has a fantastic reputation in Ireland for its health services, so we’re thrilled to be working with them on such an important part of their digital strategy and continuous improvement programme.

“They have joined the MAXIMS user community at a particularly exciting time as we make advancements to our product set, which offers greater mobility and more personalised care, but for now, our focus with Bon Secours is very much on the forthcoming go-lives!”

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