Another View: Of conference season

It must be conference season: Neil Paul has attended three separate meetings in almost as many weeks. As our GP columnist reflects on each – the EMIS National User Group, a panel on entrepreneurship in healthcare IT, and a BCS Primary Health Care Specialist Group meeting – he sees causes for both optimism and concern.

A few weeks ago, I attended this year’s EMIS National User Group. It was at a new venue; a hotel at the NEC Birmingham. The venue was easy to get to for me, and while it did feel a little enclosed and some of the exhibitors I spoke to felt the talks were quite a way away from the stands, overall a lot seemed to attend.

Which is interesting as I’m not really sure what I learnt. There were no key themes. Most people I spoke to felt the keynote from EMIS was a bit lacklustre. “We will do better” seemed to be the main message. I didn’t really get any great sense of an innovative roadmap, nor any real commitment to helping me as the end user run my practice more efficiently. There is a lot going on at NHS England and NHS Digital and yet I didn’t really get a sense of what their response to it was.

So much content, so little time…

The conference had the usual format of a load of interesting talks. I understand why it’s spread over two days to cram them all in – and for professional conference goers I’m sure this meant lots of drunken debauchery overnight – but I find it hard enough to get a whole day away, never mind two. So there were some interesting talks on the second day that I missed.

Luckily, they seem to have been videoed. While I always think this is a good idea, I also always struggle to find the time to go back and watch them, so I wind up never convinced it works. There were some very well attended talks and some speakers clearly had more to say, so I wonder if workshops would be a better format. I also agree with one of the organisers that it would be nice to hear more from some of the sponsors, or even from those who can’t afford to sponsor but who might have a promising product to show.

It’s definitely conference season, because two weeks ago I was invited back to my old school to be part of a panel on healthcare IT. The other speakers were mainly non-medical entrepreneurs who were talking about their start-ups and some of the struggles they had getting the NHS to even engage with their product. The event was chaired by a venture capitalist and it was clear there was plenty of investment money around, with people talking six or seven figure sums for companies with a good product.

The start-up challenge

Given the PR I hear from the academic health science networks – including my local one, the Innovation Agency – I was surprised to hear how dismissive this group was of the NHS due to their bad experiences. Many were looking to foreign markets; one had moved on into another field away from medicine. They all felt they had products that would really benefit the NHS, it was clear they all had a passion and ideas, and that they’d all had a hard ride.

At a time when we need all the help we can get, it worries me that we are turning it away. That said, having been a commissioner previously – and more recently having helped a couple of companies get their product to market – I get that a lot of people don’t understand how the NHS works, how the money flows, and how to really take cost out. Also, many people have a solution in search of a problem rather than the other way around. And lots have a lifestyle or fitness product, not a health product. I really think we need more meetings between clinicians and startups.

What most struggled with was getting reference-ability. It’s clear the VC people wanted to invest in a proven case above all – ie. one with a clear use case and preferably a clear return on investment for the purchaser.

Getting the NHS involved in case studies or trials was often meeting a wall of people who could say no or slow it down but no one who could just say yes. I think Digital Health’s championing of the CCIO role here is the right thing – these individuals should be able to test stuff out.

To complete my event hat trick, I went to the BCS Primary Health Care Specialist Group meeting. I hope they forgive me for saying this, but at their core they are a group of “old timers” who have been the driving force behind primary care IT for years.

Picking a winner

A couple of years ago I won their John Perry prize – designed to recognise those who are pioneering the implementation of new computing systems in general practice – and was kind of admitted into their outer circle (I’m flattered and honoured).

The conference was almost everything the EMIS National User Group wasn’t. It talked about all the upcoming issues around SNOMED, and changes to GP System of Choice and so on. In the keynote they found a recording John Perry made in the 70s. Perry – who in 1972 organised the first Oxford Conference on Primary Health Care Computing – was talking about patients recording their own blood pressures into their own electronic records. Amazing foresight but scary it’s still not happening.

This year’s prize winner was Raza Toosy with his PatientLeaf product. It was this product’s stand that I found to be the most interesting of those at the EMIS National User Group, so it’s nice to see I can pick a winner.

Raza is delivering what I’ve long asked for; a customisable user interface that allows me to understand my patient’s data better.

Getting UI right

I’m convinced that the way EMIS presents information to me – especially now we are moving to wide screens and dual monitors – could be much better. Interestingly when I’ve had conversations with people at Vision, they appear to get this. Their UI is apparently very user controllable and puts the information you need on each page. By comparison, EMIS – in my humble opinion – is locked in a module methodology. In the prescribing screen I see drugs but not the last values the drugs might treat. And vice versa.

PatientLeaf overlays EMIS, and tries to put all the relevant data in one place in a clever UI that shows what has happened over time. I haven’t used it in anger yet, but am planning to trial it at my practice – the demos I’ve seen look good, and I think it’s a useful product with great potential.

Raza is a working GP and a bit of a data geek so he has the right background and enthusiasm. Let’s hope he can find a compelling use case for purchasers – hopefully with a ROI – so people buy it. And let’s hope next year’s conferences contain more of this sort of stuff: helpful innovation designed to make running primary care easier.