Global Adjustment

It’s fair to say that the world has changed dramatically over the past few months. Unless you can remember the last World War, nobody will have experienced such far-reaching changes to everyday life in such a short space of time.

A global pandemic has touched every aspect of how we live, work and communicate, giving new insight into each other’s lives as our personal and professional lives have merged.  Many of us are now meeting and collaborating remotely in ways we couldn’t have imagined (and, indeed, some argued were impossible) before a global pandemic made adoption of digital solutions essential, rather than a nice-to-have.

The NHS, of course, has pursued digital strategies for years as a route to reduced cost and improved patient care, but initiatives have often moved slowly with limited results. One of the potential benefits of the Covid response is that it has taught us a lot about what we can actually achieve when pressed. Not only is the NHS implementing technology solutions successfully, at speed, but we are finding in many cases that they offer the kinds of benefits sought for many years.

What’s changed isn’t necessarily the technology available, but the approach to developing and deploying solutions. As a health technology company, we have long-advocated the benefit of an agile methodology, working collaboratively with Trusts to establish requirements, deploy a Minimum ViableProduct to provide immediate benefit, and layer additional functionality overtime as requirements change. Strategic decisions by committee can be cumbersome and, with a situation like Covid, the picture may change many times before there is agreement. It is far more important, therefore, to engage in an ongoing conversation with NHS Providers as the product is developed: ‘here is the minimum viable product? How does this look? What else would you like to see included? Who should we make this available to?’ and so forth.

Our Response

This is exactly the approach we took when we began working with Greater Manchester LHCRE to develop a Situational Reporting Tool to provide information on the status of NHS organisations in the region. They, in common with all providers, couldn’t easily say in advance what they needed; there was an awareness that Situational Reporting would be important, but no real template for what that might look like.

Combining advice from government bodies, NHS England and Healthcare providers in Greater Manchester, we were able to develop a Situational Reporting tool for Greater Manchester’s central COVID-19 response using a forms-based solution with some additional integrations to GM systems, in order to capture information on 3 key areas:

1. Staff (total numbers, how many well, how many sick, clinical/ non-clinical, etc)
2. PPE (Available gloves, aprons, masks, etc. with supply measured in days and weeks)
3. Status of service (OPEL Scoring from Green, or CapacityAvailable, through to White, or Service Suspended).

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This was initially deployed in a hospital context, but it so on became clear that the potential application was much wider, incorporating hospital care, community care, mental health Trusts, GP Practices, dentalPractices, and Pharmacies. For the solution to be able to offer any meaningful insight into the current situation and preparedness of these organisations, it was critical that we had good staff engagement in order to gather a large dataset and that the questions asked (and responses collected) were relevant.

Cabinet Member for Health and Wellbeing, Bury Council, Cllr Andrea Simpson, said: “The care home situation reporting system has transformed the way we work to support care homes across Bury.

The system is saving time for both care homes and council colleagues, by providing one dashboard where people can access the required information. Information on infection rates, PPE stock and staffing levels are entered into one system which immediately flags any issues so council staff can urgently escalate as necessary. The situation reporting system has been so useful, we plan to continue using it when we move back into a more business as usual setting post COVID-19.

Lesson Learnt

One of the early lessons we learned during this time was that, no matter how short we made the forms, understandably, staff who were already working at capacity became fatigued with filling them out over time and response rates dropped. We made a change to allow the solution to remember previous field entries, so that respondents could make changes only where needed, and submission rates improved dramatically. Likewise, when ‘loss of sense of taste and smell’ was added to the list of Coronavirus symptoms on 18th May, we were able to incorporate this into the Greater Manchester solution almost immediately. The flexibility of the tool and our approach meant such changes could be implemented in hours, rather than days and weeks. With a situation which looked radically different from one day to the next, this responsiveness was key for any solution to remain viable and useful over time.

Of course, the real measure of success in any of this is the impact on health outcomes. Working with GM LHCRE stakeholders, we were able to collate SitRep data into a dashboard giving real insight into staff shortages and availability of PPE, and allowing for a significant redistribution of protective equipment and resources in the region to where they were most needed. This helped maintain service and reduce infection rates in clinical settings, potentially saving lives of both staff and patients.

What are the lessons from all of this? That despite inevitable challenges which come from digitising workflows, rapid, agile solution development is possible in all settings, from GPs, to Hospitals, toCare Homes, and that the requirements of a technology solution can be driven as much by user feedback and engagement as they are by strategy and initial intentions.

Covid has taught us how quickly we can innovate when we need to, and how instrumental technology can be in supporting healthcare functions.If this has been demonstrated in the space of two or three months in the midst of a global pandemic with the inevitable constraints that brings, it is encouraging to consider how we could progress digital health solutions inHealthcare in the months and years to come.