The NHS needs to develop digitally and a big part of that is making it digitally interoperable. How do we tackle the conundrum of digital interoperability and the NHS? David Parkin, senior membership and policy officer at the NHS Confederation, tells us more.
The digital readiness of the NHS has come under renewed scrutiny in recent months – the creation of a departmental digital policy unit ‘NHSX’, the National Audit Office (NAO) investigation into the use of digital technology in the NHS and a shift in the way we talk about tech has collectively shaped the public discussion on what the NHS can achieve with the use of technology.
In the clamour to lay out an ambitious roadmap, punctuated variously by leaps in genomics, artificial intelligence and telemedicine, less thought has at times been given to the foundation that these and other targets will be built on - interoperability. Although NHSX’s early goal will be the creation of open standards, this alone will not be sufficient - interoperability is still proving difficult for many NHS organisations and systems to implement, with significant variation across the country.
Our annual conference, Confed19, took a closer look at the issue, bringing together representatives from the national, regional and trust level as well as the third sector to discuss their experiences implementing interoperability.
The discussion touched on a wealth of issues - emphasising the importance of clear open standards, strong information governance and new guidelines for professional language in places where technology is poised to open up communication between formerly disparate roles and sectors.
Central to all of this though, is the preparedness of the NHS provider sector. The will to change is a starting point for any transformation, but in the case of digital transformation this will must be supported by a host of other practicalities – the ability to synchronise contracts, sell the benefit of change and source the funding to achieve it. Achieving this sort of alignment is no small feat, but it is not beyond reach.
Drilling down into some of the specific challenges in bringing about change, panellists stressed the importance of getting clinicians on board. Without their cooperation, an interoperable system is simply an empty vessel. One key issue in this regard was the perception that a computer might create a barrier between patient and clinician in a consultation and that notes would take longer to type than write has slowed down progress in many areas. Although valid concerns, as with the macro-challenges like creating partnerships and securing funding, the challenge with getting buy-in from clinicians is about one thing – making the case for change.
At its heart, interoperability is about improving outcomes for patients, freeing up clinician’s time and delivering services that are better connected – the key to unlocking this for large swathes of the NHS is in communicating this message. Sessions like the one at Confed19 are a fantastic opportunity to take a look at some of the most advanced IT and health systems in the country, but they are not indicative of the wider service. When it comes to tech, the NHS has long relied on talented and committed individuals in the right place at the right time to drive change, but to create systemic and meaningful change we need shift the conversation on technology and create those individuals and those conditions in places where they don’t yet exist. The resounding message from the session was one of momentum – where you can make a strong business case for change and you have the alignment you need, the momentum of partners in that venture will carry it through.
This is a message the Confed intends to take forward. Over the coming weeks we will begin a process of engagement with both our membership and the wider health-tech sector to establish levels of interoperability in the NHS, and to recognise the barriers to achieving it and understand how to overcome them. This research will form the basis of our future work programme – identifying what support is needed and how to bring about digital change. More than anything, our session showed that there is good work going on in the NHS and while a fully interoperable NHS is well within reach it is still a way off for many trusts. Chance and happenstance will always be at the core of innovation, but we cannot rely on them for systemic change. They have shown us what we can achieve, now we need to work out how.
David Parkin is senior membership and policy officer at the NHS Confederation. Follow him on Twitter @DavidAKParkin and the Confederation @nhsconfed