Why ICSs should prompt us to reconsider digital partnerships

In a piece for Digital Health, Martin McFadyen, who is head of public sector at Virgin Media O2 Business, looks into why Integrated Care Systems (ICSs) may prompt a discussion on digital partnerships.

Even with the NHS having made 3-5 years of digital progress since the first lockdown hit, better integration will continue to have a positive impact on patient care.

It’s not new news that different groups involved in healthcare delivery, such as the NHS, local councils and third sector organisations, benefit from improved communication with each other, so that they can work as one. If they don’t, a patient could move from one point of care to the other with different parties lacking an understanding of their condition and health history.

Integrated Care Systems – designed to strengthen relationships between healthcare providers, facilitate joint decision-making and support the implementation of new infrastructure – are set to become statutory entities this summer.

They will require leaders to think differently about digital transformation. The experience of the pandemic highlights that they will need to show ambition and prepare to move rapidly to achieve meaningful results.

This will also require a reconsideration of how the healthcare sector works with its technology suppliers, pushing them more and expecting more from them.

The vital role of technology in integrated care

Digital innovation has a critical role to play in enabling integration between different health and social care organisations.

The Cumbria and Lancashire Telestroke Network is a prime example of the role of connectivity in bringing different stakeholders together to address patient needs. This remotely connects a specialist team of 15 stroke consultants, who provide ‘out-of-hours’ clinical advice from their homes across the county, to eight hospital sites.

Each consultant is linked by a secure broadband connection to a ‘Telecart’ at the patient’s bedside. This enables a ‘two-way’ virtual consultation to take place so that the medical expert can see and speak to patients via innovative teleconferencing equipment, view CT scans and recommend appropriate treatment.

Without the Telestroke Network, it would be impossible to access the expertise of different stroke consultants around the county at speed.

This illustrates the broader importance of connectivity and digital innovation to Integrated Care systems, particularly their critical role in bringing stakeholders together effectively.

Integrated data systems are also crucial to delivering joined-up healthcare, ensuring different parties benefit from access to vital patient information.

One such initiative is the Discovery East London project, an attempt to build an integrated data system covering 1.5 million people. It involves GP practices, mental health trusts, Clinical Commissioning Groups and Queen Mary University of London.

It aims to predict individual health needs in real-time based on patients’ medical records and live data, allowing healthcare professionals to intervene early when they see warning signs.

While still in its inception phase, there have already been impressive results. In Tower Hamlets, anonymised datasets have been combined with information on where people live and work to map deprivation and morbidity outcomes across the borough.

This has created a much clearer understanding of health issues and is being used to allocate resources. So far, clinicians say they are spending around 48 per cent less time on paperwork, saving £940,000 in the process.

The success of the project so far shows what can be achieved from innovative thinking about interoperability and integrated care.

Expecting more from technological partners

A lot has been said about cultural and digital change brought by Covid-19 when it comes to digital transformation.

Jeremy Drake, CCIO, Buckinghamshire Healthcare NHS Trust captured this at a recent Digital Health-organised roundtable when he commented, “There was a lot of adrenaline as we went into the pandemic and our backs were against the wall. We had to come up with new ways of working.”

These new ways of working – combined with the pressures faced by the health service – contributed to some cultural challenges, such as burnout. However, there has been recognition that, broadly speaking, digitally enabled flexible working has had a positive impact.

Part of continuing to support new forms of collaboration will be about expecting more from technological suppliers. In a fast-moving, ever-changing landscape, the NHS and its strategic partners will need to make sure that major investments, like digital transformation, are focused on the bigger picture; specific outcomes to drive their organisation forward.

Vague commitments from their partners won’t cut it. NHS and Integrated Care System leaders need to agree on specific outcomes they want to achieve with their technology partners.

The relationship should be based on partnership, flexibility and a commitment to customer success rather than one-off transactional interactions.

Grasping the opportunity

Integrated Care Systems represent an opportunity to improve the delivery of patient care, cater for local needs and better tackle health inequalities.

To reach their potential, the NHS and its strategic partners need to sustain the momentum from the last two years of digital progress.

This means recognising the role of continued digitisation and connectivity and demanding more from technological partners.