EHR vs PriMani

Moving to a new and exciting organisation for the 2nd time in 18 months brought me back to this blog idea from some time ago. The change this time, came through a strategic buy-out from a heavy hitter in the European Digital Health Market rather than a career move and as we pivot on this new organisation and the exciting new plans for its future, I thought, it was a good reason as any to revisit the blog.

The nature of a post-modern Electronic Health Record (EHR) being described as a dichotomy of the nature of tailoring!

To have a bespoke suit made from the best tailor in town is considered to be the epitome of extravagance and a lifelong must-do for us ‘normals’. To go to Paul Smith and ‘simply’ ensure the fit off the peg is the right length of arms and legs is a wedding-ready treat. To simply walk into Marks and Spencers and grab an off-the-shelf suit is the equivalent of workwear disposable. And the price equivalent for these experiences are appropriately graded.

Yet the fully bespoke EHR, the one you always wanted, the one that is the right colour, size, and functional fit is the cheapest route to excellence, and the off the peg work wear EHR is the most expensive EHR money can buy, how does that work?

As some may know reading this, my digital health journey started in earnest as the head of integration at LTHT and my passion and belief that this is the key to unlocking any successful EHR journey for any size of Healthcare organisation stills stands strong today.

The desire in the NHS is for a bespoke Saville Row suit at PriMani prices has always been strong and with a modular-based EHR and a fantastic underpinning Integration engine and using the best of what a Trust already has, this makes this entirely achievable.

As we approach the end of what has been one of the hardest periods the NHS has ever known, we all know that all roads lead to one place….. Finances. This Pandemic has cost the NHS £1.5 billion a month more than pre-Covid costs and experts believe it will take upwards of 4 years to recover. Nationally and Locally focus will soon shift to see how this money can begin to be clawed back and as all NHS digital folks know, first stop… IT!

Many Trusts had spent 2019/2020 shining up their new Digital Strategy with some looking to buy a “Harvey Nicks” EHR and some being hip and trendy with a Paul Smith option and some being told by the FD that Primark will have to do. Now I believe all strategies will have to be dusted off and looked at again through COVID spectacles.

To support this dusting off, I believe one tiny, shiny positive that has come out of the Pandemic is the sudden desire (or maybe need) for digital to drive through. Some Trusts are stating a digital maturity achievement in 12 months that they previously believed would have taken 3-4 years pre-Covid. Now some of this is driven by the very nature of the disease and its transmission through touch requiring less paper, but also taking complete advantage of the streamlining of the governance that often comes with digital projects in the NHS.

When we get a chance to breathe later in 2021 and Trusts start to look again at their long-term Electronic Healthcare Record strategy and no matter what the balance sheet is telling them, I believe that there will be, and needs to be a significant switch from rip and replace to analyse and improve. As Healthcare suppliers we need to be giving Trusts the tools they need to realise the potential of what they have and then help them build what they haven’t. CareSuite underpinned by DC4H for example, can give you the choice of 4 modules that cater to all from nurses, clinicians through to community and patients. However, if you already have a system which you have heavily invested in, then let us bring that together with what you haven’t got, in one place for all of your user groups to use. This will give you your “tailored EHR”, and there are many others in the market with some smaller ones hot on our heels to ensure we don’t get lazy in our approach.

There are many advantages to this approach and not just the obvious flexibility around timescales, speed of rollout, or the financials. It also allows for both supplier and customer to be more adaptable to the current need of the Trust or in the case of COVID the National need. It will also help us break into new territory that few are doing across digital health which is realising the benefits of joined-up digital healthcare outside of the immediate care setting but rather how can we use the terabytes of data created every day to help us arm the NHS with what it needs to deliver better healthcare for the future.

As we begin a new financial year, we see the National focus shift to the realisation of the Integrated Care Systems and although this concept has been in existence for over 2 years, it is recognised there is a large disparity of maturity across the country. That said, this brings a new approach to joined-up care across all care settings both in the NHS, local government, and 3rd sector, and with it, the need for digital solutions to support this.

For this to be successful, a partnership is key. When I was the Associate Director at LTHT, when any current or new supplier came to see me, I had one question in my head. Are they a partner or someone looking for their next purchase order, because like all good partnerships they grow and evolve and you support each other on a journey.

As a supplier I know this is something we need to be better at, as do most. However, I also think outside the box of partnership because for an EHR, it is not just about the norm i.e. results, PACS, MPI, it is now much more. It is about AI, Population Health, RPA, Machine learning, Terminology services. Where we as EHR vendors are not the experts and will never be, we just need a strategic set of partners to help us bring true value to the customer.

Then we get to a Saville Row suit, with a lapel pin, and hanky all for a fraction of the cost but making that user feel they have the power to do anything!

The “top hat” to the whole affair is unfortunately something that we are further away from. This is the concept of “front office” ward and clinics and “back office” finance and human resources becoming more joined-up digitally.

Just today I have been part of a discussion around the power of driving a nursing acuity tool with the live data from and EHR aiding the modeling of nurse rostering. How powerful this could be, not only on finances and waiting lists but on the welfare of staff. If we can begin to realise this joined-up approach of the clinical data driving back-office decisions, I believe it will help Trusts on their post-Covid financial recovery and truly deliver the best-of-breed digital approach through a collaborative journey.

I will finish with a quote that I think is quite appropriate for many on the digital evolution journey, and when on a mission to find the perfect outfit 😊

“Change is hard at first, messy in the middle, and gorgeous at the end”

Robin Sharma