Blog by Dylan Roberts

The current Health Care System cannot meet the demands of the future without change. We want to move to a whole system approach across places that enables people to independently look after themselves, to connect them to their wider circle of care (of which the traditional health and care organisations are only part) using some of the latest technologies to make it happen.

This Asset Based Community Development (ABCD) approach to health and wellbeing aims to nurture, sustain and build health assets in every individual, family and community in order to improve people’s life chances and enhance positive health and wellbeing. Connecting these assets and the health and care system so that they can work as if they are one team is important and technology can enable this to happen.

People use our health and care services because they need our help. Our job is to help them in the best way that we can. This seems a simple arrangement and with perfect information it could be much simpler than it is. Perfect information is the right information (the whole picture not parts), in the right format provided at the right time. However, the fact is that we are far from having perfect information.

Perfect information allows us all to care for the whole person, not just the condition that presents itself when our services are called on. Perfect information allows us to work in a team where we each contribute our skills to the wellbeing of our clients perfectly in harmony with the work of our colleagues.

Yet our current Health and Care System is not designed to provide us with perfect information. It is fragmented around service lines and information is locked within the organisation that collects it. Paradoxically, it is the absence of perfect information that prevents our Health & Care System reforming itself to centre on the needs of our citizens and embracing the new technology which empowers people to better look after themselves with reduced dependency on our services.

Surveys of people with multiple conditions and complex needs consistently place “care for the whole me and act as one team” as their top priorities. The challenge that we give to commissioners and providers of health and social care is to listen and arrange the system so that carers from all organisations coalesce alongside community assets around the needs of the individual.

In short what is being called for is mass personalisation of care and wellbeing. Mass personalisation is a phenomenon that we have all been experiencing since the start of the Internet age. It is the ability of an industry to use information to precisely tailor its services to the needs and wants of individuals. A consequence of mass personalisation is self-service. As services are better aligned to people and information tailored to their precise requirements then people and carers can use tools to better look after themselves.

Can a single vendor or the current legacy technology providers possibly meet the multitude of different requirements? The answer, in my opinion, is that they can’t. Mass personalisation can only be achieved by an ecosystem of multiple providers that specialise on different personal requirements.

What is Yorkshire and Humber’s strategic play in the emerging digital health information economy?

The strategy of Digital Giants (e.g. Amazon, Google, Apple) is notably to provide platforms[1] that broker relationships between multiple providers and content producers to enable mass personalisation of solutions to consumers.

The best performing public stock of the decade was Netflix (+3700%) – a platform company that transformed the provision and development of media content and entertainment which disrupted the media and entertainment market.

Could we be the region to take the lead for “UK plc” to broker and regulate an unprecedented ecosystem of data driven innovation and investment by health and tech (HealthTech) specialists for the benefit of all individuals? In this model we, the public sector provide the platform[1] and can regulate the ecosystem of providers who use it. We can ensure that data is used ethically for the public good, and with an ecosystem of interconnected, informed activity from public, private, and third sectors that is capable of seeing one person holistically and providing the right mix of personalised health and wellbeing information and solutions that in many cases will prevent sickness in the first place.

Our technology and data strategy for the YHCR has been to build the foundations of our platform that if we invest and exploit it can enable an ecosystem of innovators to develop new capabilities to deliver the mass personalisation aspiration above.

Yorkshire are blessed with the best software engineers who develop quality code and solutions that are stable and reliant. We have employed some of the best through our software engineering partners and developed an open standards based integration infrastructure (our platform) and a “paint by numbers” adoption pack that organisations can use to get connected. This enables all Health and Care partners nationally to integrate their systems in a “cookie cut” manner and by doing so enable their data to transform into national standards and formats. i.e. FHIR and the next iterations of the Care Connect profiles that we are contributing to.

In the same way the adoption pack can be used by the ecosystem of healthtech providers to develop their capabilities against. Which means that the data they collect or use is interoperable with the professional care record systems used across our whole system. Further as this platform is licence free it is also available for solutions that are developed for community based assets. E.g. This could be solutions for Care Homes, solutions for individuals and their families.

The YHCR is cloud hosted and therefore the capability is scalable and can be easily adopted by other regions as well as organisations within Yorkshire and the Humber.

This approach has parallels to the “Fixing the plumbing” initiatives that local authorities collectively, in partnership with MHCLG, are moving to address as stated in the Local Digital Declaration.

 

OUR CHALLENGE

The volume of demand is what will ultimately pump prime the market and investment in it and the platform. The more patient records (systems) that are integrated to the platform the more patients/people will demand products to improve their health and wellbeing and the greater the economies of scale.

This cannot be an agenda led by Digital and Technology Leaders alone. Our leaders, clinical or otherwise, need the skills and knowledge to understand digital economies, brokering and platform based models in order to generate the volume of perfect information and users.

This can start by organisations singularly or collectively developing and evangelising the platform based use cases that deliver value and better outcomes for people. This could include changes to the existing models of care all of which will inform the market as to what is needed and lead to innovative developments and products.

What is the Digital Academy syllabus, mentoring and support we need to achieve this?

Who will win the Health and Wellbeing platform game >> Tech or Pharma Giants or a great opportunity for the Public Sector working with the best of tech partners?

CONCLUSION 

We are at a tipping point where the opportunity to take this on must be grasped now. There are opportunities to work with some of the Amazon Smarts, we have the software engineering brilliance in the region, we have leading Smart Cities initiatives, part funded by Gov Tech cash, developing Smart healthy homes all of which can be connected to our integration platform. We have award winning Digital Inclusion programmes, full fibre roll out being accelerated in parts of the region so the means to get populations connected. All of this the basis for Yorkshire and Humber to differentiate ourselves globally if our senior and clinical leadership grasp the nettle to become digitally savvy and sign up the YHCR platform.[1] One driver of this digital transformation has been the use of technology platforms, whether these are proprietary, like Apple’s iOS, or more open, like Google’s Android. Such platforms provide standardised environments that stimulate whole ecosystems of businesses to build products and services, attracted by the volume of demand that these platforms generate. Platforms can drive astonishing rates of innovation, investment, choice and competition.

 

By Dylan Roberts
Technical and Local Government Lead
for Yorkshire & Humber Care Record

Follow on Twitter @DylanRRoberts

FOOTNOTE

[1] One driver of this digital transformation has been the use of technology platforms, whether these are proprietary, like Apple’s iOS, or more open, like Google’s Android. Such platforms provide standardised environments that stimulate whole ecosystems of businesses to build products and services, attracted by the volume of demand that these platforms generate. Platforms can drive astonishing rates of innovation, investment, choice and competition.