Has NHS IT moved from Star Wars to Star Trek?

Matthew D’Arcy reports from the opening morning of Scotland’s Digital Health and Care 2019 conference.

Richard Corbridge is a chief information officer best known for healthcare roles in Ireland and England. But his keynote remarks to Scotland’s annual Digital Health and Care conference made it clear that he doesn’t want to be known for his tech expertise.

“We need to move away from being IT directors”, the CIO of Leeds Teaching Hospitals NHS Trust told the event in Edinburgh. “I’m a CIO – I don’t want to be considered an expert. I want to be considered a collaborator.”

Digital is a platform to deliver appropriate care, he said, adding that success rests in building technology with users. “Doctors are perceived to hate computers – I don’t think they do,” he went on. What they hate are systems that seem to get in the way of what they need to do to care for patients.

Fortunately, he argued, NHS technology culture has “changed from Star Wars to Star Trek”; moving away from a top-down imperial march – an “evil empire taking control” – to working together – so everyone can “boldly go”.

Seek out new innovators

Delegates gathered at the spectacular Dynamic Earth centre weren’t told to find new life or new civilisations. But conference chair Margaret Whoriskey, the head of technology enabled care and digital healthcare innovation at the Scottish Government, did tell delegates “to seek out new innovators”.

Colin Cook, director of digital at the Scottish Government, insisted innovation was essential to avoid “replacing the old world in a slightly faster, fancier way.” He agreed with his fellow presenters that innovation needed the buy-in of those who used the products and services it produced. “When we design a service in Scotland users will be in the room,” he promised.

An interesting new angle on this was provided by sessions on data and on machine learning. An afternoon session heard about the new National Digital Platform, which promises to create a single data repository, with access controls, that “contains the same health data wherever you may be.”

Presenters enthused about the possibilities for planning care and measuring outcomes; and also giving patients access to access to key data. One predicted it would mean the end of systems being a closed, “black box.” Further into the future, the revolution presaged by genomics promises to improve the accuracy of cancer diagnosis and treatment and usher in an era of “personalised medicine”.

However, Chris Feltham from Intel UK argued that to realise the potential human factors will remain critical. “Nobody wants to hear their diagnosis from a machine,” he pointed out: and the service designers of the future will need to remember that.

Boldly go, and repeat

Nor will innovation be enough. Last spring, Scotland published a Digital Health and Care Strategy that aimed to take some bold steps towards what it described as a “truly national” approach towards digital infrastructure and development.

It promised a national decision making board to find “an accelerated approach to scaling up and doing things once nationally or regionally, rather than multiple times locally”; along with specific measures to support this, such as a pan-Scotland approach to information governance.

At the same conference 12 months ago, this theme of ‘doing things once for Scotland’ was emphasised by Paul Gray, who stands down as NHS Scotland chief executive this month. Initiatives like the National Digital Platform notwithstanding, a year later, it’s clear that a lot still needs to happen. “Individual pilots that achieve huge success” are still not being replicated elsewhere, Cook said. “We have to scale these ideas.”

Transformation: the final frontier 

One IT provider to have scaled its solution widely across Scotland is InterSystems, which has delivered its electronic patient record, TrakCare, to NHS boards, along with other technologies.

But Mike Fuller, the company’s regional director of marketing, returned to the recurring theme of the need to make sure that technology is implemented effectively and in a way that resonates with users.

In his session, he told delegates that technology is just 10% of digital transformation; the other 90% is all about people and change. After all, he pointed out, tools like scales and tape measures, hadn’t necessarily made people change their behaviours, so why would digital tools be any different?

It was important to not become “distracted by shiny new toys”, he said. “We need deeper understanding about workflow and the data that powers transformation. Otherwise we have a bridge that goes 80% of the way – where no one will use it.”

The conference is organised by Holyrood and runs from 20-21February 2019. It features contributions from digital leaders across health and care in Scotland.