Fourteen predictions for 2014

EHI asked a wide range of healthcare IT experts for their predictions for 2014 and, since this is the age of Twitter, it asked them to make them in 140 characters or fewer.

Our fourteen picks predict that 2014 will be a year of fundamental change in the NHS, the year that the tech fund delivers, and the year that chief clinical information officers come into their own. Also, that it will see the welcome demise of the crime against fashion that is the onesie…

Another year of change for the NHS

As the NHS started 2013, a reorganisation “so big you can see it from space” was still to take effect. As the NHS starts 2014, its new commissioning bodies are starting to settle down; but also to face up to the many challenges ahead of them.

In the summer, the retiring chief executive of NHS England, Sir David Nicholson, warned the NHS that the gap between flat funding and rising demand that he has been warning about since 2008 will reach £30 billion by 2020, unless the NHS moves from looking for efficiency savings to making some fundamental changes to the way that it organises health services.

Against this background, the government has shown a new interest in integrated care services, setting aside £3.8 billion to support initiatives to link up health and social care, and continued support for the telehealth industry, even as commissioners struggle to make the business case.

While we have been here before on both integrated care and telehealth, some of the experts that EHI asked for 2014 predictions picked progress on this policy agenda as their thing to watch in 2014.

“A push for interoperability will drive scalable examples of the integration of health and social care data, leading to better connected care” – Tom Frusher, director of policy and corporate affairs, McKesson.

“2014 will see signs of growth in the telehealth and telecare market as care organisations look to cut unplanned admissions” – Ian Dalton, President of BT Global Health.

The year the tech fund delivers

The year just gone was also something of a watershed for NHS IT. At the start of the year, there was still a lot of focus on the National Programme for IT in the NHS, on the legacy of its national infrastructure projects, on the future of the money that it has still to spend, and on the future strategies of trusts looking to move on from it.

NHS England has taken some bold decisions in relation to the national projects, bringing in new suppliers and new approaches – not least open source technology – to refresh everything from the NHS data spine to Choose and Book. Some predicted that 2014 would be the year that the NHS saw the value – or otherwise – of these decisions.

“BJSS to do a world first and deliver an on time and on budget the e-referral service, proving the value of agile project delivery in the NHS!” Tom Whicher, founder DrDoctor.

Meanwhile, in January, health secretary Jeremy Hunt electrified healthcare IT by announcing that he wanted to see a ‘paperless’ NHS by 2018.

This triggered a wave of debate about what this might look like, a new information strategy from NHS England, and funding through the ‘Safer Hospitals, Safer Wards: Technology Fund’ that – with matching funding from trusts – will reach £1 billion over three years. Many of EHI’s experts felt that 2014 will be the year in which this new approach will deliver.

“The DH Technology Fund starts to deliver real benefits and does more in 12 months to aid the provision of IT systems in the NHS than NPfIT did in its entire existence”- Christine Walters, director of IM&T at Pennine Acute Hospitals NHS Trust.

“2014 will be the year when the NHS begins to properly forge a bright, IT enabled future. It finally emerges from NPfIT’s dappled shadows” – Dr Johan Waktare, chief clinical information officer at Liverpool Heart and Chest Hospital NHS Foundation Trust.

However, there was a word of warning that the new focus on trusts devising their own strategies and contracting approaches will expose those not up to the job.

“2014 will see a growing gulf between trusts with a clear strategy to 2018 and those yet to identify a credible path to paperless”- Emil Peters, vice president and general manager, Cerner.

The year e-prescribing comes into its own

The outcome of the first round of bids to the tech fund was finally announced, in part, in December, after delays caused by the Treasury asking for more evidence of value for money on the projects submitted.

While full details will not be available until January, it is clear that e-prescribing projects have found favour. This lead a number of experts to predict that 2014 will be the year that e-prescribing finally takes off in the NHS, after many years in which it has been confined to trusts willing to put in years of effort.

“Momentum from funding, more open procurements and positive rhetoric all points to doing things differently in 2014 – continuing the same way is not an option”- Robert Tysall-Blay, chief executive, JAC.

Others pointed out that this kind of sea-change in IT use will require some good infrastructure underpinnings; including the roll-out of wi-fi infrastructures across hospital estates and community services alike.

“Maturity of mobile devices, wireless infrastructure and systems enable clinicians to spend the majority of their time with patients.” – Neil Turnbull, head of programme delivery at Ipswich Hospital NHS Trust.

“2014 – the year when electronic records transform delivery of healthcare, and to do so will require ubiquitous low cost wi-fi” – Jon Harris, IT director at NHS Western Isles.

But it looks as if there will continue to be passionate debate about the best technologies and development approaches to use – with some experts keen to argue that open source will be the way forward; and others to argue that it won’t be.

“I predict that in 2014 open source health software will reach its peak of inflated expectations. I would like to think we will start to get some real traction in offering patients a true interactive experience with their healthcare providers” –Adrian Byrne, director of information management and technology, University Hospital Southampton NHS Foundation Trust.

The year of the CCIO

While the technology has to be right, it is getting the information that it can be used to record, recall and manipulate to the right people at the right time that really matters. EHI launched the CCIO Campaign two years ago to support greater clinical involvement in both major IT projects and information initiatives in trusts.

Since then, it has run the CCIO Leaders Network to support the chief clinical information officers that have been appointed to the health service, and to encourage further appointments. A number of the network’s members predicted that 2014 is the year that CCIOs will gather critical mass.

“Expansion of CCIO numbers will foster innovation at the front line of care. 90% of trusts will appoint a CCIO” – Charles Gutteridge, CCIO at Barts Health NHS Foundation Trust.

“By next Xmas, members of the #CCIO Leaders Network will know the usability score of every system and its cost per patient per year #knowledgeispower”- Joe McDonald, EHI columnist and CCIO for Northumberland, Tyne and Wear NHS Foundation Trust.

While good information is essential for good, direct care, good data is also needed for other uses, including helping trusts and their commissioners to get a real handle on the cost of services, and for researchers.

NHS England has run into problems with its care.data project to expand the Hospital Episode Statistics and to link them to other datasets, with critics arguing that big, aggregated datasets are not the way forward, that the NHS does not have the systems to deliver what is planned, and that there are real consent and confidentiality issues.

Some of EHI’s experts, though, felt that the value of the project will be demonstrated over the coming year, including Daniel Ray, whose Birmingham trust is probably one of the few that could deliver the new hospital dataset.

“I hope that 2014 is about for providers developing and starting to implement strategies to be able to meet the new national care episodes statistics, which will create a national knowledge base on a scale unforeseen before,” – Daniel Ray Director of IT, University Hospitals Birmingham NHS Foundation Trust.

The year fashion gets real again

Overall, EHI’s experts were optimistic about the year ahead. There is a mood in the air that the direction set by Hunt, the tech fund and its focus on projects that can deliver tangible benefits for trusts, and the growth of clinical interest in IT will make 2014 a good year.

Paul Rice, head of technology strategy at NHS England summed up: and also hoped that the coming year would see the end of those onesies…

“E-prescribing established as a must do amongst NHS providers, bold steps taken towards the delivery of integrated digital care records, appeal of onesies wanes?”- Paul Rice, head of technology strategy, NHS England.