Technology in the NHS has been a touchy subject in recent years.
The failed National Programme for IT (NPfIT) saw billions of pounds wasted and new plans have received mixed responses from staff and users alike.
However, this hasn’t stopped a number of leading organisations from embracing what new technology can bring to the health service in the UK and being innovative with the tools available.
One such Trust is University College London Hospital (UCLH). James Thomas, director of ICT at UCLH, has been driving his organisation towards embracing mobile and, in the past four years, has seen some great results.
“I think we have been moving at this pace since around 2009,” he explains. “That year we wrote our scenario-based vision for 2013 to drive technology for that journey. In 2012, we opened the Macmillan Cancer Centre and it all became a reality, with patient portals, self check-in, mobile devices, real-time scheduling.
All our aspiring led to us delivering on that.”
The hospital uses an outsourcing model, partnering mainly with Logica to choose where to go. However, when it comes to unified communications, it has teamed up with Azzurri Communications to push forward its mobile agenda.
We had two BlackBerry failures within just two to three months of each other and as a 24/7 acute hospital, that is a lot of our important infrastructure affected
James Thomas, director of ICT at UCLH
“Probably about 18 months ago, we were BlackBerry only,” says Thomas. “It was an internal enterprise purchase and one we had stayed with for some time. But then we had two BlackBerry failures in just two or three months of each other and, as a 24/7 acute hospital, that is a lot of our important infrastructure affected.”
But it wasn’t just past events that inspired the director to look towards new platforms.
“I was at a Gartner event and the speaker asked the audience who was using BlackBerry Enterprise Server,” he continues. “Unsurprisingly two thirds of the audience put their hands up.”
“However, when he asked who intended to be using it in the future, a mere 25% raised their hands. I found this quite startling and along with the concerns I already had with BlackBerry, I knew we had to diversify.”
Thomas and his team began to look at the other mobile options out there, with a keen focus on security which was what had led them to stay with BlackBerry for so long.
“All the indications pointed towards Apple’s iOS as the first step so internally we brought in iPhone 4G and 4GS, alongside mobile device management (MDM) from Mobile Iron to provide that same level of security.”
Trends in healthcare IT
But as well as devices, more options were opened up to the hospital through the new MDM deployment.
“At the same time we began to investigate mobile applications which are enormous in health right now,” says Thomas. “Mobile Iron gave us the launch pad to explore Bring Your Own Device (BYOD), deploy profiles onto mobile devices and to create mobile app stores to be used and validated internally.”
Although smartphones were the first move, it quickly became clear staff wanted tablets as well to give them even more choice.
“We have 8,000 employees, including a large community of consultants who also work in their own private practices,” he says. “These are affluent people who would purchase iPads for use outside of the trust as well as internally.”
The IT team knew what devices were needed so next it was time to look at what sort of apps would be beneficial to the organisation. It split into three areas – clinical, non-clinical and patients – and then looked at what apps they would want to use.
“For non-clinical they wanted apps such as email access and procurement; clinical were wanting data depositories and scheduling systems; and then patients want to be able to access public Wi-Fi for their own apps; but we also wanted to get feedback from them when they are at the hospital,” says Thomas.
“The result of this drove functionality, the ability to cater for different platforms and the whole BYOD project kicked in.
Also, we were now able to look at internal app development and some of these projects have enabled us to unlock legacy systems.”
One example was UCLH’s core PAS system.
The hospital developed a web services layer to deploy over the top so something like discharging a patient could be wrapped into a mobile app.
The future of mobile at UCLH
UCLH is still using BlackBerry, although it hasn’t purchased anything from the firm for the last 18 months and now has a number of iOS devices, but is still hesitant about the other mobile operating systems available.
“We have looked at Android twice and both times we have found we just cannot secure it enough for our environment,” says Thomas. “The next device type we would be looking to adopt would more likely be Windows mobiles as there is a lot more enterprise capabilities.
“From the enterprise perspective it makes sense to go through BlackBerry, iOS and then have Windows next in line but it is not what people are buying. No-one is knocking the door down and asking for Windows compatibility. We just need to see if it takes off. We aren’t ruling Android out for the future but we don’t want to dilute security.”
Mixed reaction to new technology
Although very pleased with how the roll-out of these new technologies have gone, Thomas admits there had been mixed reactions from staff.
“With 8,000 employees, ranging from world class consultants to minimally paid administration staff, there has been a whole diversity of experiences and responses,” he says.
“Some have been very positive and enthusiastic, saying how liberating it is, allowing them to choose how to do their jobs and do work where they want to. However, some institutions have been a little slower in embracing it.”
We aren’t ruling Android out for the future but we don’t want to dilute security
“Nursing colleges, for example, have said BYOD is a way for nurses to subsidise the NHS, paying for their own devices rather than being provided them. But this has not been the view of the nurses we talk to.
If they need a smartphone or tablet for work and it can be justified we will buy them one, but many like to supplement this with the one they have got personally.”
A future of apps at UCLH
The trust is already looking to the future, having written its next mission statement on the vision for 2017 early last year. Mobile is again at the centre and Thomas wants to continue to build on the progress his team has made when it comes to apps.
“One example is in the way we manage new drugs being released into the trust and deciding whether to use them,” he says. “In the 2017 vision, this will be an advisory board app to make the decision.
There are more than 5,500 clinical apps available now and we want to be part of this revolution.”
And it seems the director has been so impressed with the Mobile Iron solution, the supplier is likely to be involved for some time to come.
“We picked Mobile Iron to start with and did the pilot when it still only had a small footprint in the UK,” continues Thomas. “The small pilot we did was hugely successful at that point so we decided to invest more.”
“We now have it so it is highly resilient, driving it out to more users and it has delivered everything it has promised. It is now part of our enterprise infrastructure and will remain so until at least our contract comes up in 2015.”
Public sector collaboration
Thomas is not just positive about his own trust’s future though and has key roles in a number of organisations in the capital, such as the London CIO Council, London Procurement Partnership and London Connect, so the public sector can share its experiences with technology and learn from one another.
He concludes: “The IT agenda in the NHS has a bad public press following NPfIT, which was fundamentally flawed because it assumed every trust was starting from the same place and needed the same solution.
A cohort of us disagreed and carried on regardless of NPfIT.”
“Now we live in a more open, collaborative world and, as long as we continue to recognise we are not all the same but we can help each other, we will get more of this innovation.”
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This was first published in August 2013