Transforming services across STPs and ACOs for true population health

Momentum is fast building behind the use of digital technology to integrate care across whole populations and health economies – from direct care to research, care planning and provision. As I write this, the NHS and its technology partners are preparing bids to become one of five new NHS England Local Integrated Care Record Exemplars, three of which could develop into full blown population health management and regional research databases or “data lakes”.

At the same time, suppliers (including commissioning support units) have just weeks to apply for a place on the new accountable care system and sustainability and transformation partnership national procurement framework.

In all this, we are once again looking across the pond for inspiration. Examples are cited of US care providers starting to use Artificial Intelligence algorithms and population health management at scale, and unfavourable comparisons made with digital maturity in the NHS.

This has its risks. The US has benefited from massive fiscal stimulus, while the NHS is under unprecedented financial pressure. Even so, as Bob Wachter pointed out, healthcare digitisation in the US is not the success story UK policymakers would have us believe.

Steps to take

If the move to a population-based approach and cross-community working here in the UK is to work, there are three important steps we must take:

1. We need to understand and articulate the very real benefits to clinicians and to patients of sharing data and mobile, clinical and cross-community digital solutions. Improving and speeding up decision making by sharing information and moving to real time task management and communication saves so much clinician and patient time and drives up the quality of care.

2. We need to get on with the task of moving our health economies off paper.

It’s all very well talking about rich datasets, predictive modelling and risk stratification but unless we improve our patchy digital performance, the reality will be towering mountains of paper rather than vast Matrix-style data lakes. Some areas of the NHS are paper light and the rest need to follow.

3. We must keep testing the impact of technology and keep pushing the boundaries. That means evaluation, documenting use cases, testing patient apps and wearables, and focusing on solutions which are designed with clinical users in mind.

Smooth deployment

It also means a relentless commitment to getting the deployment right, since a smooth deployment is the key to a successful transformation project. Experience and methodology count for everything here. And we need energy in spades. Transforming workflows and care pathways is hard work.

Like other suppliers, the System C & Graphnet Care Alliance is committed to developing the clinical, mobile technology that will enable health economies to break down organisational barriers. We are right behind the importance of large integrated care records, both for direct care and, once deidentified and with the correct consent, for population health and research purposes. Our shared care records hold over 10 million citizen records and are used in over 50 clinical commissioning groups.

We know first hand the benefits of large pools of clinical data. Our shared record data helps reduce accident and emergency attendances, admissions and length of stay and improve patient safety and clinical outcomes. The technology is there. Let’s deploy and use it.