John Coulthard
Microsoft UK Healthcare Director
In October, the Healthcare Commission released its ‘new and improved’ annual health check to great fanfare. This years’ report was the Commission’s most in-depth yet on NHS performance covering ground not previously examined. For the first time, NHS Trusts were assessed to determine whether they are meeting general standards and managing areas that matter to patients.
The report made interesting reading providing a picture of how the NHS is performing, with measures such as financial planning and value for money being highlighted. Since this is a first attempt we can expect each subsequent report to me more robust and complete.
The report highlighted some areas for concern, together with others where the NHS is performing well and patients are happy with the experience they receive. Waiting times, for example, are continuing to fall.
However, the interesting thing for me is what lies behind the hard data. I believe this report reflects the NHS’s continuing evolution. The health landscape is changing in response to the need for greater involvement of patients in controlling and deciding how their healthcare should be provided.
Informed choices
In the education sector, for example, parents now have enough information about the academic standard of the schools in their area to make an informed choice as to which schools they’d like their children to attend. Whilst the health sector is not yet at this level, patients are increasingly demanding transparency to allow them to make informed choices about where they will be treated, and who will treat them when they are there.
Although change often creates an air of insecurity and uncertainty, it doesn’t always mean doom and gloom. I believe there is definite cause for optimism in the health sector, particularly for those working with technology, despite the often negative headlines on the NHS.
For the first time in the history of the health service, we have the opportunity to deliver truly innovative solutions and infrastructure to the heart of the NHS which will have a direct effect on the way patients’ access and move through the health system. We should not forget that the IT journey the NHS is on is unique across the world.
Pressures and drivers
There are some new pressures developing for the Information Management and Technology (IM&T) community of the service. The introduction of the independent sector into the NHS with their focus on cost effective delivery of specific healthcare outcomes, together with new health management organisations taking control of a specific disease or disability in a community or area, the issue of patient choice and finally, the introduction of personal health care records and sites on the internet.
These pressures will require decision healthcare leaders to focus on management data, I mean by this the delivery of effective information to decision makers in the NHS that is accurate, timely and well displayed will become a paramount skill for IM&T specialists in the NHS.
While technology is a key driver behind the majority of NHS modernisation initiatives and the IT sector has a responsibility to support healthcare providers as they transform the way services are accessed delivering new ways of working that are user-friendly and can be accessed across a hospital whilst placing the patient at the heart of everything they do.
A solid infrastructure framework, focused on the end user, is essential to the successful delivery of effective and efficient management processes which will result in improved care for patients. I believe that there needs to be a policy focus on three areas of information.
Firstly, Information Administration, this is the discipline of making sure that information is captured once and provided to the right systems at the right time.
Secondly, Information Management, which means the aggregation and analysis of information for delivery inside and outside the NHS.
Finally, Information Exploitation, the delivery of decision support systems such as scorecards to support effective decision making of healthcare leaders.
The importance of people
Inevitably this is about people and their IT ability, whether they are gathering information, designing systems to move it around, making information available outside the normal organisational structures or using the data to make to make decisions.
A recent study by PriceWaterhouseCoopers highlighted that too few companies take their people into consideration when structuring IT. Although 78 percent of businesses said their ‘people’ were their most important asset and 91 percent say technology helps people do their job better, only 39 percent have an IT strategy focused on their people.
It would be wrong to claim that all problems within the health sector can be solved by using technology and IM&T to support people and decision making. It takes more than that. The leadership of any organisation provides people with a vision and values, the culture provides them with a supportive work environment they want to work in, and the tools provide the framework that allows them to excel and innovate in their working lives.
The NHS, as with industry, needs to understand technology is there to help, not lead, them. The technology is there to create a modern health system for the 21st century, but it is the users that will ultimately determine its success. The way that clinical and admin staff use the technology available to them will generate the efficiency and productivity required to drive the NHS agenda forward.
We need to think differently about information and how it will be used, as the provision of healthcare in the UK becomes more competitive through consumer pressure and independent competition, access to timely information will be the differentiator of some organisations, those that do it well will succeed, those that do it badly will not only fail their patients but they will fail as organisations.
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