However, cyberattacks are not the only threat to patient data. A range of diverse risks also exist on systems, applications and hardware that store sensitive information, and each of these vulnerabilities must be addressed to protect the healthcare sector from future attacks.

These attacks emphasise the need for healthcare providers to holistically evaluate their patient data management systems and ensure they are safeguarded against all threats.

Evaluate existing IT infrastructure

All businesses face cybersecurity challenges. For the healthcare sector, the magnitude of connected networks and devices exposes organisations to external risks, with many hospitals and clinics maintaining patient data in outdated operations systems. In fact, Prof Ciaran Martin, the founding CEO of the UK’s National Cyber Security Centre (NCSC) recently warned that “In parts of the NHS estate, it’s quite clear that some of the IT is out of date.”

This is important as once software passes its end-of-life and is no longer updated, it stops receiving updates, increasing the likelihood of the information housed within it can be easily accessed by cybercriminals.

This was proven in 2019 when software technologies company Check Point tested the cybersecurity of a Philipps HDI 4000 ultrasound machine and was able to gain access to the machine’s entire database of patient images. The vulnerability was caused by the machine using Windows 2000, which was passed its end of life and so no longer received updates and is prone to attacks.

To mitigate this threat and limit exposure within healthcare organisations, their systems must be regularly evaluated for weaknesses. This can mean separating outdated systems from networks storing patient data to ensure they are not used as a back door by cybercriminals.

Identify the best cloud solution for hospital workloads

NHS Guidelines advise health and social care providers to use cloud computing services to house data, with all data needing to be hosted within the UK borders to ensure data sovereignty. As a result, many public institutions leverage public cloud systems – a multi-tenant environment, with different customers using the same pool of IT infrastructure – to store sensitive data.

However, in June, Microsoft admitted there was no guarantee of sovereignty for UK policing data stored on its hyperscale public cloud infrastructure, raising questions over the level of oversight and control the police could ensure with its data. Organisations that use this platform are at risk of their data being transferred internationally, opening routes for foreign governments to access British citizen’s data.

As a result of this and other damaging cyber incidents, many people are concerned with how the NHS stores patient data, with 87% of the public in favour of keeping their personal healthcare data stored in the UK.

To safeguard patient data and ensure they are compliant with the sovereignty guidelines, IT leaders need to investigate their current cloud solutions and check the risks affecting patient data. Easing concerns by introducing a suitable sovereign cloud designed to meet legal, regulatory and operational requirements will enable NHS trusts to embrace the cloud while ensuring patient data is kept in the UK.

Create secure physical locations for health data

Sensitive patient information is also vulnerable to inefficient data management, particularly when data centres that are located on-premises run essential systems required to keep hospitals and clinics running. In July 2022, overheating and power outages in two data centres at Guy’s Hospital and St Thomas’ Hospital occurred when ageing technological infrastructure failed to cope with record temperatures and overheated, subsequently causing weeks of disruption to clinical services and patient data. This IT failure was attributed to a combination of factors, including  insufficient cooling systems, outdated technological infrastructure, and fragmented management of the data centre’s various components. To mitigate physical security issues, hospitals and clinics should review their current data storage plan and adopt a secure private sovereign cloud service managed by infrastructure experts to reduce the reliance on outdated and insecure data centres.

Setting the healthcare sector up for success

Attacks on NHS data like the 111 service attack on Advanced’s health systems and the Synnovis data breach set hospitals and clinics back months and highlight vulnerabilities within the healthcare sector to external threats. Yet, cyber threats are not the sole risk to patient data. It is also necessary to make sure this data can be viewed by medical practitioners to ensure the availability and resiliency of this data.

To ensure data is readily available and resilient, IT and security leaders need to follow this blueprint to enhance their security and protect patient data against all forms of disruption.

By Rick Martire, General Manager for Sovereign Services at Rackspace Technology

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“If the NHS is going to become more productive, we need to put the nursing and midwifery workforce at the heart of it,” Natasha Phillips, founder of Future Nurse, told the Highland Marketing advisory board.

To raise productivity, the NHS needs to streamline its workflows and handovers, to make every touchpoint with the patient as efficient and effective as possible. And it is nurses and midwives who drive that, because: “a large part of their role is to co-ordinate care around the patient.”

CNIOs are just the start  

Over the past quarter of a century, considerable investment has been put into IT systems to try and capture data and drive care co-ordination. Yet the results, in terms of productivity, or releasing time to care, have been disappointing.

One reason, Natasha argued, is that there hasn’t been anything like enough investment in equipping nurses and midwives with digital skills. True, there has been some progress. As chief nursing information officer for England, Natasha saw the number of trusts with chief nursing information officers increase from 20% to 80%.

“However, that’s still a tiny percentage of the nursing and midwifery workforce,” she said, “and all of them need digital skills centred around their practice, which is to help people to live their best life, or to have the best possible death.”

New drivers: genomics and AI

The question of how to make sure the nursing and midwifery workforce has the digital education and skills it needs is particularly pressing with the arrival of new technologies, such as genomics and AI.

Sam Neville, who modestly describes herself as “a jobbing CNIO” in the East of England, pointed out that nurses and midwives are already being asked to use genomic tests, clinical decision support systems (such as NEWS2), and AI-driven rostering and flow tools as part of their practice.

So, it’s important they understand them – and can communicate about them with patients. She outlined a “persona” developed for the Phillips-Ives review that outlines the skills a future midwife, Jax, will need throughout her career, as she gains experience and moves into leadership roles.

Education and skills on a loop  

The Phillips-Ives review was commissioned by NHS England and led by Natasha and Jeanette Ives Erickson, who works in the US. It’s never been published, but it was leaked over the summer [‘Severe shortage’ of digital nurses, warns Phillips Ives review | Nursing Times].

Chris Tack, a digital health consultant and former physiotherapist and AHP information officer, who, like Sam, contributed to the review, told the advisory board it developed a model to address the current shortage of NHS digital specialists and tech skills, and to create the nurses and midwives of the future, built around four strands.

Broadly, these are: revamped education for nursing and midwifery students; competency-based training for working professionals; more support for digital nurses and midwives; and a career track for the leaders of the future, so “they can feed back into academia and training and create a positive feedback loop.”

Time to publish Phillips Ives

The model would need to be underpinned by a regulatory and competency framework and practical support, such as a digital passport for staff to carry around the system. So, getting something like it in place would be a big job. Around 730,000 of the NHS’ 1.3 billion employees are nurses and midwives; and another 185,000 are AHPs.

Even so, Nicola Haywood-Cleverly, a non-executive director at several public bodies, said there was a need to reach even more people – including administrative staff. Natasha agreed. “We need to push for a national plan, but it does not have to be for nursing and midwifery,” she said.

“Neil Perry, a consultant who used to lead IT at Dartford and Gravesham NHS Foundation Trust, argued that just getting Phillips Ives formally published would be a start.

“That way, it would become mandated reading for NHS organisations’ leadership teams, receive a formal response, and be discussed alongside the new government’s health plans.”

France switches digital priorities

Like Nicola, Neil argued the whole workforce needs digital skills if transformation projects are going to work. “There is a difference between innovation and adoption,” he said. “You need a small group of enthusiasts to work on innovation, but you need everybody to enable the change to be adopted.

“And where I think that really matters is sorting out upfront data entry and quality, because without that, you will never get the good quality algorithms, or data to train machine learning models that we were talking about earlier.” Sam agreed, arguing it is essential that people understand why they are being asked to collect data in the way they are.

“If people think: ‘Oh, I have to do this now’ they will find reasons not to do it,” she said. “They’ll say: ‘The computer logs me out’ or: ‘There are too many screens and it will take too much time’.” Chris said France spotted exactly this problem.

Which is why, when it launched its latest, five-year Digital Health Roadmap in 2023, it chose to put £100 million into competency-based training, before trying to create an “ecosystem” for care, research and innovation, or progress big telehealth and personal health record projects.

Better infrastructure, devices, UI needed

Still, James Norman, a former NHS chief information officer who now works in industry, argued it would help if the NHS had more user-friendly IT. Over the past decade, a lot of IT policy and marketing has been conducted on the basis of slogans: create “a paperless NHS”; “go cloud-first”.

When the real need has been to focus on the infrastructure, devices, logins, interfaces, and data exchanges that staff have to use – or try to use – to do their jobs. Unless that is sorted, James said: “Even with a strategy, and education, and training, NHS staff will be hamstrung by the tech, because nobody has joined the dots.”

Ian Hogan, the chief information officer at a mental health trust, pointed out that the companies that build or commission technology out in the consumer world spend a lot of time on user interfaces. “There’s something called the ‘three click’ rule, that says that if people cannot get to where they want to get within three clicks, they will give up,” he said.

“Amazon, the BBC iPlayer etc, have got it down to a fine art, but it’s not like that in the NHS, where EPR systems are too big and too old.” David Hancock, a consultant who used to work in industry, said that even where EPR vendors are looking to improve things, they “tend to think about doctors rather than nurses.”

He argued they need to involve more staff groups so they can input on “how to collect data at the point of care” as part of their roles. This triggered a debate about whether NHS nurses, midwives and AHPs are getting involved with IT systems and tech developments early enough.

Nurses need to design tech, not just use it

Nicola said she’d been to a virtual wards conference recently, and while there were lots of nurses in the audience, there weren’t many working with vendors. Natasha agreed that: “We have made progress in getting CNIOs and nurses involved in implementations” but “there’s a way to go in the ideation space.”

One of the things that Future Nurse wants to do is to create a community of practice, to bring suppliers, digital nurses and midwives together.

Andy Kinnear, a consultant who used to run an NHS commissioning support unit, felt nurses and others need to be involved even earlier, in debates about emerging technology. “I have been to conferences in Munich and Amsterdam this summer, and there was AI everywhere,” he said.

“It’s a whole new world, but I wondered who is talking about the ethics of it. We need to get nurses, midwives and AHPs involved, because it feels like there’s a danger of adopting some things before we’ve really thought about whether we should be doing them.”

Sam said CNIOs and nurses may be involved in AI deployments. But Natasha agreed there is a need for policy and guiderails at a national level. Perhaps, she suggested, this is one area in which the Royal Colleges could be active, “as keepers of professional standards.”

People first

Getting involved in debates about the future of technology, working with suppliers to make systems fit for use, supporting implementations and adoption, just using IT as part of the job. There’s a lot for nurses, midwives and AHPs to do in the health tech space.

Advisory board chair Jeremy Nettle argued there’s a need to prioritise. “It’s interesting looking forward, but we need to sort out the basics first,” he suggested. “We need to get in place the things that let staff deliver holistic care for people because, at the end of the day, that is what they are all about.”

Longer term, Natasha argued that what is needed is focused, joined-up thinking and joined-up working across the system to deliver it. “We need programmes that are connected to do the things we really want to do,” she said. “Tech in the NHS is all: go paperless, go to the cloud. It’s not: make people better, sort out prevention. Or: do it efficiently, do it well.

“If we keep focusing on the tech, things in the NHS will only get worse. That’s why we need to put the focus on people. France got it the right way round.”

About the Highland Marketing advisory board 

The Highland Marketing advisory board includes: Jeremy Nettle (chair), formerly of Oracle and techUK; Cindy Fedell, regional chief information officer at North western Ontario Hospitals, Canada; Nicola Haywood-Cleverly, former ICS CIO, NED at Mersey Care and UHMB NHS FTs, health tech strategist and advisor; Andy Kinnear, former director of digital transformation at NHS South, Central and West Commissioning Support Unit and now consultant at Ethical Healthcare; Ravi Kumar, health tech entrepreneur and chair of ZANEC; Dr Rizwan Malik, consultant NHS radiologist and director of SMR Health Tech Consultancy; James Norman, EMEA health and life science director, Pure Storage; Ian Hogan CIO at the Leeds and York Partnership NHS Foundation Trust; Neil Perry, former director of digital transformation at Dartford and Gravesham NHS Trust and now director at Synergy Digital Health Innovation; David Hancock, digital health strategist specialising in interoperability; Jane Brightman, director of workforce strategy at Skills for Care; Natasha Phillips, former national CNIO and now founder of Future Nurse. 

About Highland Marketing      

Highland Marketing is a specialist marketing, communications, market access and consultancy agency, focusing on the health tech and med tech industries. We offer an integrated range of services, covering all elements of the marketing mix, to help organisations achieve their goals by ensuring their messages are heard, understood, and acted upon by their chosen audiences. Our highly experienced and well-connected team has deep knowledge of health and care technology, strong contacts in the industry, and is well-versed in delivering effective campaigns and content. We support clients across the NHS and EMEA healthcare markets and work with clients looking to expand from the UK into international markets, and with overseas companies looking to enter the UK market.

www.highland-marketing.com  

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Data silos can pose significant risks for healthcare institutions, such as fragmented data records, inefficient data sharing, and difficulties in monitoring patient health – resulting in misdiagnoses, redundant tests, and delays in treatment. On a wider scale, data silos can also prevent medical institutions from effectively analysing the broader health landscape which is essential for identifying trends and making informed policy decisions. The disruptions caused by data silos can be both costly and labour-intensive, draining resources that could be better spent on healthcare. Healthcare institutions need to adopt a comprehensive solution to address this and cloud technology could be the answer. The technology can help organisations effectively deal with data silos while enabling a more connected and effective healthcare system.

Key challenges posed by data silos

For healthcare organisations, the inability to access data at the right time can have devastating consequences for patient health. Data silos can cause fragmented records, making it difficult for professionals to access complete patients’ medical histories. This can lead to misdiagnosis, inappropriate treatment plans and patient safety risks. In addition, internal communication systems can be delayed by data silos, preventing critical data from reaching medical teams in real-time and leading to significant diagnostic challenges.

Data silos can also hinder the ability of healthcare organisations to monitor patient health effectively. Continuity of care is compromised when healthcare providers are unable to receive a holistic view of the patient’s medical history and journey. This fragmentation can lead to gaps in care. It can also result in missed opportunities for early intervention, which is crucial when managing chronic diseases and improving patient outcomes.

The damages caused by data silos are not only operational but also financial. Inefficiencies and redundancies associated with data silos can lead to increased operational costs due to faulty testing and delays in treatment. Healthcare institutions also require substantial IT support to manage multiple data systems. Data silos can interfere with operations, forcing IT teams to maintain and troubleshoot siloed systems rather than improving patient care.

Top benefits of cloud data integration

Cloud integration offers numerous benefits for healthcare companies that can help address the issues posed by data silos. Unlike traditional systems where data is scattered across different departments and locations, cloud solutions offer healthcare providers the option to store all their data in a single unified repository enabling easy access and management. Access to medical databases, diagnoses, imaging, and billing is possible at any time and from anywhere, streamlining workflows and expanding the options for new work models and collaboration. Unified data storage capabilities also enable uninterrupted data sharing allowing medical staff to benefit from improved efficiency and enhanced quality of care for patients.

Cloud integration also supports advanced data analytics which is critical for modern healthcare. In the healthcare industry, timely intervention is of paramount importance. Medical teams need to be able to analyse, predict, and address issues at the right time to prevent the spread of fatal symptoms and diseases. By aggregating data from various sources into a single platform, healthcare organisations can leverage big data analytics to identify trends, predict outbreaks, and make evidence-based decisions.

Cloud solutions also offer scalability and flexibility, allowing healthcare organisations to rapidly scale their data storage capabilities up or down without significant capital investments. By deploying cloud solutions, healthcare institutions can effectively manage large volumes of data produced by medical devices and facilitate seamless data accessibility and management.

Best practices for successful cloud integration

Integrating cloud technology into healthcare systems is a transformative process that requires careful planning and execution. Healthcare businesses must adopt several best-practices in a multi-layered strategy that addresses technical, organisational, and regulatory challenges to achieve seamless integration.

A key aspect of cloud integration is staff training. According to Statista, lack of staff knowledge of data ranks among the top five barriers to effective data utilisation. Therefore, investing in comprehensive training programs that cover the technical aspects of cloud systems as well as best practices for effective data security and management is essential. By leveraging appropriate courses to upskill healthcare staff, organisations can help mitigate data risk and benefit from a more educated workforce.

Healthcare organisations can also use cloud solutions to help comply with evolving data regulations and guidelines. Businesses need to clearly define data ownership, establish data quality standards, and ensure compliance with data regulatory bodies. By implementing robust data governance policies, healthcare organisations can ensure that utilised data is accurate, reliable, and used responsibly across all levels of the organisation.

Adopting and integrating cloud technology is now a necessity for healthcare institutions. Businesses need to adopt a holistic approach to cloud integration ensuring that cloud solutions are intertwined with processes and systems across the organisation. By embracing cloud data solutions, healthcare organisations can minimise data silos, enhance patient care, and stay ahead of the curve in an increasingly data-driven industry.

By Dominik Birgelen, CEO of oneclick Group AG

The post From Data Silos to Seamless Integration: How the Cloud is Reshaping Healthcare Data Management appeared first on .

The need for better data management is clear, but how to achieve it is less so. To remedy that, here are six best practices for data centers in healthcare.

Practice Strong Cybersecurity

Cybersecurity is one of the most critical considerations for any data center, especially in healthcare. Data breaches in this industry have more than doubled since 2018 and continue to trend upwards.

Medical data centers should deploy automated monitoring technologies to catch and contain attacks early. Segmenting them so an attack can’t spread from one area to all others is similarly crucial, especially for larger organizations. Other best practices include minimizing access privileges, encrypting all sensitive information and conducting regular penetration testing.

Remember that robust security doesn’t just apply to internal systems. The Red Cross suffered a major data breach in 2022 because an attacker targeted third-party data centers. All partners must meet high security standards before earning trust.

Don’t Overlook Physical Security

As prominent as cybercrime is, healthcare organizations must remember to consider physical threats, too. Data centers that don’t have thorough physical security are still vulnerable to damage and infiltration, even with the most advanced technical defenses.

Servers should remain behind locked doors at all times.  Only people who need in-person access to this equipment, like maintenance personnel, should be authorized to enter the data center. Keycards or biometric authentication and security cameras can enforce these rules.

Physical security should also protect against threats like natural disasters or equipment failure. Fire suppression systems, flood barriers and anchoring equipment to prevent racks from falling are a good start. Sufficient cooling infrastructure and surge protection are also important.

Keep Data Organized

Organization is an easier-to-miss best practice for healthcare data centers but a significant one. Hospitals generate 50 petabytes of data annually on average. Without sufficient organization, sorting through those massive volumes to find needed information or uncover suspicious activity will be difficult.

Healthcare organizations should adopt a tiering system to efficiently manage their data. As records become less impactful or less frequently accessed, they move to lower-level tiers. The highest levels should run on the fastest, most reliable storage systems, while the rest reside in cheaper but slower solutions.

This organization impacts security, costs and quality of care. Healthcare providers can act faster when critical data is more easily accessible. The increased visibility similarly enables faster cyber incident responses. If nothing else, tiering reduces storage costs.

Ensure Redundancy

Redundancy is another crucial data management technique for healthcare organizations. Data center downtime costs American businesses $700 billion annually, and sensitive information like health records are costlier than most. Redundancy minimizes this disruption.

Healthcare data centers need two types of redundancy. First, they need backups of the information itself. Backups aren’t necessary for the entire organization’s data but are essential for patient records and other sensitive information. These spare copies should exist in a different medium than the originals to minimize risks.

Next, healthcare data centers need equipment redundancy to prevent outages in the first place. That includes backup generators, cooling systems and uninterruptible power supplies (UPS). More mission-critical servers should have higher levels of redundancy than those hosting lower-value data.

Have an Emergency Response Plan

Similarly, healthcare data centers must have a formal response plan for when things go wrong. Prevention is always ideal, but considering 60% of data centers have experienced an outage in the past year, forgoing emergency response is too risky.

Response plans should include steps for reporting the issue, retrieving backups, communicating with key stakeholders and performing remediation. A list of responsibilities for each employee will also prove useful to enable faster responses. Larger or more sensitive organizations may need multiple response plans for different emergencies.

All plans should revolve around two main goals — securing sensitive patient data and keeping mission-critical systems as available as possible. If data centers do that, healthcare professionals can keep delivering quality care and comply with regulations despite the issue.

Routinely Rethink Data Needs and Strategies

Healthcare organizations must also recognize that data center strategy is not a one-time practice. Over time, some information will grow less useful, new data will become critical, innovative technologies will emerge and regulations will change. Healthcare data centers’ needs must also shift, so review and adjustment are necessary.

At least once annually, data center operators should review their current practices and compare them to their changing needs. They may need to adopt a new organizational strategy, upgrade infrastructure, adjust backup practices or move to a new security system. Some unexpected changes — like new laws or disruptive technologies — may warrant review outside this normal time frame.

As part of this ongoing improvement, data centers should also routinely benchmark their performance and costs. This will generate hard data to reveal trends highlighting improvements or the need for change. Some factors to measure include response time, available space, cybersecurity incidents and server temperatures.

Healthcare Data Centers Must Meet High Standards

Data centers are the backbone of a data-driven society. Consequently, optimizing them is crucial, especially in industries facing such high standards as healthcare.

Meeting these goals may initially seem intimidating, but it doesn’t have to be. Healthcare organizations that follow these six best practices can keep their data accessible, secure and resilient. They can then deliver higher standards of care and remain compliant in any situation.

By Zac Amos, rehack.com

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Orion Health’s UK and Ireland Customer Conference 2023 opened with a breakfast discussion about “mind-blowing tech” led by Dr Raphael Olaiya. The GP, researcher, and thought leader has a particular interest in virtual reality and AI, but he argued that “mind-blowing” technology isn’t about futuristic thinking; it’s about scale and application.

“A lot of research is focused on ideas that are not applicable to the masses, but to the few people who can afford it,” he said. “We see a lot of technology that has been around for years that has not been scaled, because while the technology itself might be fine, it can’t be applied where it is needed.”

With this in mind, Dr Olaiya’s list of “monumental” technologies included wearable devices that enable patients to monitor their own conditions; apps to help them take control of their health; digital platforms to improve access to medicine; communication tools to support multi-disciplinary teams; and decision-support tools to put the latest thinking into the hands of clinicians.

Solid foundations in the shared care record 

Orion Health is already working in some of these areas. Its technology underpins nine of England’s shared care records, which are creating a longitudinal record of the demographic and key medical details of more than 20 million people and putting it into the hands of health and, increasingly, social care professionals at the point of care.

The conference heard that NHS England is encouraging SCRs to build on these foundations by adding new functionality, such as care plans to help MDTs support people with chronic conditions or nearing end-of-life, or portals, to open-up access to patients.

While, internationally, Orion Health has developed a digital front door concept aimed at making Ontario’s healthcare system truly “digital first.” However, Orion Health’s ambition is to make sure that integrated care systems and trusts can use the data in the shared care record to address some of the challenges they are facing.

Or, as Martin Curley, professor of innovation at Maynooth University, put it: to stay left and shift left in a world in which demand is growing but funding and staff numbers are shrinking. “We need to stay left – which means keeping people well as a start” – and shift left – which means that if they are ill we try to keep them in the community,” he said.

“It is ten times more expensive to have someone get ill than to keep them well, or to treat them in hospital when we could treat them at home. We need to shift left from illness to wellness, activity to outcome, systems to people.”

Global healthcare challenges, global interest in AI to tackle them 

Orion Health chief executive Brad Porter told the conference this will mean taking the vast amount of data that healthcare generates every day and applying the latest data analytics and AI techniques to it. This will include machine learning – in which algorithms teach themselves – and generative AI – in which algorithms create new material.

“Orion Health works in 12 countries, and everywhere I go I hear that healthcare is broken,” he said. “I don’t think it is broken, but I think it is disorganised. We need to use data to get it organised, and to get it organised in the right way.”

Although barely a day goes by without a traditional or social media report on AI and the potential of products like ChatGPT, it isn’t much used in healthcare – yet. Porter said it will take time to: “Build trust, make sure we are using the right data sets, avoid human biases, and ensure equity and inclusion.”

But he insisted that “while there are lots of questions to be answered, a future powered by AI is exciting” and: “We should be using AI to address population health challenges, to decide who to send into hospital, to tackle administration, and to make personalised healthcare the norm.”

The Unified Healthcare Platform with Orchestral at its heart

Orion Health has just launched a Unified Healthcare Platform to underpin its Amadeus Digital Care Record, Virtuoso Digital Front Door, and Orchestral Health Intelligence Platform. Orchestral has evolved out of work undertaken by Precision Driven Health, a seven-year collaboration between Orion Health and more than 50 universities, healthcare bodies, and partners, to use data to develop new healthcare tools.

Its algorithms are now used across New Zealand and globally, but Dr Kevin Ross, Orion Health’s SVP for product enablement, argued Orchestral will move data use “into the next generation.” “At the moment, there is a lot of data coming in, and we all know we should be doing something with it, but we are not sure what, while AI is coming towards us,” he said.

“I am sure you have all tried something like ChatGPT and been awed or scared depending on what you have done with it. But it is going to be game-changing, so we need to think about how we can use it to unlock the value of that data, securely and safely. And we have technology that can help.”

Orchestral helps by ingesting data that has been collected by different healthcare organisations, using different systems, formats, and standards. It stores this information against a data model with a standard structure which means it can be safely exported to off-the-shelf business and research analytics packages.

At the same time, it includes some specific tools to ensure the confidentiality and integrity of healthcare data, such as a de-identification tool to suppress, mask or randomise data items for research, a data monitor to look for data quality issues, and a smart code to clinically code free text and make it easier to search.

Harnessing the power of generative AI with Pieces 

In addition, Dr Ross said Orion Health is doing a lot of work on natural language models. For example: “Ontario realised that patients needed a way to interact with the system without searching through documents,” he said. The result is “a chatbot that remembers where you were in a conversation if you leave and come back again, so you are not starting from scratch.”

Another example: Orion Health has formed a partnership with Pieces, a US company that started out by working with Dallas’ healthcare system to create what Dr Ross described as a “tweet-level summary” of a healthcare interaction. This can be sent to clinicians or patients, to give them a rapid overview of an encounter, without working through pages of medical records or results.

“All of these things are possible today,” he said, “although we do need to think carefully about the clinical safety element. We are worried about hallucinations. And we are working to make sure the guidance we are developing is consistent and in line with best practice.”

AI in healthcare can also tackle ‘data waterboarding’ 

Back at the breakfast meeting, there was a lively discussion around some of the potential challenges posed by the new world of data, analysis, and tools that platforms like Orchestral will make possible. Dr Olaiya argued that tools that give MDTs access to the full patient history and map in the latest pathways, guidance, and research on treatment, will be “mind-blowing.”

But there’s a danger they could blow minds. As Dr Phil Koczan, a GP, national and London tech leader, put it: “As a GP, I understand that having lots of information in the summary care record is a good step forward, but we are starting to get what is sometimes called ‘data waterboarding.’ We are being deluged with data, just as we are seeing a general increase in workload.”

Orion Health CEO Brad Porter argued that the partnership with Pieces could help here, by “condensing the information in the longitudinal record into a usable, 140-word form.” Similarly, there was concern that patients would be overwhelmed by data and put more pressure on the healthcare system as they look for help in interpreting it.

Again, Porter felt AI would help. “We sometimes talk about the worried well, but all the evidence from Ontario and other places is that if people are given more information, they are more proactive and less anxious,” he said. “I am more interested in where data is going in the system.

“If we are remotely monitoring someone, for example, we could be sending data to three places [the patient, the monitoring team, and a GP or consultant]. Generative AI can help here because we can use it to create summaries, clarify our pathways, and build dashboards, so clinicians only see what they want to see.

“That is what hospital clinicians like about the big electronic patient records: all the data is in front of them, but they have some control over how they access it. That’s different from standing under the waterfall, and we can achieve that by building out our data capabilities from the shared care record.”

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From staff management solutions to diagnostic tech tools, technology is permeating every aspect of UK health and social care. This is a positive trend. Implemented well, technology has the power to provide significant support in tackling the challenges facing our healthcare service, such as record waiting lists and rising staff shortages, and to ensure better outcomes for staff and patients. However, a lack of interoperability threatens to undermine the potential of many of these promising tools, preventing them from working effectively alongside other NHS systems.

Interoperable technologies are those which allow information to be transferred seamlessly and securely between different systems. There are hundreds of different digital systems in use across the NHS, from organisational databases like the Electronic Staff Record (ESR) to the vast number of systems used for different prescription and referral services. The inability of a new tech solution to integrate and effectively communicate with any of these can hamper its impact and ultimately harm long-term adoption.

Lack of interoperability can typically be traced back to either a failure to prioritise it when building and scaling a new technology, or by an inability from legacy systems to enable fresh innovations to integrate with their existing systems. However, there is a growing awareness within the NHS that tech solutions are hamstrung by this lack of interoperability, with NHSE recently noting its desire to promote interoperability and boost collaboration. This represents a growing interest in contracting health tech solutions that can work with existing NHS systems.

If a technology is incompatible with other NHS systems, this increases the admin burden on already stretched staff. It’s estimated that one in three NHS workers are made less productive as a result of dealing with multiple systems. More time has to be spent manually transferring and re-entering data across different systems, intensifying the pressure on their already high workloads and increasing the risk of data errors being made. This can understandably cause frustration and often leads to these valuable healthtech tools failing to adequately meet the specific needs of users, causing disruption across the wider organisation.

Making interoperability a priority

For new and existing healthtech innovators, interoperability has to be an absolute priority. To be successfully implemented and impactful in the long-term, new healthtech solutions must be built with the capability to ‘speak to’ and share information with all the other systems that they may interact with, and legacy systems must do what they can to empower and enable this. Start-ups must also endeavour to make it as easy as possible for new market players to become interoperable with their own platforms or solutions.

From day one, this means working in close partnership with the NHS – and at every stage of product development – to ensure that the solution is built to accommodate and integrate with the systems already in use. Close collaboration helps you to truly understand the specific pain points that need to be overcome to achieve genuine interoperability, and to build in a way that stops these from becoming hurdles further down the line. It is essential for ensuring that your solution works in practice, and not just in theory.

It is also important to make sure that your solution doesn’t just work at one particular organisation or Trust. Following the formal introduction of ICSs last year, collaboration between multiple different layers of the NHS is more important than ever. Technology must therefore be primed to facilitate this.

Lastly, innovators must also ensure that they are providing a high level of support both during and after implementation, including championing and enabling future integrations with new or existing systems. This ongoing technical and service-led support is essential. The NHS is a fast-paced and ever-changing institution; offering continued support will help you to identify any changes that might be needed and make sure that your solution is interoperable with any new systems that are adopted along the way.

Healthtech solutions cannot exist in a vacuum. If we are to create effective solutions that work as intended within the NHS, innovators need to prioritise the interoperability of our technology and design products so that they can effectively integrate with each other. Meaningfully meeting the needs of the healthcare service requires tools that can be woven into the current infrastructure; ensuring frictionless adoption and delivering genuine, long-lasting impact.

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The NHS, Europe’s largest employer and the world’s 5th largest, is working its way through the aftermath of Covid, the biggest health challenge in its history.

While the pandemic has reinforced some of the best features of the organisation, it has also highlighted areas where further work is urgently required. For decades, technology has played a key role across the NHS but the path towards digital transformation has been challenging. The recent move by NHSX to publish new digital guidelines to “support local NHS leaders and organisations to transform services for patients” is therefore, welcome.

The reality and perceptions of healthcare has changed and digital enablement is the route to a better patient experience and outcomes. Across NHS England, legacy systems and proprietary solutions continue to hamper progress. While initiatives, such as the Global Digital Exemplars and Digital Aspirants programmes continue to shape trusts’ digital journeys, existing barriers to rapid adoption and implementation of digital solutions must be removed.

Critical patient data is still not native

Healthcare systems are complex entities of structured and unstructured data, with estimates by Frost & Sullivan suggesting more than 75% of patient data is unstructured, while growing by more than 50% annually. It concludes that “healthcare organisations need better ways to unlock that value and maximize its potential”.

The storage and utilisation of unstructured data affects key day-to-day tasks, including the tracking and assessment of patient progress, or even scheduling appointments, leading to inefficiencies in the system. This cascades into burgeoning costs and decreasing patient satisfaction and outcomes.

Progress is being made but a new challenge is emerging with the growing use of mobile devices. According to a survey by HIMSS, nearly one fifth of imaging was found to have been captured offline, via smartphones, portable ultrasound machines and other devices, which are not integrated with core clinical systems.

The challenge is this: hundreds of applications managing petabytes of data, leads to IT sprawl and a tangled web of technology infrastructure. The lack of a centralised repository that connects all disparate systems and presents a cohesive view, affects the delivery and patient care outcomes.

Interoperability for a frictionless system

NHSX’s What Good Looks Like sets out a clear framework for the adoption of technologies that help drive digital transformation across NHS, based on seven measures of success: leadership of the digital transformation programme; ensures smart foundations; safe practice; supports people; empowers citizens; improves care; and healthy populations.

For all of this to come together, interoperability is the key. Colleen Sirhal, Hyland’s chief clinical officer, has described interoperability as a ‘people issue’ that will require the involvement of a much broader range of stakeholders, to reach a consensus on what is the right data and how to get it to the right people, at the right time.

The fact is, that technology-enabled care will deliver safer, more efficient and cost-effective healthcare. But if patients and healthcare providers are to enjoy the benefits, the strategy must facilitate the seamless and efficient access to information in real-time, which requires an integrated and truly connected system that brings content services and enterprise imaging together.

Integrated content services are the future

A Forrester report commissioned by Hyland, which surveyed organisations across a wide range of industry sectors, found that “those who embrace integrated content services are better positioned to realise digital, customer experience, and employee experience goals”. In fact, according to the same report, efforts to digitise content management services have accelerated in the past year (Figure below).

Image | Figure 1

According to findings, over 50% of respondents said that content services allowed employees to more easily use content as a source of data for insight, and processes for creating, securing, storing, or disposing of content. From a healthcare perspective, integrated and unified content services accelerate registration of patients, while improving visibility and understanding a patient’s medical history and journey.

Image | Figure 2

Access to unstructured data, whether handwritten registration forms, faxed or scanned documents, alongside DICOM or non-DICOM images, can help support the transformation of a healthcare organisation, leading to improved delivery and successful patient outcomes.

The integration of Hyland’s OnBase content services platform with Epic electronic medical record at Great Ormond Street Hospital (GOSH), has brought unstructured data into a single, complete, patient-centric record and significantly reduced time-consuming processes, such as signing of multiple consent forms. It also gives GOSH the flexibility to add specialised applications for example to human resources, accounts payable or enterprise resource planning and incorporate existing integrations bringing in a significant savings in time, cost and effort, besides improving practitioner and staff efficiency.

To meet NHSX’s plans to “digitise, connect and transform”, the wider digital transformation lessons must be shared throughout the NHS. Importantly, the digital transformation objectives will only succeed where not just the standards and formats for data exchange are addressed but also the wider policies and procedures.

Article by Peter Corscadden, Install Base Manager EMEA at Hyland. www.hyland.com

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When organisations are running up to hundreds of software products, it is inevitable that inefficiencies become embedded. Information silos can be created by the introduction of each new piece of software leading to data becoming trapped or the writing of custom code being required for it to be released. This causes inefficiency, creates costs and leaves healthcare practitioners without the information they need to provide the best patient care.

Taming the content and information in your organisation can be a challenge. For instance, given the various communication protocols and the number of proprietary solutions in healthcare, compatibility of information across the organisation can be hard to achieve.

Managing Healthcare IT Sprawl

So, how do you properly manage your IT expansion to ensure existing and future technologies integrate seamlessly, with minimum disruption, and without the wholesale replacement of legacy systems?

A growing number of organisations, across public and private sectors, are turning to content services solutions, which provide the flexibility to bring unstructured content together and integrate it for use with your existing EPR, HRIS, ERP and AP systems.

Now, instead of unbridled IT sprawl, your unstructured data is consolidated on a single information platform that provides integrated workflow with core systems. Healthcare practitioners don’t have to hunt it down or guess where it might be. They don’t need to learn a new system since the data is integrated in the EPR they use daily. As a result, data is available anywhere it is needed in your enterprise, from the point of patient care to the back office for improved decisions.

And since the implementation takes months rather than years, it’s possible for a healthcare organisation to transform its operational capabilities quickly, without major implications for staffing or other costs.

So, if you are looking to introduce content services into your organisation, or replace one already there, which platform should you choose?

The right system will scale with your needs so it is most important to choose a platform that will be sufficiently flexible to cope with change.  You should look for an organisation that continues to grow and update their platform.

It is also important that the platform has a broad base of customers, not just in healthcare, but in other sectors too. If there is widespread usage among all types and size of companies and organisations, you can be pretty sure the platform is adapting to market needs and is likely to do so in future. Since the evolution of software ultimately depends on the vendor, you want to ensure that content services is the core focus of their business.

For example, Hyland’s content services portfolio is continually updated and enhanced. With key updates and enhancements in each release, the solution will continue to accommodate the evolving needs of healthcare organisations, whether they’re very area-specific or right at the core of an organisation’s operations.

Great Ormond Street Hospital (GOSH), for example, integrates OnBase with systems like Epic, to bring unstructured content into a single, complete, patient-centric record and to remove time-consuming processes, such as signing of multiple consent forms from the administrative burden.

GOSH also has the reassurance of knowing that they can add any number of applications for human resources, accounts payable, enterprise resource planning and more and incorporate existing integrations that Hyland has made to these systems. That presents a significant saving in time, cost and effort.

It also provides the freedom to update their platform as they wish, adding enhanced workflow, case management, robotic process automation, enterprise search and more to enhance practitioner and staff efficiency.

When the time comes to change out an EPR or consolidate the number of legacy systems, your content service platform and unstructured data can be integrated into any workflow.

You can be confident that with a cutting-edge content services platform in place, you will have the most cost-effective solution for managing the complexity of your IT sprawl.

Haroon Iqbal is Install Base Account Manager EMEA with Hyland Healthcare. www.hyland.com

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As a doctor and a healthtech innovator, I’m hugely excited by the green shoots of progress emerging from the NHS digitisation drive. However, my enthusiasm is tempered by frustration at the nature of the relationships that some third party tech providers are establishing, or have historically established, with their NHS customers.

These relationships are more accurately described as one-way transactions: evaporating the very moment the tech is handed over. They are relationships that are unfit for the unique demands of NHS tech roll-outs and they are hindering progress and impact. It’s time for a paradigm shift.

Tech must stop being parachuted in 

In scenarios where these problematic relationships are allowed to play out, the technology – whether that be an app, a data sharing dashboard or a digital collaboration tool – is developed and then handed over to the end user by a third party supplier. Thus ends the ‘relationship’. In other words, the technology is parachuted in, and the provider is swiftly extricated from the proceedings.

This state of affairs rarely delivers value for the NHS organisation and its teams.

This is because, firstly, there is no such thing as a ‘one size fits all’ tech solution. New solutions need to be configured to meet the unique demands of each clinician or organisation, a process which can also necessitate post-launch iterations. Only the tech providers themselves have the specialist product knowledge necessary to do this effectively. Despite this, not all seem willing to  put in the time upfront to configure their solutions for the specific situation at hand, and then remain engaged and ready to deliver additional services and support when needed.

Secondly, transformational tech solutions are, by their very nature, complex. NHS management teams don’t typically have the bandwidth to oversee implementation or fully induct and train staff, let alone to troubleshoot or re-engineer around potential hurdles.

Expecting them to do this is like a mechanic handing you the new engine for your car and wishing you the best of luck with its installation and maintenance. 

A lack of partnership – the risks  

The failure of certain tech providers to provide adequate roll-out and post-implementation support means that many new initiatives fail or fade out before they have the chance to take root and achieve their full potential.

The resulting delays and backtracking wastes the time, money and effort of all stakeholders. What’s more, it makes NHS teams understandably jaded, and less willing to engage with future digital transformation projects.

In worst case scenarios, poorly implemented tech could cause systems to break down or data to be lost or leaked – causing potentially severe harm to patients.

Tech implementation shouldn’t, and doesn’t, have to happen like this. 

Reimagining the relationship 

In order to achieve the ambitious digital transformation goals of the NHS Long Term Plan, tech companies and the NHS must agree on a set of non-negotiables.

It’s time to push for a paradigm shift to a new normal where healthcare technology providers are knowledgeable, service oriented, and long-term partners to the NHS. This means that they are fully committed to taking ownership of the implementation and maintenance of their solutions; embedding best practices from day one, and providing the ongoing support needed to ensure end users achieve their desired outcomes.

Encouragingly, some providers do break the mould. They are setting the benchmark for what a successful public-private partnership looks like. They are investing in the provision of dedicated support staff who are seconded to work alongside the customer’s own transformation teams, making end-to-end, wraparound support their standard. They are aligned with the NHS’s objectives and share their mission to deliver world-leading care.

Now is the time for these isolated examples to become the expected norm. That means  carefully imagining what sustainable, impactful partnerships could look like in the future, and designing a means to make them happen. Ultimately, by setting the bar higher for technology providers, it will become possible for the NHS to convert this decade’s incredible rate of innovation into improved outcomes for patients, staff and employers.

Article by Dr Anas Nader, CEO and Co-Founder of Patchwork Health

Patchwork Health recently announced a revolutionary approach to healthcare staffing – ‘Outcomes-Based Staffing;’ enabled by a newly launched rostering solution. 

Find out more or get in touch to apply to join the Patchwork Rostering Accelerator.

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As we collectively wake from the fog of the coronavirus, analyzing the data collected during the pandemic will be essential for determining future treatment guidelines, such as: what are the long-term effects of the coronavirus on marginalized populations, and what, if any, unintended adverse healthcare outcomes will impact those who got coronavirus. Additionally, the data collected from inoculations will be crucial for determining which vaccine had the greatest efficacy. During the pandemic, healthcare organizations had to decide what security processes they should implement to protect electronic private health information and how to provision hundreds of clinicians in near-real time.  Post the pandemic, healthcare organizations will need to have an automated way of documenting of how they removed access for hundreds of contracted employees.

In some twisted fate of coincident, mHealth solutions that were previously deemed novel became essential for mobilizing large segments of the population. Folks were using mobile apps to book appointments for coronavirus testing and others were using apps to get appointments for inoculation. Candidly, many of us were using mobile apps and telehealth platforms for mental health check-ins and tune-ups.

In effect, coronavirus highlighted two significant trends: early adoption of health IT matters and automation is essential for driving operational and clinical efficiencies. Early adopters of health IT solutions had a slight, if not significant, advantage over late adopters. Healthcare organizations, who had invested in mHealth apps and collaborative IT solutions could quickly pivot and triage resources to go virtual. This ability to seamlessly go virtual was essential for patient care and operational efficiencies.

The use cases for adopting healthcare solutions with automation, such as machine learning and artificial intelligence, has been proven with the manual IT war stories of the coronavirus. In the end, manual healthcare processes were simply not a match for the Covid-19 pandemic. Manual processes were slow, error prone, and time consuming…and the old adage:  “If it ain’t broke, don’t fix it” proved to be a very painful lesson for many organizations.

As we move through 2021, the hard part begins. How do we give access to large groups of clinicians to study the global impact of the coronavirus? How do we ensure identity security for clinical collaboration? What mHealth solutions shall we keep? I suspect there will be healthy debate for several months to come. However, right now, most of us simply want to get back to hugging our family members, having dinner with our loved ones, and coffee with our frenemies.

About the author

Ms. Alison Haughton serves as  a Senior Manager, Healthcare at SailPoint. Ms. Haughton focuses on health IT, population health management, identity governance, cloud, and digital care transformation. Ms. Haughton was one of the principal members of AT&T’s ForHealth practice and  has served in a series of senior product marketing and leadership roles at IMS Health (now IQVIA), Harvard Medical School, Parexel, and a variety of early stage healthcare companies implementing mobile and cloud-based solutions.

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