News in brief
NHS reorganisation was disastrous, says The King’s Fund: Radical changes to the way the NHS in England is organised have been “disastrous” and “distracted” from patient care, leading analysts have said. The evaluation by The King’s Fund think tank said the coalition government’s changes had wasted three years, failed patients, caused financial distress and left a strategic vacuum. But it also said Labour is “crying wolf” over its privatisation claims. The government said the report showed its plans for the future were right. The behind-the-scenes changes may not have been immediately apparent to patients in GP surgeries. But they were described by NHS leaders as “so big you could see them from space”. Chris Ham, chief executive of The King’s Fund, told BBC News: “People in the NHS focused on rearranging the deckchairs rather than the core business of improving patient care. That’s contributed to the increasing waiting times and declining performance that patients are experiencing.” He described the reforms as simply “disastrous” and said that only in the past two years had the government got its focus right.
Experts call for ‘greater transparency’ in big data projects: Public participation should be at “the heart” of big data projects in healthcare and biomedical research, according to experts. Recent health data projects, such as care.data, 100K Genomes and UK Biobank, have raised a number of ethical questions surrounding the use of data. And the report by the Nuffield Council on Bioethics calls for “greater transparency” about how people’s data are used, and recommending the introduction of criminal penalties for “data misuse”. Professor Martin Richards, chair of the Nuffield Council on Bioethics Working Party and Emeritus Professor of Family Research at the University of Cambridge, told National Health Executive: “We now generate more health and biological data than ever before. This includes GP records, laboratory tests, clinical trials and health apps, and it is becoming easier and cheaper to collect, store and analyse this data.” Among a number of recommendations, the report says that health authorities should track how data are used; that people should be told if and when there have been breaches of data security; and recommends the introduction of robust penalties, including imprisonment, for the deliberate misuse of data, whether or not it results in harm to individuals.
‘Hello my name is’ campaign adopted by 100 plus NHS trusts: More than 100 NHS organisations have signed up to support a campaign to improve patient experience, which has officially rolled out on Monday, reported Nursing Times (subscription required). The campaign was set up by Dr Kate Granger, a hospital consultant from Yorkshire with terminal cancer, who became frustrated with the number of staff who failed to introduce themselves to her when she was in hospital. It started as an online initiative in 2013, using the social media site Twitter and the hashtag #hellomynameis. Today, Dr Granger and others are hoping to drive the campaign more widely with a “mass launch” via trusts that are also signed up to another initiative called the Listening into Action network. In addition, the Scottish Government has announced that £40,000 will be allocated to NHS boards to roll out the campaign across Scotland. The campaign is based on the simple premise of reminding staff to go back to basics and introduce themselves to patients properly. Dr Granger described it as “the first rung on the ladder to providing compassionate care”.
NHS 111 helpline adds to strain on doctors, says BMA: An NHS helpline is adding to strains on GPs, as well as accident and emergency departments by advising people with colds or sore thumbs to visit doctors, the British Medical Association told the Financial Times. Based on its analysis of official data, the BMA said the number of telephone callers to NHS 111 that were referred to GP services had risen 186% between 2013 and 2014 and referrals to accident and emergency departments were up 192%. Separately, figures from the Primary Care Foundation research group estimated that the number of calls designated as “self-care” fell from 48% in 2012 to an average of 15% in 2013 and 2014. The BMA’s findings follow last month’s claim by Dr Clifford Mann, head of the College of Emergency Medicine, that 111 service referrals accounted for almost all the recent sharp rise in patients attending A&E. Dr Mark Porter, who chairs the BMA’s ruling council, suggested that the fundamental problem with the 111 service was that it employed “non-clinically trained staff who follow a formulaic script rather than using clinical judgment to assess how calls are dealt with”.
openMAXIMS CIC approved: Three NHS trusts have officially become the first members of a community interest company to act as “code custodians” for IMS MAXIMS’ open source electronic patient record system. Taunton and Somerset NHS Foundation Trust, St Helens and Knowsley Teaching Hospitals NHS Trust and Blackpool Teaching Hospitals NHS Foundation Trust formally signed the agreement to join the CIC last December, and have now received approval from Companies House. Last March, NHS England said it was looking to set up a number of CICs to act as custodians for open source products introduced to the NHS and undertake activities such as testing and code control. The CICs are also meant to help less technically able trusts take open source solutions by providing the same assurances as with a proprietary vendor. IMS MAXIMS released the code for its openMAXIMS product suite last June after it decided to make the move to open source. Malcolm Senior, Taunton and Somerset’s IT director, told eHealth Insider the CIC will give organisations and clinicians using openMAXIMS “a greater level of ownership and control” in the development of the electronic patient record, while encouraging greater collaboration.“In some respects, we are going back to the days when NHS clinicians worked alongside NHS developers to enhance existing systems and products to maximise the clinical benefits available.”
Single opt-out “needed” for patient data: Health authorities should implement a single Spine-based opt-out for identifiable patient data, covering all care settings, to uphold a promise to respect patients’ rights, an NHS privacy watchdog said. eHealth Insider reported that MedConfidential has released its proposal for a single opt-out following the Health and Social Care Information Centre’s revelation that it is working to resolve a significant flaw with the wording of a current opt-out. In a letter to the parliamentary health committee, the HSCIC said that patients who register a ‘type two’ objection “will not be approached for direct care services like e-prescribing, bowel screening, e-referrals or e-pathology reporting”. The letter said the HSCIC is contacting all patients who have registered a type two objection to ensure they fully understand the implications of their request.
Cerner completes acquisition of Siemens Health Services: Cerner has announced the completion of its acquisition of Siemens Health Services’ assets, client relationships and associates, reported eHealth News.EU. Cerner and the former Siemens business unit have a combined annual research and development investment of more than $650m. The cumulative resources are expected to speed delivery of the company’s next generation of health IT solutions, enabling clients to control costs and improve health care outcomes in their communities. Neal Patterson, Cerner chairman, CEO and co-founder, said: “By combining client bases, investments in R&D and associates, we are in a great position to lead clients through one of the most dynamic eras in health care.”
GP practices across UK face compulsory data protection audits: GP practices face compulsory audits from this month by the information commissioner to check their compliance with data protection laws, reported GP Online. GP leaders warned that the moves could put patients at risk if they piled more bureaucracy on top of the heavy workloads already faced by practices. Following an overhaul of regulations, from 1 February the Information Commissioner’s Office (ICO) will be able to carry out compulsory audits to assess data protection by organisations including GP practices. Previously the ICO was only able to force these checks on government departments. NHS organisations including GP practices found to be in breach of data protection laws have faced heavy fines. GP Online reported in 2013 on campaigners warning that practices could face fines of up to £500,000 for breaching data protection rules, and the ICO has issued fines totalling £1.3m to NHS organisations.
Wrightington, Wigan and Leigh Foundation NHS Trust picks Allscripts Sunrise ahead of TTP SystmOne: Wrightington, Wigan and Leigh (WWL) NHS Foundation Trust is working with IT services provider Trustmarque to implement the Allscripts Sunrise electronic medical record platform across all of its sites to cut costs and help clinicians work more efficiently. Stephen Dobson, associate director of information and technology at WWL, told Computing that the trust wanted to get a high-end electronic patient record system that would enable it to use electronic prescribing and electronic documentation, among other features. “The amount that trusts in the UK ask of our doctors and nurses is too much, [they have a lot] to remember, so we needed to build the right tools to augment their capabilities. We went out to procure these systems last year,” he said. The trust, which provides acute hospital services for a local population of over 318,000, signed a seven-figure deal with Trustmarque in October 2014 to deploy the Allscripts platform after a competitive tender process.
New online registration for medical devices: The Medicines and Healthcare products Regulatory Agency (MHRA) has announced that its Devices Online Registration System (DORS) will be live by 11th February 2015 as part of a move towards digital services, reported Integrated Care Today. The MHRA website last week moved to the centralised gov.uk domain, introducing an improved feedback service and a design overhaul “so it is easier and clearer to understand”. Once the DORS is live a range of medical devices can be registered online including class I medical devices; systems and procedure packs; custom made medical devices; custom made active implantable devices; in vitro diagnostic devices online. In addition, users will be able to manage their details directly online. The online registration system will be live for three months and after 11th May 2015 the MHRA will stop accepting paper registrations and all users will have to register online using DORS.
Computers ‘could diagnose illness’: People who are feeling unwell could be diagnosed at home by their computers under plans being considered by the government, reported Yahoo News. Health secretary Jeremy Hunt said ministers hoped to introduce an online version of the NHS 111 care line within the next two years, as the government looks for ways to ease pressure on hard-pressed accident and emergency units. Speaking on LBC radio, he said the system could enable people to obtain access to a speedy assessment of their condition without the need to go through a lengthy question and answer session with call centre operators. “If there is one thing that I think is really missing from 111 now, which I’d like to see happen, it is an online version of it so that you can actually go on to a website and not have to go through those questions with someone in a call centre but (that) actually answered online,” he said.
5 Boroughs live with RiO: 5 Boroughs Partnership NHS Foundation Trust has gone live with the RiO electronic patient record (EPR) system across its physical health services, four months later than originally planned. The trust is now continuing with plans to implement the RiO EPR across its other community health services, and all of its mental health services. 5 Boroughs was the second of seven trusts in the North West clinical information systems framework group to award a contract, when it signed with Serverlec Healthcare in July 2013 covering its mental health, learning disabilities and community health services. The trust postponed the go-live until February 2 due to “a number of issues…identified through the testing, service transition and operational readiness activities”. The problems included “a number of intermittent technical issues” as well as data quality concerns, but the trust resolved the problems last December before setting the revised go-live date. Dr Louise Sell, the trust’s medical director, told eHealth Insider eight of the trust’s community health services went live on RiO this week “after a significant amount of work by the RiO project team and a large number of staff”.
Apple’s health tech takes early lead among top US hospitals: Apple healthcare technology is spreading quickly among major U.S. hospitals, showing early promise as a way for doctors to monitor patients remotely and lower costs, reported Reuters UK. Fourteen of 23 top hospitals contacted by Reuters said they have rolled out a pilot program of Apple’s HealthKit service – which acts as a repository for patient-generated health information like blood pressure, weight or heart rate – or are in talks to do so. The pilots aim to help physicians monitor patients with such chronic conditions as diabetes and hypertension. Apple rivals Google and Samsung, which have released similar services, are only just starting to reach out to hospitals and other medical partners. Such systems hold the promise of allowing doctors to watch for early signs of trouble and intervene before a medical problem becomes acute. That could help hospitals avoid repeat admissions, for which they are penalised under new U.S. government guidelines, all at a relatively low cost.
Opinion:
Why can’t patients receive blood results via text or use Skype for appointments?
Michael Seres, a long-term patient tells his story on The Guardian and argues that while patients are ready for the technological change, the NHS is not.
“Information governance is no excuse, and privacy and security challenges can be overcome. The technology is also not to blame, and some companies are already helping NHS organisations to safely and securely unlock the value of their information with models that can be integrated within their IT systems.
“Being a long-term patient with multiple complex chronic conditions means two things to me. Firstly it’s imperative that I am an active participant in every aspect of my care. I want to know everything that is happening to me and be part of every decision. Secondly, I am aware that I am one of the biggest drains on healthcare resources.
“I recognise technology is not for everyone but the Pew Institute has some interesting health facts – 86% of people go online to look up health matters, 71% do it from home via their mobile and 25% of patients benefit from online communities. The biggest demographic of online patient users are those over 55, according to HIMSS. We are ready for this technological change but the cultural shift that is needed in the NHS is not there yet; there aren’t enough brave chief executives or clinicians.
“Patients understand the benefits, and data protection issues can be overcome. Years ago, the idea of getting money by walking up to a cashpoint where anyone could see you typing in a pin number would have been laughed at. Now we can bank on our mobiles, we can shop and manage virtually every aspect of our lives through technology. I want to manage my healthcare in the same way.”
Another view: just do IT
GP Neil Paul tells eHealth Insider that it’s time to stop talking about big data and tech funds and do something useful – like give every district nurse (DN) in the country an iPad.
“I keep seeing pots of money for tech funds. I keep hearing about big data. And I keep hearing complaints about how inefficient district nurses and, to some extent, health visitors are.
“How difficult is it to give each DN a tablet? This would immediately mean we could track them and give them lone worker protection; but it would also allow us to start collecting data on what they do.
Reducing trips back to base, allowing them to do paperwork in the field, and giving them instant access to support and advice – whether that was from a senior nurse, a tissue viability specialist, or even a doctor like me – should be easy.
“Ever since the Transforming Community Services agenda – as a result of which community staff were moved from primary care trust control to a host organisation, usually an acute trust – there has been a feeling of unease.
“Most practices feel they aren’t getting their fair share of the resource that is available. However, that share is often based on a rough list size split, not on a need split. This is where the big data should come in; to analyse need and match it to resource. Using the patients’ demographics, knowledge of their illnesses, perhaps some variables on their level of function, isolation and ability to cope, could help nationally set budgets more accurately, based on patients’ actual need. Rather than arguing about nurses per 1,000 patients we could then have the staff to do the work.”
NantHealth CEO on world’s first cancer genome browser
Dr Patrick Soon-Shiong, CEO of NantHealth talks to IDG Connect about his ambitions to radically change the way we treat cancer – and technology infrastructure required to achieve the transformation.
Soon-Shiong describes the latest product from NantHealth in partnership with Blackberry – a cancer genome browser which gives doctors access to a patient’s genetic data in real-time.
“The best way to think about it is very much like Google Maps. Think about how you would browse through the planet to get to an address. This is very much like how you browse through the three billion letters to get to the abnormal or wrong address that is causing the cancer cell to divide and spread,” says Soon-Shiong.
“It allows you to browse for a specific patient all the way down to the abnormal address. We have identified the address at the molecular level for every patient and you can now browse to that address and find the right drug to treat that mutation.”
On the infrastructure needed to deliver cancer treatment that is based on genetic mutations, Soon-Shiong says: “It is very challenging because nobody has built the eco-system. You need to build an eco-system to monitor the patient’s vital signs, capture the heart rate and temperature. [Plus] you need to figure out what drugs the patient needs to be on by looking at the molecular signature. And then you need to compare that with the entire population to ensure that you have a learning system. You need transport systems that can transport large sets of big data and then you need data centres.”
Blog
In this week’s blog Marta Sieczko shares some of the benefits Google+ presents for businesses and gives pointers on how to make the most of the social media platform.
