Every time a plan is published for the NHS, the health IT community holds its collective breath for a moment as it waits to see how its digital fortunes will fare. Fortunately, on this occasion a plan has been published with the backing of a health secretary that few could argue is not profoundly embracing technology. However, amidst the collective sigh of relief, we have to probe more closely about the key themes that have emerged and what they mean in practice.
For me, there were three elements that jumped out in the plan that are clearly related to one another – access, interoperability and security. These are not new themes but they have definitely gathered steam in the last 18 months. For example, telemedicine has been around for a generation, but it is only now that providers of app-based video consultation services seem to be gaining traction within the NHS, albeit not without controversy.
Meanwhile, interoperability has been a raging issue between healthcare providers and vendors so much so that the government has stepped in to support the development of regional Local Health and Care Record Exemplars (LHCREs). Finally, cybersecurity has continued, with good reason, to be a part of the conversation at all levels, and the NHS has actually made great strides in improving its risk posture in a way that is actually enviable for other health systems. That, perhaps, is the silver lining that came from WannaCry.
Yet, when I look at these themes I don’t study them in isolation. If we want to empower people to live healthier lives and patients to take control of their information, then we have to make sure they can trust the systems we are giving them access to. Trust means having easy to use systems that are accurate and secure.
Easier said than done. It’s not enough to only have video consultation services operating in isolation and only useful for a small segment of digital savvy users who need to refill non-urgent prescriptions. We need video services to be part of an interoperable digital framework that means patient care can be managed seamlessly across the entirety of the NHS’s services from diagnosis to intervention to rehabilitation and social support. That means interoperability across a plethora of systems.
Moreover, when you interconnect an increasing number of services then you risk creating adding many more vulnerabilities into a network therefore creating opportunities for attackers to cause chaos.
It’s critical that there are significant standards that vendors and healthcare providers need to follow to make sure not only that they minimise technical risks, but know what to do in the event of a cyber-attack to protect their patients clinically and to prevent a threat spreading far and wide. That applies, of course, to small companies as much as it does large ones, and if one group of companies does concern me it is the telemedicine start-up community.
Overall, the ten-year plan has the right message. It is unabashedly pro digital and that is great. It is up to us now in the health IT community to embrace this by focusing on the details to make sure we keep moving forward successfully on our collective digital transformation journey.
Dr Saif Abed is the founding partner of health IT consultancy firm AbedGraham.