#11. W/c 11th November '24
Alastair Allen
Partner, Head of Healthcare Technology at EY | Board Member at openEHR UK
What I read this week: the development of a new open architecture for health data interoperability, essential strategic principles for planning digitally enabled interventions in health care, insights from the NHS Providers Conference 2024, and an exploration of the challenges in NHS medical record sharing highlighted by coroners’ warnings.
An Open Architecture for Health Data Interoperability
A report by The Linux Foundation highlights the potential of open source to revolutionise health data management by addressing interoperability challenges in the healthcare sector, often referred to as the "Information Dark Ages".
The study identifies unique challenges in healthcare involving non-standardised data exchanges and the dominance of proprietary electronic health records (EHR) platforms that result in poor data interoperability, hindering innovation and effective patient care.
The study recommends constructing a digital health architecture that standardises components and technologies, thereby enabling proprietary applications to interoperate seamlessly. It suggests that a foundation like the Linux Foundation could lead efforts to create this architecture by uniting stakeholders who share a common interest in improving health data practices.
The report makes a compelling case for open source as a means to address interoperability challenges in healthcare, but it is important to distinguish correlation from causation in this context. While open-source solutions can facilitate interoperability through their transparency, adaptability, and community-driven standards, they do not inherently guarantee it. True interoperability depends on adherence to shared protocols, information models, collaboration among stakeholders, and the adoption of standardised frameworks—factors that are independent of whether a system is open source or proprietary. Open source can provide a valuable foundation for interoperability, but its success in doing so relies on intentional design and widespread commitment to common standards.
Essential strategic principles for planning and developing digitally enabled interventions in health and care settings - BMC Health Services Research
The article from BMC Health Services Research outlines essential principles for planning and developing digital health interventions. Despite the potential of health technologies to enhance service delivery, many fail due to poor integration with user and organisational needs. The authors propose seven strategic principles to improve the development of digital tools.
Firstly, it is crucial to evaluate if digital solutions are the best approach for organisational change, considering alternatives like non-technological interventions. Digital interventions should be seen as complex, multifaceted changes that require integration with existing practices. The development process must include varying degrees of co-creation, recognising potential biases and power dynamics that can influence participation.
Additionally, digital tools should be adaptable to different contexts while remaining applicable to broader settings. Integration with existing infrastructure is vital, though challenges such as data overload and user time constraints should be addressed. Planning for the intervention to fit within broader health pathways is crucial to ensure alignment with existing service models without excessive customisation that limits scalability.
The authors stress the importance of iterative, formative evaluations throughout the development and implementation processes. These evaluations can inform changes and improve the user experience, ultimately enhancing adoption and scaling of digital health tools. By considering these principles, strategic planners can enhance the likelihood of successful digital interventions in health and care settings.
Amanda Pritchard speech to NHS Providers Conference 2024
Amanda Pritchard, CEO of NHS England, addressed the NHS Providers Conference in Liverpool, sharing key insights and outlining future plans. She recognised the significant challenges faced by the NHS over the past decade, including organisational reorganisation, financial constraints, and increasing community needs. Despite these challenges, she highlighted the NHS's ability to adapt and innovate, achieving efficiency savings and enhancing care delivery through initiatives like virtual wards and community diagnostic centres.
Pritchard emphasised the importance of reform and continuous improvement, appealing for ideas and collaboration in developing the forthcoming 10-Year Health Plan. She also addressed the need for better integration between primary and secondary care, urging organisations to utilise digital innovations and central resources like the NHS App and Federated Data Platform.
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She outlined the NHS's commitment to optimising current systems without drastic reorganisation while advocating for improved accountability. Pritchard, acknowledging the financial constraints, stressed financial rigour and efficiency, urging NHS leaders to take proactive steps to manage resources effectively and improve care delivery.
The Sudlow Review
The Sudlow Review, titled "Uniting the UK’s Health Data: A Huge Opportunity for Society," is an independent report led by Professor Cathie Sudlow. Commissioned by the UK health authorities, including the Chief Medical Officer for England, the report was released on 8 November 2024. The review highlights the UK's potential to improve health outcomes through the effective use of health data. It identifies challenges in accessing and using health data due to various barriers and proposes five key recommendations for systemic reform. These include establishing a coordinated national strategy recognising health data as critical infrastructure, creating a national health data service with accountable leadership, enhancing public engagement, standardising data access processes across the UK, and developing a UK-wide system for secure data environments.
Professor Sudlow is known for her expertise in data science and her leadership in significant health data initiatives. The review was supported by consultations with experts from various health and statistical organisations and aims to create a secure and trusted health data system for the UK.
NHS patients dying because of problems sharing medical records, coroners warn
Coroners in England and Wales have raised concerns this year about the inadequate sharing of NHS patient information, with 36 warnings issued due to failures in accessing critical health data that have resulted in patient deaths. Conflicting IT systems and limited access to medical records impede staff from obtaining crucial details about patients, significantly impacting care.
In one tragic incident, a three-year-old boy with Down’s Syndrome died from a streptococcal infection after an NHS 111 adviser, unaware of his condition due to poor information sharing, did not urge immediate hospital care. Similarly, an 11-year-old died because critical information was missed during a handover from ambulance to A&E staff, hindered by incompatible IT systems. Another case involved a mental health patient who was released instead of being detained under the Mental Health Act, leading to her suicide after her digital records were unavailable.
These incidents highlight the urgent need for improved information sharing within the NHS. Labour proposes storing patient health data centrally and making records accessible through standardised systems across the NHS in England. Health Secretary Wes Streeting reaffirmed the commitment to modernise the NHS, including a £2 billion budget boost for digital improvements and a goal for a single patient record via the NHS app.
However, privacy campaigners express concerns about patient confidentiality with Labour’s plans, fearing potential misuse of centralised records. A call has been made for transparency, allowing patients to track who accesses their records.
Babylon founder Ali Parsa returns with new healthcare AI venture
Ali Parsa, founder of Babylon Health, has launched a new healthcare AI venture named 'Qu'. Announced via LinkedIn on 12 November 2024, Qu aims to develop personal digital clinical assistants that are comprehensive, controllable, and customisable, enabling healthcare professionals to better manage AI for utility, safety, and quality purposes. Backed by Swedish venture capital firm Norrsken, Qu seeks to address healthcare's structural imbalance between high demand and limited clinical supply.
Babylon Health, once valued at £4.2 billion, faced liquidation after failing to deliver on promises and expanding too aggressively. Parsa has assembled a team of scientists and innovators to form Qu, which draws parallels with Babylon Health's mission of using pre-generative AI for virtual diagnostics and triage, though Qu seeks a more expansive approach. It plans to support clinicians across a complete range of clinical and administrative tasks and in multiple languages.
Board Member | Director - World Data Exchange * Human Centric data sharing platform * Data Intermediary. Founder - ID Exchange * Privacy and Consent Impact Systems | Multi Award Winning leader in emerging technologies.
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