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A Manchester perspective on digital transformation in healthcare

18th September 2018

Categories: Latest News

By, Professor Ben Bridgewater, Chief Executive, Health Innovation Manchester

We all know that most health care systems are struggling with similar challenges as a consequence of increasing volumes of elderly populations, a rising burden of lifestyle diseases, increasing consumer expectations, unacceptable variation in outcomes and escalating costs of care delivery.

And for the large part we know what we need to do to meet these challenges, including greater education and empowerment of citizens to enable them to take more control of their choices and outcomes, focus on prevention of disease as much as treatment and chronic disease management.

In Manchester, devolution has been a catalyst for change - in 2016, we became the first place in the UK to take charge of our £6bn ($8bn) healthcare budget and be granted powers to make decisions about how to best to meet the needs of local people.  Leaders from the NHS and Councils are now united and working together to improve local health and wellbeing.

We recognise that we need to do things radically differently, which led to the creation of Health Innovation Manchester in October 2017.  We have brought together our fantastic researchers and innovators from across Manchester to drive improvements forward at quicker pace.  However, digital will be key to delivering outcomes to our collective challenges, and our real problem is how to deliver new and effective solutions at pace and scale.

Retail, banking, insurance and transport have undergone major digital transformation already. Healthcare is just on the cusp.

Technology is shifting the global landscape from being paper dependent to embracing digital. The rapid growth of information requires technology to be interoperable to allow greater connectivity between sectors such as health and social care and patients themselves, which can benefit citizens by creating greater opportunities to collaborate and more data to drive insights.

Momentum has been gathering, and today every aspect of our lives is moving away from simple digitisation to digital transformation, where larger and more disruptive change is affecting society as a whole (think Facebook), industries (think Airbnb) and creating big winners and losers (think Kodak).

There are three digital truths: 

  1. The citizen is already digital and will define the next move.
  2. Platforms disrupt value chains.
  3. Winners exploit platform effects.

Truth #1: The citizen is already digital and will define the next move.

We know that the proportion of the world who use digital connectivity is high and growing. We also know that particular cohorts vary in this regard, from very high use in young people with chronic disease to lower penetration in the elderly. But even this is changing and most of the children supporting their elderly parents are connected.  The new Secretary of State for Health, Matt Hancock, has vowed to advance digital transformation in healthcare at a pace over the coming years, which will mean that products such as Babylon’s somewhat controversial GP at Hand, which uses next-generation cognitive approaches to give you a doctor in your pocket, will truly empower citizens to define the next move. Assuming these tech organisations can earn and maintain trust, they will provide convenience and disrupt healthcare providers who do not make these citizen-facing digital approaches part of their service delivery. 

Truth #2: Platforms disrupt value chains.

In healthcare, the value chain may include governments, regulatory agencies, primary care, secondary care, social care, professionals, insurance, other payers, life sciences, academia, and of course the patients and their carers. This is a very complex value chain indeed, made more so because of the challenge in defining value in healthcare. The complexity of resolving the politics and governance of a move towards accountable care is high compared with the challenges involved in digitisation.

In healthcare, there is a need for digital platforms along with re-imagining of care around the patient, while measuring outcomes and cost for every patient, paying for care differently, integrating care delivery across separate facilities and breaking down the local nature of care delivery.

The politics in all of this is clearly complex, and whilst the technology is not easy, at least we understand what we need to build as future healthcare platforms, including data integration, consent management, embedded analytics, clinical decision support, role-based access and security, resilience, optimised user experience for all players, scalability and the agility to benefit from future unexpected developments. And we also need all of this delivered at optimised cost. In this environment, data will flow securely between previously stove-piped systems, with artificial intelligence (AI) “bots” continually monitoring the stream of data looking for abnormal events (such as increasing blood glucose levels of a diabetic) and automatically alerting patients and the relevant care provider to transform outcomes, as well as supporting multiple new forms of interaction between all players.

The good news is we have most of the basic ingredients to make this vision possible, such as hybrid cloud techniques, mobile applications, interoperability standards, machine learning algorithms and the internet of things.  In Manchester, we are now working to implement a shared care record for all 2.8m citizens, while also exploring how population data could be applied within a digital innovation hub.

Truth #3: Winners exploit platform effects.

In healthcare, the winner should rightly be the patient or citizen, but you can view things from the perspective of providers, commissioners, medical professionals, life sciences or wider overall economic benefits to society. The sweet spot here must surely be accountable care systems exploiting platform effects for the benefit of the citizen.

There are digital healthcare platforms emerging that give value through sharing data for direct care, better platforms and substrate for analytics and innovation, utilising care co-ordination to drive efficiency and clinical effectiveness across complex landscapes and, possibly of most importance, segmenting the population to drive precision healthcare for key cohorts. And these platforms also can drive actions directly into the work flow of those delivering care, thereby improving outcomes and mitigating the real risks of information overload in digitised health and care ecosystems.

And the losers? Well, radiology is ripe for disruption from machine learning and collaborative platforms. How much of dermatology needs direct face-to-face consultation in an era of effective telemedicine? How will a hospital’s business case stack up when everything that can be done outside its walls is done in the community, unless hospitals reconfigure to maintain a slice of the pie? There will be other winners and losers as we start to target medications towards precision-based care rather than the implementation of crude guidelines. The list goes on and on, but no one knows how it will play out right now.

So the three digital truths apply to healthcare, maybe not entirely and with some contextual subtlety, but it certainly seems a decent place to start considering how to enable digital transformation of healthcare at scale.  The key to achieving this will be through extreme collaboration with citizens, between professionals, organisation and public-private partnerships.  This is what we are now driving forward in Manchester, enabled by devolution and Health Innovation Manchester. 

Manchester will be visiting the MedTech Conference in Philadelphia between Sunday 23rd September and Wednesday 26th September and Boston on Thursday 27th. To book a meeting with the team including Arjun Sikand from Health Innovation Manchester please click below.

Arrange a meeting in Philadelphia

Arrange a meeting in Boston

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