Health Professions January 28, 2019
Non-clinical service efficiency – digital is part of the answer, but only part

By Mike Hobbs - World Healthcare Journal

A digitally-enabled NHS with patients owning their own healthcare information and clinical practice supported by artificial intelligence, machine learning and data analytics is a vision that few would disagree with. And it’s not only these headline-grabbing aspects of the NHS that get name-checked in this digital vision. More humble activities including logistics are rightly recognised as being opportunities that can be unlocked through digital innovation. And at its core much of healthcare is about getting the right patient, at the right time, to meet with the right clinician, with the necessary information and the right equipment to undertake the clinical activity – a long way of saying logistics.

Yet healthcare providers don’t think of themselves as major logistics operations. And over the years many end-to-end logistics processes have developed to manage failure. Thus there is significant opportunity for improvement in the patient and staff experience and in delivering improved efficiency. And digital certainly has a part to play.

But digital is not the answer. It is an enabler. Almost by the day there are new digital options all proclaiming to enable improved quality and reduce cost. Before being able to assess this, it is necessary to understand the fundamental question that is being answered. There is little point in improving the efficiency of one part of a process only to create larger bottlenecks or disruption elsewhere. The starting point should be to understand the workflow, which may benefit from targeted data analytics and subsequently identification of appropriate technology and digital enablement.

The digital revolution needs to be fuelled by in-service data. Data that initially will almost certainly be able to be challenged. However, it will be the exception to get a perfect dataset that no one can challenge. A mindset change is needed that recognises when data is sufficient to make informed decisions to improve processes that people know are inherently wrong or ineffective.

Healthcare processes are often operationally reactive, correcting processes that are failing, without recognising that the same failures are repeating themselves. Data analytics has a part to play in transiting from reactive to a proactive performance culture focused on continuous improvement and celebrating doing more with less. In this context, innovation can be defined as a new idea utilising a more efficient device or process.

There are many opportunities to invest in technology and digital. For instance, the Internet of Things attracts much press. But the IoT relates to devices that capture more data. There is already a world of data produced by existing systems, much of which isn’t used because any shortcomings in a data set are used to discredit the whole data set. The opportunity must be taken to identify robust data elements within existing datasets and to use digital analytical tools to maximise the impact of existing data on process improvement and ongoing monitoring to drive continuous improvement.

The IoT becomes relevant when specific business cases are identified where acquiring timely data to support a business process has the demonstrable potential to reduce or avoid costs. As an example there are many applications of the IoT in building maintenance. However, the level of engineering staffing is often close to the minimum to achieve statutory compliance. Hence, is it likely that investment in IoT devices will have the desired impact of reducing costs? It will almost certainly have a disproportionate cost benefit in terms of improved service but this does not meet the primary objective of reducing cost.

Embracing and reaping the rewards from digital enablement requires a cultural change. A change that will include the development of new capability and capacity in the workforce. It is a major change programme that needs adopter organisations to recognise it is a longer term change programme and to seek out the quick wins on this journey to digitally-enabled healthcare.

It is difficult to find any fault with the Secretary of State for Health’s statement that: “The time is ripe now to bring about this tech revolution in healthcare”. The test of success will be measured against  another statement from the Secretary of State: “The critical part is that it will save money in the medium term and it's abiding by the standards that will allow a system to run better. ” 

Mike Hobbs is an independent consultant with over 25 years experience in developing and delivering health infrastructure projects and support services both in the NHS and the private sector.

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