EHI Live is UK’s national event for healthcare technology, in particular the infrastructure and hospital technologies. On Tuesday, November 5th, we went along to scout out the action. Thanks to what is occasionally a parochial environment in the UK -along with the sudden influx of developers in the apps-and-solutions segment of the market- EHI Live is a business in which global players (Cerner, Microsoft etc.) sit side-by-side with small but ambitious start-ups.
In no particular order whatsoever, below you can find four useful things we learned:
1) Five challenges for app developers
Ewan Davis of Handi Health offered a list of five challenges for health app developers. He would like for Handi Health to be the community that answers these challenges. Whether Ewan achieves this or not, the articulation of the challenges make sense. Here they are for you to mull over:
- Helping people to find safe and appropriate apps for their respective conditions
- Interoperability of apps and their datasets: cross platform and cross form-factor
- Ensuring that apps have sustainable business models
- Healthcare apps could use some generic design principles, possibly based on the Common User Interface
- Need of of Quality Assurance testing benchmark for healthcare apps, beyond the respective App Stores’ tech assessments.
2) The NHS is getting really smart about Apps
Some of the above challenges were answered by Inderjit Singh of NHS England, addressing the NHS’s app strategy.
A good thing to know is that the NHS already has a rudimentary App Library. However, it only contains around 150 authorized apps, whereas handset App Stores contain up to 1000 times more. Of course, the NHS’s library is curated, which means there is a quality threshold (not least, that these apps will not cause harm) and are rigorously tested by a clinical team, which generally takes a few weeks. Even so, Joe Soap is almost certainly going to use his device’s App Store instead.
So what can the NHS do? Singh’s masterstroke is part of a broader culture of sharing at the top of the NHS, which challenges much orthodoxy. As a behemoth of an organization, for all its failings, the NHS has bags of data, information and knowledge resources. So, instead of running a resolutely second-best App Store, the NHS will allow approved apps to benefit from a squirt of NHS information or even a live data payload, through an API. Patients will get a better, tailored and relevant UK-focused service. Developers will get tech support at scale, and the NHS will get a positive differentiator to leverage knowledge and brand together for better health outcomes. Smart.
3) Interoperability is this year’s magic word
Partly because our previous attempt at applying IT to healthcare was a multibillion-pound game of Jenga, which has now been replaced by local solutions for local challenges; and partly because the Health 2.0 ecosystem is knocking on Health 1.0’s door with lots of ideas, speculative business models, and lean development strategies, interoperability is the magic word.
In essence, it has dawned on everyone that extracting commercial value from the healthcare space is a high-availability data business, whether that’s getting patients into the right bed, or getting them to care more about their own future welfare. And data systems don’t work without solving interoperability challenges.
4) Tim Kelsey likes sharing. And business.
In a keynote speech, Tim Kelsey, NHS England’s National Director for Patients and Information, laid out a five-point plan for committed information sharing from the NHS with the rousing call to arms, “We are the pioneers of this knowledge revolution”:
- Unlock information within NHS silos – whether the barrier is accessibility or breadth of data available.
- Support the interoperable use of richer data to, in and from hospitals by tidying up the previously “confused national environment” of agencies.
- Commit to the ‘Voice of the Patient’ (honourable mentions here to the US service Patients Like Me, now coming to the UK too).
- Consumerize patient records. Kelsey is absolutely correct that if the narrative of health records becomes one of personal ownership (rather than the ‘us and them’ problem of previous attempts at EHRs – tarnished further by other abortive projects like ID Cards), there’s a chance people will buy in. In his words, “We may be able to responsibly demonstrate the benefits of data sharing”. He is also spot on that most people are comfortable with online banking, and that therefore that degree of comfort in the health space must be somehow possible to replicate. He’s also right that a sense of ownership might support interesting mashups between my health record, my gym and my insurance company. When he also mentioned Tesco Clubcards, we thought: a bridge too far…
- Collaboration over top-down. Expect APIs wherever possible to make NHS knowledge and information usefully available in as many contexts as possible; q.v. Indi Singh’s comments above.
There’s a big difference between data collected for compliance purposes, data, which can be used for whistleblowing and a transparency agenda, data used for targets and measurement, data owned by the patient, and data which is being used anonymously and punted out to independent or commercial third parties. They overlap on so many criteria; and once again, the models for access, usage, outcomes and commercialization are by no means clear. But Mr Kelsey did use the word ‘entrepreneur’. A lot. And we did get a sense of some concrete answers for patients as to how their data might be used (again, a narrative which was previously crucially lacking).