Overcoming Barriers: The Rise of the Machines

David Newell is Head of Healthcare at Gemserv. David has a 30-year career focused in delivering digital transformation of healthcare. David started his career as an NHS CIO and has led a range of healthcare software vendors and consulting businesses.

My career for the last 30 years has been focused on delivering technology-enabled change to the health and life sciences sector.

Over that time the label has changed a few times: “informatics”, “IT” and more recently “digital transformation”. But two things have remained constant. The challenge has always been to change the way we work by adopting new technologies. And that challenge has always been surprisingly difficult to achieve.

Technology-enabled change in the health service is a complex challenge.

Indeed, change in any environment with such a complex set of interrelationships, stakeholder groups and conflicting priorities would be a challenge. But it safe to say that digital transformation in healthcare has fallen behind many other parts of society.

The recent National Audit Office report on Digital Transformation in the NHS concluded that while the main bodies plans for digital transformation are “ambitious”, the track record in the NHS has been “poor”.

Something different began in March 2020.

In March our teams were working hard with a number of clients. In particular, our work with the Isle of Man Transformation programme was gathering pace. We were actively involved in the delivery of Sir Jonathan Michael’s 26 recommendations from his earlier Independent Health and Social Care Review. I personally was commuting to the island on a weekly basis, leading service reviews and supporting the digital change agenda. And by the end of the month the borders were closed.

Given the difficulty of large-scale change, the prospects for programmes under these circumstances looked bleak.

But over the first month we pivoted, changed our approach, re-planned and adopted new ways of working that were underpinned by technology. The world moved to video calls.

It has not been easy, but it has been effective.

In parallel, the same pivot has taken place across many aspects of our lives from work to education and entertainment. Our lives have changed in a very short space of time.

Areas of healthcare delivery that have long been discussed as targets for digital transformation have also rapidly changed, such as joint, remote working using Microsoft Teams for Multi-Disciplinary Teams (MDTs) and online consultations in primary care and outpatients.

These technologies were deployed in days, not the months or years which had been the norm prior to COVID-19.

These rapid deployments are not without their own challenges. I am sure that there will be a degree of remedial activity required. Information governance and data protection in particular will need some attention as the debate around privacy and contact tracing has impacted adoption. I am also sure that cyber-security will be an ongoing issue to address, as criminals exploit what they perceive as the COVID-19 “distraction” to attack the NHS.

Out of the challenge of COVID-19 has nonetheless come one fundamental change.

We have proved that rapid technology-enabled change in healthcare is not only possible, but it works. In many areas of service, “digital first” will become the norm. The term “outpatients” will take on a new meaning. As we help our health service clients through service re-start and recovery, the role of technology in service redesign is critical. In 30 years, I have never seen “normal” change as quickly.

But I also believe we can use technology to jump pass the “new normal to a “better normal”: where digital transformation is that norm.