William Edwards is chief information officer and Director of eHealth at NHS Greater Glasgow and Clyde (NHSGGC), which is the largest NHS organisation in Scotland and one of the largest in the UK, covering a population of about 1.1 million and employing around 39,000 staff. The board provides strategic leadership and performance management for the entire local NHS system in the area.
“My role is to ensure we exploit technologies and information as much as we can, in order to make sure we are as productive as possible and to ensure we are also helping to redesign care pathways across the organisation,” Edwards tells NS Tech.
The NHS board has a programme called Moving Forward Together, which is about changing the way the organisation treats patients, ensuring that it delivers care with the needs of individuals in mind, regardless of operational boundaries. The idea is to make sure there is access to the right information, and that patients can receive a targeted and supported experience.
This means that those within the organisation are encouraged to redesign the way existing pathways are put together. Dr Chris Carlin, a consultant respiratory physician at NHSGGC had an interest in redesigning pathways for Chronic Obstructive Pulmonary Disease (COPD) patients. COPD is a serious lung condition affecting 1.2 million people in the UK. As it is the second most common cause of emergency hospital admissions in the UK and the illness has many complexities, it’s a main driver in rising NHS costs – in fact, each unplanned hospital trip costs in the region of £6,000.
With hospitals overloaded and struggling to manage increasing numbers of admissions, this isn’t just a burden on costs but on patient care.
“We wanted to create an innovative project to ensure patients can be better managed, having a more open dialogue with clinicians and keeping track of vital signs, and we put in a successful bid to Innovate UK who funded this piece of work to try and redesign the pathway of care for patients suffering from COPD,” says Edwards.
The programme involves a trial of 400 patients with the aim of being proactive rather than reactive; predicting what will happen with a patient, so that their treatment can be adapted, meaning they can avoid a hospital admission.
NHSGGC is working with KenSci, a business that specialises in machine learning facilitated by Microsoft Azure’s cloud platform to store data, and Storm ID, a Microsoft partner that develops digitally enabled care models. In addition, the organisation is using wearables in a bid to empower patients to get better control over their condition. It means clinicians can remotely monitor COPD patients’ ventilation machines and their daily activity, with algorithms in place to proactively track and anticipate when a flare up is likely to occur. Clinicians would then automatically be alerted, so they can take action immediately.
It’s still early days of the trial but Edwards says that the project has been promising so far.
“Some patients in the pilot have been really complimentary about how they feel more engaged with clinicians and the ability to contribute to how they’re feeling. In terms of unplanned admissions, we believe that some of those patients in the trial could have had to be admitted [if it wasn’t for the trial] and this would have resulted in additional costs for the NHS,” he states.
The biggest benefit to NHSGGC could be the framework itself, as Edwards could see it being used for other conditions.
“I see it as a blueprint for a number of other areas such as diabetes or asthma monitoring or various other conditions. A big benefit has been the ability to use cloud technology to capture patient-generated data – we have traditionally only generated data within the health environment and not outside of it, and this breaks down the barriers of that,” says Edwards.
“The benefit is more about how much we’ve learnt from this project around cost savings and patient experience – and how we can use these principles to convince other services, because while COPD had Dr. Carlin, there will be clinicians in other specialities that need convincing that they can use technology to lead this kind of pathway,” he adds.