How can technology drive transformation in healthcare?
10 July 2017
Following the election the country is facing a period of uncertainty. But for those in the health sector the situation hasn’t changed - the struggle to find ways to meet the daily demands of the service alongside the need to make significant transformational change still dominates. But, despite these challenges, there has been a rise in the number of large digital and technology related tenders that have been released via the usual government and public sector procurement channels.
There are a number of reasons this has happened:
- expiry of the previous contracts issued under the National Programme for IT;
- legacy systems at Trusts that is costing a lot more to maintain and skills less available in the market;
- a drive from the Department of Health and NHS England to meet the ‘Paperless by 2020’ goals set out in the Five Year Forward View plans; the reduced costs of ‘utility computing’ such as data centres, networks, end-user devices;
- the recent WannaCry malware incidents that brought security front and centre into the boardroom.
The new generation of trust leaders are very cognisant to the fact that these are not, and should not, be introduced as ‘technology’ initiatives but rather as ‘business transformation’ programmes. However, they are constantly caught between the struggle of managing the hospital versus making the investment that’s needed for the future.
We know from our work with trusts that delivering value across clinical, operational, financial and societal functions requires more than just funding. System change needs to happen too. We have identified a two speed approach to address the short term challenges whilst ensuring the longer term investments can also happen. The short term focus on taking costs out must sit alongside the drive towards more transformational initiatives. The first speed ensures stability and keeps trusts running. The second is more of a sprint for new ideas, technologies and methods. This dual process enables technology change that reduces costs, can be introduced at speed but is also evidence-based and, most importantly, is developed around the needs of patients and clinical staff.
The rise in digital tenders means the issue of outsourcing is back in play. Although outsourcing has suffered from negative publicity and has had some mixed results, if done properly, it can be one way of delivering transformational change. It can allow staff to shift all of their focus to delivering or enabling patient care and can be used to unlock capital expenditure. The recent ransomware attacks have impacted this debate and the instinctive reaction to this has been to insource all IT services. It is true that certain services such as clinical and medical ICT should be run by trust staff. However it remains the case that maintaining things such as data-centres, networks and end-user computing can be done more effectively and efficiently by external providers.
The market and technology has evolved substantially since the early 2000’s when a number of these large contracts were signed. Competition and cloud based services have caused costs to drop by an order of magnitude whilst service delivery levels have risen. In the US, hospitals have reduced their infrastructure spend by between 15% and 25% through such arrangements. In turn, patient and staff satisfaction increased as a result of more reliable and faster running devices. As the pendulum swings from one end (completely outsourced) to the other end (completely in-house), a balance needs to be arrived at where the trust can play the role of an ‘intelligent buyer and contract manager’ keeping their focus on enabling and providing patient care and not keeping the lights on.
This is just one of the areas where digital and technology can be used to unlock value in the near to medium term. PwC teams are taking this head-on in the hospital turnaround and transformation projects we are undertaking, working alongside trusts to identify technological changes that are both impactful but also affordable.