To kick off the summer months, we’re going to be sharing a story every week for the 12 weeks of summer, showing you how healthcare organisations are using technology to transform patient outcomes and increase productivity. For the first blog in the series, Michael Nelson, Healthcare Technology Lead in the south of the UK, will be sharing an example of how virtual consultations are helping healthcare organisations deliver the quadruple aim by transforming patient care. 

In 2017, my wife rang me from the back of an ambulance. She’d been to the gym in the morning and had snapped her Achilles’ tendon. I headed to the hospital where emergency care had been given to pick her up. After some back and forth we were referred to a local hospital’s orthopaedic outpatients service. So started my experience with outpatient appointments, where technology could completely change care through the introduction of virtual consultations.

Between January and March 2019 there were 462,000 missed outpatient appointments^[1]. Almost half a million people failing to attend an appointment that costs around £100 each^[2]. And in some respects, I get it.

We went through the process of driving to the hospital, parking a 10-minute walk away from the fracture clinic, and waiting almost an hour for our delayed appointment. We then had a three-minute assessment of my wife’s injury and were sent away to repeat the process six weeks later. It made me wonder whether I should go back. It also fails to address the quadruple aim of healthcare:

1. Improving the patient experience
2. Improving the clinician experience
3. Improving population health
4. Reducing the per capita cost of care^[3]

Managing change in healthcare

Leadership teams at the NHS have also noticed this. In July 2018, Matt Hancock started as Health and Social Care Secretary.

In the following months, policy leads at NHS England got busy creating a strategy to transform how services are delivered and to improve patient experiences. The long-term plan was the result of this work.

It identified that technology plays a fundamental role in changing services and dedicated a chapter to digital. One of the foundational aims of that chapter was:

Over the next five years, every patient will be able to access a GP digitally, and where appropriate, opt for a ‘virtual’ outpatient appointment. ^[4]

Leveraging technology to overcome challenges in the healthcare sector

It’s both pleasing and exciting that some are ahead of the game. Modality, a Microsoft partner have been working with a large mental health and community trust to change outpatient experiences and keep people in remote care using consumer technologies. The technology, OneConsultation, is a fully managed virtual consultation service that leverages modern technologies to deliver services in a secure and easy to use manner.

Together, they have addressed three challenges: waiting rooms, anonymity, and GDPR.

Transforming the outpatient experience with virtual consultations

Clinicians join secure virtual consultation waiting rooms using Microsoft Teams or Skype, and the service user joins the consultation via any web browser. You can use a phone, laptop, or tablet to have your remote service. No plug-ins, downloads, or apps have to be installed.

The service doesn’t store any confidential information, clinical anonymity is maintained, and all notes are captured on the EPR. The whole service is hosted in Microsoft Azure; creating a strong foundation for compliance and security.

The benefits for the organisation are that they can increase access to services and allow people to stay in their homes.

DNAs are driven down by offering options for attendance. The cost of physically attending an appointment is reduced, there’s no parking or petrol to pay. Those who have access or accessibility challenges can chose to stay at home. Clinicians get to spend time with patients that really need their help. Waiting times are reduced and because of this the patient experience improves drastically too.

And so far it seems to be successful. The mental health and community trust have had 15 percent of patients who were offered virtual consultations take up the offer.

If the rest of the NHS could save 15 percent of DNAs that would mean a £7m saving per quarter.

However, similar to many things in healthcare, finances need to transform too. At the moment, there is no central tariff for a virtual consultation, so providers don’t have a uniform way of getting paid for the delivery of the service.

Reducing the cost of care and improving population health

Virtual consultations are just one way that technology can address the quadruple aim. Patient experience is improved, clinician experience is improved, and the cost of care reduces. If more appointments are attended in this way too then population health will also improve.

At Microsoft everything we do is driven by our aim: To empower every person and every organisation on the planet to achieve more.

Virtual consultations not only save money but create an accessible means of healthcare. We all want to spend as much time at home as possible, and that’s even more important for the disadvantaged in society – technology has the power to allow this.

Find out more

Find innovative solutions that help deliver better care

About the author

Michael is the Healthcare Technology Lead in the south of the UK. He owns the overall relationship between healthcare customers and Microsoft and has over 10 years of experience working with the Public Sector. With a young son and elderly parents Michael is passionate about the opportunities for transforming healthcare.

[1] https://www.england.nhs.uk/statistics/statistical-work-areas/hospital-activity/quarterly-hospital-activity/qar-data/

[2] https://www.chelwest.nhs.uk/about-us/news/news-archive/2014/what-is-the-real-cost-of-missing-your-appointment

[3] http://www.annfammed.org/content/12/6/573.full

[4] https://www.longtermplan.nhs.uk/online-version/chapter-5-digitally-enabled-care-will-go-mainstream-across-the-nhs/3-supporting-clinical-care/

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In an ongoing series ahead of our inaugural Health innovation event, we have explored at how technology such as Skype for Business and Microsoft Health can help the NHS not only meet rising demands, but also save time and money.

For example, we looked at how Microsoft Health’s platform can support apps that help empower patients to take control of their health, while Skype for Business can help drive efficiency with the ability to manage and monitor care remotely.

In the final blog of the series, we will take a look at how the Cloud can help NHS organisations make even greater savings for the healthcare economy.

UK Data Centres

Earlier this year, Microsoft announced the introduction of UK data centres to provide cloud based services for businesses and public sector organisations that have difficulty hosting data outside of UK soil.

With the UK data centre comes the opportunity for NHS organisations to re-think how they deliver services – from internal IT and data analysis to managing finances and enabling small and medium enterprises to provide innovation to business units within the NHS.

For instance, financially, services such as Infrastructure as a Service and Platform as a Service reduce the demand for costly on-premise data centres as organisations can rent space in a Microsoft managed, maintained and upgraded data centre. By moving to the Cloud and Cloud services, NHS organisations can therefore reduce spend on maintenance and real estate.

Similarly, using Cloud can save NHS organisations time and deliver greater efficiency. With more and more NHS organisations requiring extra storage through PACS (Picture Archiving, and Communications Systems), connected devices, and clinical applications, the requirements for flexible and unlimited storage is evident.

This is where Cloud services such as Azure Stack and Azure Site Recovery can help.

For many Public Sector organisations, scalability is key. With Azure Stack – Microsoft’s new hybrid cloud product – organisations are able to deliver Azure services from their own data centres meaning they can create scale and high availability from an on-premise environment. This gives organisations the flexibility to access data and Cloud services in a way that suits them.

Similarly, Azure Site Recovery provides Disaster Recover As-a-service, which helps simplify and automate the replication and recovery of services in a disaster.

And with a greater drive to improve public health by enhancing online access, website traffic, portals and communication systems are going to increasingly feel the strain of ever greater demand.

NHS Choices chose Microsoft Azure to provide the scale they needed for their website. In January 2015 they had 52 million visits – something that would not have been possible without the elastic scale of cloud services.

Not only did Azure readily handle that recent all-time-high figure (up from 43 million in January 2014), but it supports NHS Choices at an annual cost that’s  40 percent lower than its previous hosting provider.

Find out more here

Microsoft’s Cloud services can also help support the innovation coming at pace from small and medium suppliers.

Independent software vendors and individual companies can list their applications on the Azure marketplace to be purchased directly, while small software vendors are able to use the scale of the Microsoft Cloud to deliver a secure, scalable, always-on application – hosted in Azure.

For example, H-POD from Paperpost, works with Trusts’ patient administration systems to ensure that physical letters are handled and delivered efficiently, as well as taking the administrative burden of the post room and outsourcing it for lower costs. Paperpost plan to use the UK hosted Azure data centres to create an online version of their software.

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Innovation in the UK healthcare economy is being driven in buckets. The top down approach of creating a 5 year forward view, with a ‘paperless 2020’ vision, supported by the National Information Board projects, creates the mandate to allow change.

Microsoft is supporting this change with our technologies and investing in proving the value of it. With engagement from Healthcare organisations, Microsoft can partner with you to deliver value back to your organisation.

The post Innovation in the NHS: Moving to the Cloud appeared first on Microsoft Industry Blogs - United Kingdom.

Of these, perhaps one of the most talked about transformations has been the drive for a paperless NHS by 2020.

Speaking at the NHS annual conference in Manchester in June, Secretary of State for Health Jeremy Hunt acknowledged the commitment to go paperless was one of the “bolder promises” of digital transformation, but was central to improving efficiency in the NHS.

Despite this, the Secretary of State acknowledged that while the need to go digital is key, IT paradoxes in the system serve as a significant barrier for some health organisations.

Over the coming weeks, we will be taking a look at some of the key devices and systems that can help NHS organisations transform. Having looked at how data platforms such as Microsoft Health’s HealthVault service can boost innovation in app development, we will now take a look at what types of technology can help NHS organisations ‘go paperless’.

The Growth in Telemedicine

One area of technology that has had its merits debated over a number of years is telemedicine; the ability to use modern technology, like voice and video conferencing, to deliver medical care to individuals without the need to book a primary, or secondary care appointment.

Over the last 5 years there has been a proliferation of the use of this technology. For example, in primary care we now see a number of public and private organisations offering GP appointments over the phone, while in community care practitioners and citizens can communicate remotely.

Likewise, in mental health there is a requirement for care in urgent situations delivered immediately to an individual, in a discreet, personalised way; highlighted by the ‘I’ statements developed by the NHS, Mind and YoungMinds.

In secondary care, patients with long term conditions can manage their own health and appointments using video conferencing, from the comfort of their own home, at times that suit them.

How can Microsoft help?

The ability to manage and monitor care remotely has significant benefits for both health organisations and the patient. Remotely accessing care not only reduces the amount of time an individual takes to be seen, but has the positive side-effect of patients and carers increasing their knowledge and confidence to manage their condition.

At Microsoft we have seen a huge increase in the interest of using tools like Skype for Business to deliver telemedicine. Two health organisations in particular have seen great benefits after introducing Skype for Business to deliver services.

In 2011 Brighton & Sussex University Hospitals NHS Trust (BSUH) recognised that telemedicine could enable patients to be assessed by a consultant out of hours. However, their system was far from ideal; the screen would often freeze, the picture quality was unsatisfactory and the line would often break, terminating the call.

Consequently, the IT team at BSUH worked with Microsoft to introduce Skype for Business as a user friendly, easy to support and cost effective solution that has been welcomed by Trust staff and patients alike.

Through Skype for Business, consultants are now able to assess stroke patients much faster and can undertake assessments even when they’re off-site or outside normal working hours.

“The difference assessing a patient was amazing the first time we used it. The quality of the pictures is so good that you feel like you’re almost in the room assessing the patient because you can see how they can move their arm, look at their face, you can assess their speech and that’s made it extremely useful and user friendly,” explains Ingrid Kane, Consultant Stroke Physician, BSUH NHS Trust

Similarly, South West London & St George’s Mental Health NHS Trust has greatly benefited from introducing Skype for Business.

The NHS Trust faced the challenge of providing ongoing care for their patients in a way that was convenient. By introducing Skype for Business, patients are now able to schedule calls at a convenient time, avoiding taking time out of their work lives and this also means that they don’t have to share the reason for their absence from work with their employer if they would rather keep this information private.

What’s more exciting is that our customers who are using, or considering using Skype for Business can now add internet calling; consolidating their ageing telephony systems and contracts and moving to an online, always available alternative.

To learn about some of these innovations and more please come along to our Innovation in Healthcare event on the 9th August.

The post Innovation in the NHS: The impact of telemedicine appeared first on Microsoft Industry Blogs - United Kingdom.

In Whitehall, Downing Street announced the establishment of a new Brexit Unit to start planning options on Britain’s withdrawal from the European Union while local councils have expressed concern over the possible strain Brexit will put on already limited resources.

For the NHS, Brexit is also likely to cause concern over the ability to deliver services in the face of possible greater financial strain.

According to a recent survey by Healthcare Financial Management Association, one in five NHS finance managers suggest that care will worsen during 2016/17 while the Health Foundation has predicted that Brexit could lead to a budget shortfall of as much as £19bn by 2030-31.

However, recent announcements over the last year from NHS England suggests that technology could help to streamline many processes in Health.

As part of an ongoing series, over the next few weeks we will look at how innovation in the technology sector – around data, going paperless, smarter working and enabling patients – can help health organisations transform.

Data

One such way to ensure transformation is to improve the use of data and applications in the health sector.

Earlier this month, Director of Operations and Information at NHS England, Matthew Swindells, spoke of the need to create an open ecosystem for innovation, where patients are able to choose applications to own their healthcare.

Speaking at the King’s Fund Digital Health and Care Congress, Swindells stressed the importance of empowering patients to manage their own health without regular need for primary or secondary care intervention.

For this to work, however, patients and professionals need to be able to access and use their data.

Recent announcements from the national data guardian also point to consent for data sharing being held at an individual level, and a new opt-out model being employed. This all supports the idea of the patient, or citizen, being in control of their health record.

What’s exciting is that this is already happening across the UK with the help of Microsoft’s open platform Microsoft Health.

Microsoft Health embraces the HealthVault platform – which has been developed to be an open platform for security enhanced data sharing between the citizen as Data ConTroller and NHS organisations.

With the citizen in control,  – Health and Social Care organisations can promote (or even develop their own) apps that connect to the Citizen’s own data, rather than worrying about hosting, data models, authentication and consent for sharing data that they own and control. The citizen and their data effectively becomes the locus of interoperability between health and social care organisations.

One such app currently using the Microsoft Health platform is the eRedbook which aims to provide accurate up to date health information for parents by keeping a digital copy of their child’s early years health record  including immunisation’s, tests and developmental milestones. Replacing the existing paper-based system, eRedbook not only improves efficiency but also reduces administration for health professionals.

Microsoft Health has also been used for citizens to own their care record in Kent in the context of social care, allowing the individual to maintain independence and the Council’s service providers to deliver services for a lower cost.

This video tells the story of Shirley and Malcolm, members of the baby boomer generation, showing how health and care can be delivered now and into the future using a citizen-controlled health and care platform:

To learn about some of Microsoft Health and other technology innovations please come along to our Innovation in Healthcare event on the 9^th August.

Register now for Empowering Health in a Mobile First and Cloud First world

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