“Data really is the key to the future”
We sat down with Gary McAllister, Chief Technology Officer and National Executive Director for Technology Strategy, Architecture and Standards at NHS England, to talk about the platform approach that is unifying healthcare across London, the vision they have of becoming the healthiest city globally, and about the challenges that came along the way.
You said that healthcare can only survive with technology and digitalisation. How far are we on the road to digitising healthcare, and what challenges remain?
We have come a long way, and shared care records, remote monitoring, wearable technology, patient engagement portals, and many other digital initiatives are all making a really positive difference now. But we still have a way to go to maximise the potential benefits of the technology within our health and care system, and this journey never really ends, thanks to the development of new innovations and new opportunities like Artificial Intelligence.
Our key challenge is doing more to create a digital ecosystem where the patient is truly at the centre of the workflow and all decisions. We need to focus on reducing the variability of user experiences when interacting with the healthcare information system, making everything appear as a unified system. Interoperability is vital if we want to avoid siloed systems and information islands, which can exist independently. We need to break down barriers and enable communication between the systems.
Getting this right will help ensure that healthcare IT systems and associated services work - for care teams and patients.
How do you make digital change happen in such a complex system as OneLondon? What does the future look like if the challenges you spoke of are overcome?
Collaboration, design, and user-centricity are the most crucial factors for success. This means reaching a point where things work for people, with patients at the centre of all decisions.
Central to this is public involvement, and in the Capital, we have a good track record of working with Londoners. We learned from them that they expect their data to be shared for direct care purposes, and the same goes for academic research and the development of new treatment methods. As long as patients benefit from such research, they are not overly concerned about how their data is used. However, they are more worried about their data being used for commercial purposes. So, there are still challenges regarding data management and privacy, and it is vital that we continue to work with citizens to ensure we create products and services which can be supported with data.
Data really is the key to the future. By collecting data on population health and other social determinants, we can direct healthcare programmes to these areas. Even just monitoring changes in certain medical conditions can make a significant impact. Taking asthma and air pollution as an example, a continuous flow of data would greatly influence asthma management in London and the rest of the country.
In London, you have a vision of becoming the healthiest city globally. What have you already done to achieve this goal, and what are the next steps?
We have accomplished a lot, but there is still a lot of work to be done. We need to have a more proactive system that will improve health outcomes for all of London’s communities. Joining up data across London is absolutely key to this and to meeting the needs of Londoners as a whole – whether through improved direct care and population health management, better system planning, or enhanced research and development capabilities.
Good progress has been made joining up data to deliver systems like the London Care Record, the Universal Care Plan and DiscoverNow. London also made a successful bid for national funding to support the establishment of a Sub-National Secure Data Environment (SN SDE), which will support research across the Capital.
Taken together, this provides a great opportunity for the Capital’s health and care system to work together to develop a world-leading resource for health and care improvement.
In unifying healthcare across London, you started with end-of-life care. What are the other use cases that you will implement?
The Universal Care Plan platform is already making a huge difference helping to ensure that more patients receive the care and outcomes they desire when they reach the end of their lives. Through Better's open digital health platform, patient care and treatment preferences can now be easily viewed by health and care professionals across London's vast health and care network.
While the UCP currently supports pathways for urgent and end-of-life care, following its success and positive feedback from healthcare staff, scoping work is now underway to expand its use to other areas of care, including supporting patients with diabetes, dementia, and cardiovascular disease. There are also extensive opportunities across many other areas, including sickle cell disease and asthma, for supporting patients with frailty, mental health needs, learning disabilities, and autism, as well as for supporting children and young people.
The ultimate goal is to provide better, digitalised healthcare for all conditions and population groups across all health services and enable personalised care planning for patients across London.
You have adopted a digital health platform for care planning. Why did you decide to go with the platform approach, and will you implement this approach for future projects both in London and widely across the NHS?
Due to the complexity of London’s health and care ecosystem and the disparate nature of London’s clinical networks, it made sense to leverage a platform approach. A platform approach enables our clinical networks, which span over 40 NHS Trusts, to work together on a single system, integrated with existing point-of-care systems, which reduces variation while improving the quality of the care we provide.
Now, with your national role, are there any lessons that you have learned in London that you could apply more widely across the NHS?
It is important that we continue to focus on the person at the centre of our care system. The UCP platform has provided us with a regional opportunity to do this for London. This approach and thinking now need to be scaled nationally to the benefit of everyone.