Bring Your Own Device – more important now than ever!

Bring Your Own Device – more important now than ever!

BYOD

The last six months has seen a myriad of changes in how we live and work, and our reliance on technology has ratcheted up to new levels enabling essential services to keep operating. That old saying ‘necessity is the mother of invention’ is as true now as it ever has been, becoming the motto in many board rooms and IT departments up and down the country. Many of us will have seen a transformation in attitudes during the pandemic with red tape and bureaucracy reducing alongside a nationally more permissive (but diligent) approach being encouraged.

I was one of the privileged participants in cohort one of the brilliant NHS Digital Academy and decided to continue into the MSc year. In April 2019 I embarked on a research project to study the use of Bring Your Own Device (BYOD) in the NHS and public sector to try and find out how organisations were responding to the exponential growth in the phenomenon. There were a wide range of views from one extreme (we’ll never allow that) to the other (we’ve fully embraced BYOD).

There is a harsh reality some would rather deny, people are using their own devices for work purposes and we need to adopt an approach that recognises this is now a fact of life.

            Some of the reasons for the rapid adoption of BYOD include: consumerisation of technology resulting in staff owning better technology than the organisation; more rapid replacement cycle for personal devices; improved productivity features on new devices; increased morale and motivation when permitted to use own device; freedom to install useful Apps on own device; free choice to use a familiar device that works well the individual rather than being squeezed into a one size fits all enterprise model.

In my research I came across articles that evidenced improvements in staff recruitment and retention where BYOD was included as part of the job offer.

            For many organisations there are concerns that losing control of devices used within the organisation poses too great a risk and it’s easier to ignore BYOD – but do so at your peril. In a Twitter poll over 80% of respondents said they should be able to use their personal devices for at least some work tasks. NHS Trusts who did not allow BYOD similarly responded saying it was 92% likely or very likely their staff were using their own devices despite not being permitted! Digital Health published an article in 2018 detailing a survey which found ‘97% of surveyed doctors routinely send patient information on instant messaging without consent, despite the fact 68% were concerned about sharing information in this way.’ Clearly there is an issue and the NHS requires new tools which support flexible ways of working to reflect modern communication needs. If these new tools aren’t centrally deployed the crowd will source their own and in many cases already are.

      A survey of public sector BYOD policies attracted over 900 responses with only 38% of NHS respondents declaring they had a policy, more worryingly 44% of Trusts said they allowed BYOD but didn’t have a policy at all. Of those whom did have policies, many were confusing and difficult for users to understand, many were buried in long technical information strategies or IT security policies. I was impressed with Trusts that had a policy stating BYOD was not allowed – but the research suggests BYOD will still be happening. There is an absolute need to keep confidential and patient data secure and organisations should seek solutions that enable modern data sharing and communication options. My advice would be to assume BYOD exists in your organisation and understand how and why, and then build policies and systems which embrace secure flexible working.

This piece would be remiss not to mention the bias revealed by the research towards BYOD in non-clinical roles and nervousness within some clinical teams. BYOD is probably simpler for office-based staff and these cohorts are likely to have more control over their working hours. For senior clinicians there was concern BYOD could bring yet more demand to their hectic schedule with an expectation they would be ‘always on’ and their need for downtime disregarded. Therefore, BYOD has risks for specialist teams and boundaries and expectations need to be explored and clearly articulated.

The figure below shows survey feedback of tasks currently done on own devices (in blue) and what the uptake would be in services if made available in the organisations (in red). It’s interesting to note that with more BYOD there was a suggested 3% drop in voice and text messaging as (assumedly) users would be able to access and update information without asking someone else to do it for them. There is clearly a desire for access to patient records if a secure solution can be provided and the recently published NHSX Clinical Communications Framework will surely help guide Trusts towards procurement of technologies that can facilitate BYOD and new ways of working.

In my research I reviewed nearly 400 policies, most of them weren’t clear on BYOD even though the organisations who sent them said it was their main policy on the use of personal devices. My plea to all organisations is recognise BYOD is here, it’s happening and it is a good thing for the employees who want it – so don’t block it because staff will find workarounds if you do. Start a review of what is happening and plan to produce a simple to understand policy entitled BYOD that is accessible for all of your staff. If you haven’t already consider installing some Mobile Device Management (MDM) software to ensure the organisation has more visibility and control of what is happening. Here is some advice and an example policy you could use as a template to get started. You’ll find further guidance on BYOD on the new IG portal.

If you’re still not convinced about BYOD why not try this exercise:

— ask your staff what the organisation policy is on use of BYOD;
— ask your staff if they ever use their smartphone for work tasks.

My guess is you’ll get a range of answers and your teams would appreciate more clarity.

The pandemic has presented challenges in every walk of life but it has enabled digital transformation at pace like never before. I believe there is an opportunity to intentionally migrate to BYOD or CYOD (Choose Your Own Device), decentralising traditional IT models, expediting equipment setup and reducing costs – but that’s probably for a future blog! Thanks for reading.

Rob Blagden was a co-creator of the NHS Digital Academy in cohort one. He now works as the Director of Libraries, Technology and Information at the University of Gloucester. He still has strong links with the health community and is a Trustee for a local mental health charity TIC+. Rob has recently produced specialist software to support high quality online learning with multiple webcams called LecturePRO and he is starting to work alongside digital health start-up Tektology to explore how digital transformation of health, care and wellness can be better informed, supported and progressed. Rob is a kidney transplant recipient and often talks about his experience as a patient and the impact digital has made in managing a long-term condition.

BYOD – Good or Bad for the NHS?

MSc Logo

NHS Digital Academy BYOD Research Study Invitation 

My name is Rob Blagden and I’m currently the Deputy Director of IT for 2gether NHS FT. I am pursuing a Masters degree in Digital Health Leadership at Imperial College London. I am conducting a research study for my dissertation. The study aims to investigate the implementation of BYOD in the NHS and produce implementation guidance and common best practices.

BYOD

You are invited to participate in this study

If you agree, you are invited to:
1. Complete an online survey of 10 questions, that is expected to take no more than 5 minutes to complete.

2. Optionally also participate in a possible follow-up interview. Interviews will be conducted sometime after the survey. They will last no more than 30 minutes and be held at a mutually agreed time and place, possibly via telephone depending on your location. Interviews will be recorded for transcription and coding and you do not have to answer any questions you do not want to. If you do not want to be recorded, handwritten notes will be taken. You can indicate if you want to opt-in to the follow up interview at the end of the online survey.

Participation in this study is completely voluntary. Your identity as a participant will remain confidential at all times. If you have any questions about this study or your possible participation, please contact me at r.blagden@nhs.net.

At the end of the survey if you provide your email address, I will email you a copy of my finished work by June 2020.

Thank you for your consideration.

If you wish to participate, please follow the link below to begin the survey. https://www.surveymonkey.co.uk/r/BYOD_Survey

If you’re technical could I ask you to complete this survey instead/too?
https://www.surveymonkey.co.uk/r/BYOD_TechSurvey

Many Thanks

Rob Blagden
MSc Candidate, Imperial College London

NHS Digital Academy – The journey has just begun

Programme overview visual

The first ever NHS Digital Academy Cohort has just finished – but this marks only the start for participants who have new skills and networks to enable the digital transformation needed in our NHS.
It also marks the start for those who got prized places on Cohort 2.

So, what did we learn on Cohort 1 and will it make a difference?
If you talk to anyone from Cohort 1 and you’ll see them come alive as they talk about the their experiences, learning, friendships and how it’s opened new opportunities and broadened their thinking.

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Module 1 : Essentials of Health Systems

Module one dropped everyone straight into learning mode and taught us so much about the complexity of healthcare. In most businesses you create a model and repeat it to generate consistent results but in the NHS there are no single interventions that can be guaranteed to have exactly the same outcomes for everyone. In complicated circumstances you can break the problem into smaller chunks. With the complex issues encountered in the NHS this is challenging because of the dependancies and uncertainties. But if you and me are able to reduce complexity in what we do we’ll improve success rates and reduce the risk of error.

I learnt about the impact of population health on the UK’s GDP and how the two are inextricably linked. We reviewed the Global Burden of Disease and the determinants of health. We looked at the purpose and process of regulation. It was interesting to gain deeper insights into the history of the NHS and investigate the apparent disparity in spending on health preventative initiatives – just 5% of NHS funding is spend on prevention. It was clear in my mind this needs to change – but it’s an impossible task to decide what you stop funding in order to invest into helping people avoid illness.

Teens in Crisis + logo

I’ve been asked to become a trustee at Teens in Crisis Plus and love their work because of the innovative way they help children (9-21) cope with life’s struggles. I believe this will result in stronger healthier happier adults and is something I wholeheartedly believe will change the future.

Gaining insights into the impact of asymmetries of information was fascinating and will help me think about how I work with others to build trust and relationships built for mutual success.

We took a look at how much the NHS spends on technology and whether it always provides the intended value – post project reviews are essential to understand benefits and develop learning – it’s something we can all help to improve. Looking at the NASSS framework was very interesting – a piece of work by Professor Trisha Greenhalgh which I compiled into a poster for my office wall.

The module looked at governance in relation to cyber security via a case study – I enjoyed this although I know some of my colleagues found it very technical. I’ve worked hard in my day job to achieve Cyber Essentials Plus and continue to champion the cyber cause recently joining an NHS Digital pilot of some new tools to provide improved external security assurance for NHS networks.

We finished module one with a look at system redesign and process mapping tools and techniques. I now have a big list of different tools which I can pick up to help me present and review systems and projects.

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Module 2 : Implementing Transformational Change

Module 2 continued the significant learning with advice from not just NHS experts but also external third parties who brought insights and experience in how to bring about transformation in our organisations with new approaches.

We learnt about organisation buying behaviour and why suppliers can have a hard time partnering and working with the NHS. We all have a responsibility to support relationships with parters because they bring experience and capabilities the NHS desperately needs.

We looked at project delivery methodologies and benefits of each. We also learnt more about risk management and innovative financing arrangements. I’m keen that future development programmes I run will be agile and iterative giving more flexibility than the traditional PRINCE2 waterfall we are all indoctrinated into. We need a hybrid that brings the best of both together.

One of my favourite items of learning was using lean canvas to present a project on a page and I can recommend giving it a try at https://leanstack.com/leancanvas

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Module 3 : Technology Strategy and Health Information Systems Implementation

Module 3 introduced Health Information Infrastructures which can be very complex and are created from systems of systems. Managing these and the data flows between them requires clear strategies and depends on long term relationships with stakeholders and vendors.

In the module introduction Kathryn Cresswell summed up the challenges brilliantly:

“Studies show that, when healthcare staff are pressed for time, they often do not consult technological systems (e.g. records or decision support) and they may also delay data entry till they have time to do this. Delayed record keeping may impair quality of care with potentially safety critical consequences. In these situations, systems do not function as intended by designers and implementers.  Systems design needs to be mindful of the social and organisational pressures on users.” 

We learnt about data driven research and the ethics of using information for research purposes. It was also useful to reflect on the significant trust the NHS has from the general population and this comes with responsibility on us to protect and use data with wisdom within the legal frameworks that exist.

We looked at integrating and improving care by sharing data across organisational boundaries. This is now working in some areas via shared care records but will become national via the LHCRE programme. This will require increased use of open standards and interoperability such as SMART on FHIR and standardised use of SNOWMED CT.

Workarounds slide

I enjoyed learning more about workarounds – what I thought was simple subject proved to be very interesting. It would seem not all workarounds are as bad as I might have assumed and there is a lot we can learn from studying workarounds. This paper on Theory of workarounds was a great read.

We concluded Module 3 by studying some disruptive technologies which seek to improve and radically change health and care – this is future we’re all called to create in our organisations.

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Module 4 : User-Centred Design and Citizen-Driven Informatics

Module 4 introduced us to techniques which can enable improved user engagement. We investigated what user centred design really meant and looked at some of the national standards that have been published recently.

“A user interface is like a joke. If you have to explain it, its not that good”.

@kimunertlphd (Twitter 04/04/19)

At Residential 3 we were treated to a visit to the Empathy Museum to experience ‘In Their Shoes’. Skeptical to begin with I put on someones actual shoes and a headset and listened to the story of the experiences of an ambulance driver who had move to the UK from Australia to work for the NHS. Hearing his empathy (and at times distress) for the people who he encountered each day was difficult to take on board. I would treat him with massive respect if I ever met him having understood what he has to experience everyday.

Perhaps we could all assume the best intentions in others and treat them with respect and value – then the world would be a better place. We shouldn’t need telling about the stresses in others lives – we can be sure they have had struggles like we have – being a helping hand rather than adding to their problems should be everyones aspiration.

The role of the citizens in health service transformation is essential as expectations increase. Evidence shows health ownership (and outcomes) improve when patients are more involved in their care, so it is essential to co design and prototype with our service users more than ever to improve inclusion, engagement and self-care.

The best learning for me was that if I really want to learn about a situation rather than getting someone to come and explain to me I need to get myself into the user environment. 90% of what you learn is indirect from just being there in the users situation. When I make someone visit me to discuss a project they learn more about me from my office and surroundings than I actually learn about them.

So from now on – I go to where you are to learn about you because that’s what I’m interested in and its the only way to ensure systems are designed using your perspective, experience and needs.

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Module 5 : Decision Support Knowledge Management and Actionable Data Analytics

Module 5 taught us about clinical decision support systems and analytics. We learnt about the learning health system which takes data, uses the data to generate knowledge and then applies that knowledge by taking actions to change processes or systems to make improvements. These improvements feed new data to keep the cycle going – generating a learning health system.

The Learning Cycle

We looked at some quite complex statistical modelling and mapping which definitely made my head hurt! I even decided to have a go at learning the statistical research software R – in the end I reverted to Excel and SQL for my assignment!

We learnt about the need to use appropriate sample sizes, frequency and segmentation to provide robust basis for analysis and generating an evidence base. We also learnt about ontologies, benchmarking, data collection techniques, complexity and governance.

I found the learning about type 1 and type 2 thinking interesting, with the former being reactive and intuitive and the latter being slower and more analytical. We thought about benefits of both and where they are best suited. We also thought about artificial intelligence and how systems that can provide additional data in terms of diagnosis suggestions are likely to become common place in the future – we just need to find ways to integrate them at the point of care seamlessly.

Developments in the areas of AI and machine learning are exponential and will need critical appraisal and analysis and we reviewed academic papers that had investigating approaches to this. We also looked at some new and emerging systems.

Module 5 was the most challenging but I was able to use data gathered for my work place project and gain new insights and understanding using techniques I’d learnt.

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Module 6 : Leadership and Transformational Change

If you think Digital Academy was mostly about technology I’d have to let you down lightly and explain it was mostly about people.

People are who will enable change and transformation to be successful (or not) and how we engage and work with one-another will be essential to making our NHS sustainable in the future.

For Module 6 we carried out a number of practical exercises at residentials helping us develop negotiating and pitching skills. The rest of the module was to develop a work place project through which we could use our learning and assess how we’d grown in our leadership skills.

The main learning points for me were:

  • I can’t lead without engaging and listening to properly understand
  • I must spend more time with clinical services
  • I should actually show empathy – just thinking it won’t show it
  • I’ll continue to inspire and release innovation at all levels
  • I need to keep finding new ways to influence
  • Keep discovering language that makes sense to the listener
  • Simplify strategy so everyone gets it – keep evolving it
  • Relstionships are critical – keep buiding them
  • Diarise more reflection time to feed the learning health system in me
  • Keep reading – knowledge is growing rapidly I need to keep up with some of it!
  • Automate and democratise – don’t be scared of giving more ‘power’ to a wider audience. Empowerment = engagement = productivity


This week I was accredited by Federation of Informatics Professionals (FedIP) which is a small but growing group of people who are recognised as being professionally qualified in informatics. I’m proud to have achieved this and recognise the NHS Digital Academy played a huge part in developing me to achieve this.

I feel very privileged to have been part of Cohort 1 and now move on the the MSc final year from May 2019 onwards.

Residential 3

The DA has an active Alumni which will grow as more cohorts complete this world class learning experience helping to share learning and build relationships. Best wishes to Cohort 2 as they start on the NHSDA journey next week.

Thank you NHS England for having the courage to commission such an innovative ground breaking course.

I committed at the start of the Digital Academy to share my learning. This blog is a part of that commitment. I hope you’ve found it interesting to read.

@robblagden

Rob Blagden works for 2gether NHS Foundation Trust in Gloucestershire as Deputy Director of IT, he is also the Trust’s Lead Governor. Rob was recently elected to sit on the first Alumni Committee for the Digital Academy.


The Digital Academy

Experiences, insights and tips from a cohort one NHSDA plodder, with no post graduate academia ability!

Modules Display at Residential 1

As I’m re-reading and tweaking the last assignments, correcting the spelling errors and checking the references this seemed the ideal time to share some thoughts on the journey the DA has taken me. Hopefully there is some musings of worth for cohort 2 and beyond within!

OK, so… you “get the email” and you are accepted! Congratulations! You’re in for a one amazing ride! The DA is still new, the paint hasn’t dried and the vibrant buzz in the room on the first day of the first Residential will be a revelation.

Team exercise to build Card Tower
‘mmm… guys look at what they’ve done…’

But first things first, we are all very very busy people… as soon as you get the Residential dates get them in your personal and work diaries immediately. You cannot (and will not want to) miss any days… the time at a Residential is golden, pure turbocharged learning, every day is massive, and every day will be packed with learning that will leave you inspired for months to come.

Day with Havard students and joint Speakers

My first top tips are to enthuse and engage with your peer group, make a What’s App group for chat and support, make a Slack group for sharing and peer critique of your work and ensure to drink a gin or two at the end of the day whilst sharing reflections on the end of your first day. 

Residential 3 Dinner

Your peer group is beyond doubt a vital lynch pin. The connections you make with these colleagues will be deep. Effective peer groups enhance the DA experience more than I can place into words.

My peer group are now trusted and life long friends, I call them “thunder buddies for life”. When the workload is high (more of that later) and you cannot find that paper / really need to let off steam; there are colleagues who can appreciate and guide and support. It’s also really good fun to be part of the DA day to day with likeminded folk!

If, like me, you haven’t done any true academic learning for over 25 years there is an element of culture shock. The first module is an excellent scene setter, and eases you in to the learning process. Top tip… define and ring fence dedicated time straight off the bat. When that time is obviously different for everyone, but make sure it’s time just for the DA. If the time is at work, turn off your email app, put your phone on divert. You will have a local to your organisation sponsor; book in regular (at least once a month) catch-ups with them. They can be crucial to help open doors for the modules. Get them on board right from the start. They need to appreciate the scale and worth of your endeavours, which will be huge. 

Module 1 Evolution of Informatics Exercise

As cohort one the DA course organisers were straight up with us, they had an idea what the time commitment was, but that was an estimate. Cohort one has truly been listened to, co-design has been high on the agenda all year. In terms of time I would say on average it’s 5 to 8 hours a week, this is for a late middle aged clinician who hasn’t done a Masters and had no idea how to write, never mind cite a paper, who has a lust for knowledge… that is the time I needed. Make of that what you will. Some weeks flew by, others took considerably more. I didn’t need to take any annual leave to complete the work, but certainly a dozen weekends over the year have been pretty much DA only. I am known in my peer group as a plodder, I’m not a fast learner.  The thing is, on the whole (everyone has a bad day once on a while) it’s not felt like a chore. The reason is simply that the course content is spellbinding.

Considering the short time frame that the degree was devised in it’s a breathtaking feat.

This will be even better for cohort 2, in fact I’m even jealous of future cohorts, as they will be experiencing an even better course. 

It’s vital you consider when you are going to take annual leave, some forward planning is needed to be sure the deadlines for the work are in your mind, so you can complete what is required and have time to relax and recharge. 

Keep your sense of humour! Yes, there are fundamental academic expectations; this is a postgraduate degree from some big hitting and respected institutions of higher learning. But, there is a time and a place for some light hearted moments, I wont put any spoilers in here, but there will be some times of pure hilarity I assure you! 

So, to rap this up I would say:

  • be organised
  • engage immediately with you peers
  • make dedicated time
  • ensure you have time for yourself
  • download as much as you can to read when you can (I also have to admit to watching the majority of the videos at twice speed whilst reading the transcripts)
  • do not skip the optional material
  • and always have in the back of your mind some relevance to your situation when composing assignments.

Finally it’s worth re-iterating that the DA is a co-designed course between the faculty and the members, you really feel part of a digital entrepreneur family. I will miss it once I’m done. I have never said that about any other post grad learning in my entire career. Enjoy it, you will miss it once it’s happened… I already am.

@JCLiaCRH

Who owns my health data?

In 2008 I was diagnosed with Polycystic Kidney disease and as a renal patient was offered access to PatientView which gave me visibility of my blood results on that same day as I have the blood test.

PatientView welcome screen

PatientView is a great system and gives me more control of my health and almost realtime access to key results information. If everyone who wanted it could have it I think it would make a real difference. If I see something that looks odd I can escalate to my consultant and get a rapid response. I use the data to plot my kidney function and accurately predicted future deterioration ahead of kidney failure.

Kidney function graph

I’ve always taken an avid interest in my health. Recently I had an ultrasound of my transplanted kidney to check all was well – I was surprised at the refusal to allow me to take a picture of the screen and the reluctance to even let me see the image on the screen. It made me think there is still a long journey to reach real engagement and patient owned records.

I was sad that the staff probably felt they were helping and protecting me by refusing my request to see my data. For someone very keen to ‘own’ their condition I felt excluded from my care.

My kidney is completely normal – but the experience made me wonder who owns my data? Me or the NHS? Was it right or wrong of the clinical team to refuse my requests to see the scan? And isn’t the image of my kidney mine anyway – or does it belong the the NHS as they funded gathering it?

In my study on the NHS Digital Academy I’ve reviewed other health systems including the innovative Estonian eHealth model where all citizens own and control access to their health data online.

I think health and care in the UK is on a journey towards more accessible records but we’ve still got a long way to go – and perhaps the culture in the NHS needs time to adjust and develop to reach acceptance that giving more ownership and responsibility to those who request it is a good thing.

I recognise the arguments for NHS control of investigative treatment data in case there is sensitive information that needs to be carefully shared with the patient. But I also believe there are benefits for one’s own health that comes about through transparency, ease of access access and visibility of my own data.

I look forward to a time when our health records are available via the internet on secure patient portals and perhaps the new NHSApp is the beginning of that future.

NHS App Screenshots

For now I’ll get on with a subject access request to get a copy of the ultrasound images of MY kidney – which no doubt will cost more to provide compared to having just let me see the images at the time of the scan.

What are your views of personal health records?
Should the NHS offer greater visibility to patients or not?

@robblagden

Rob Blagden works for 2gether NHS Foundation Trust in Gloucestershire as Deputy Director of IT, he is also the Trust’s Lead Governor. Rob was recently elected to sit on the first Alumni Committee for the Digital Academy.

Professionalisation of NHS Informatics

At our final NHS Digital Academy residential this week we talked about what’s next and can we maintain momentum of what’s begun this year. 


In a video from Robert Wachter we listened as he talked about the work still to do to move from the digitisation of clinical data to real transformation. He says we still needed to ‘reimagine the work’ to take full advantage of digital tools and that  graduates of the @NHSDigAcademy and other informatics leaders needed to pick up this complex challenge. 

So how do we define informatics leaders in the NHS and what are the accreditation routes?

As of today there are two routes to accreditation:

Faculty of Clinical Informatics (FCI)  

From the website https://www.facultyofclinicalinformatics.org.uk

THE FACULTY OF CLINICAL INFORMATICS HAS BEEN ESTABLISHED AS THE MULTI-PROFESSIONAL MEMBERSHIP BODY FOR ALL HEALTH AND SOCIAL CARE QUALIFIED INDIVIDUALS WORKING AS INFORMATICIANS ACROSS THE UK.

Since the initial formation of a Steering Group in 2015, the Faculty has made significant progress and in only three years has moved through Shadow Board status and elected its first Council and Officers. At present, the Faculty is formed of over 150 Founding Fellows and Fellows, and is set to welcome further Associates, Members and Fellows into the organisation, in early 2019, following a recent successful member recruitment round.

During 2019, the Faculty of Clinical Informatics intends to continue establishing clinical informatics as a fully recognised and respected profession, in line with its Mission, Vision, Values and Objectives. This is will be achieved by fulfilling a number of key objectives, including:

  • Developing and publishing professional standards.
  • Supporting revalidation processes.
  • Providing professional accreditation for individuals and training courses.
  • Supporting clinical informaticians at every stage of their career.
  • Continuing to promote the profession.
  • Providing professional leadership.
  • Supporting recruitment and careers in clinical informatics.

The Faculty of Clinical Informatics has been, and continues to be, shaped by its unique, multi-professional membership cohort who bring a wealth of combined knowledge and experience.

Federation for Informatics Professionals (FEDIP)

From the website https://www.bcs.org/membership/get-registered/federation-for-informatics-professionals-fedip/

The Federation for Informatics Professionals (FEDIP) in health and social care brings individuals and organisations together to unlock potential in the informatics community.

You’re ready to apply for FEDIP if you:

  • work in a professional informatics role using data and technology to support health and care delivery
  • perform a range of activities including complex and non-routine tasks
  • understand how your role impacts upon patient care
  • demonstrate quality and integrity in your work
  • You need to be a member of a professional body licenced to award FEDIP:
    • BCS, The Chartered Institute for IT
    • Institute of Health Records and Information Management (IHRIM)
    • Chartered Institute of Librarians and Information Professionals (CILIP)
    • Association of Professional Healthcare Analysts (APHA)

The Problem

Don’t we need a single route or a single accreditation? Retaining two separate bodies generates silos and different standards each risking the dilution of the other. Not to mention confusing the whole concept of accreditation.

Which is better of the two above?
It depends if you’re a clinically trained or technically trained because each will only take one or the other – not both.
Should this really be the case in a modern digital society?
Don’t clinicians and doctors and analysts and technical people each add equally as much value in the arena of digital transformation?

But the FCI and FEDIP have worked hard to build reputation and standards so it doesn’t make sense to throw the baby out with the bathwater. 

Could there be a third way?

I wonder if a standard accreditation called something like ‘Accredited Digital Specialist’ could be awarded to anyone (clinical or non clinical) with the requisite qualifications or other significant experience. 

Perhaps the two current organisations could be the approved routes to this accreditation with FCI accrediting clinical staff and FEDIP accrediting non clinicians.
We need a set of agreed standards across both organisations and a single logo / set of initials to indicate we are accredited.

I think we could benefit from some support and input from our National CCIO (Simon Eccles) and CIO (Will Smart) to help us reach this point. Or perhaps our Secretary of State Matt Hancock could provide some useful direction.

I believe we need our digital future to be coordinated and well led via a single recognised accreditation whatever your background, skillset or route into informatics and this will really help us all. 

Comments or ideas anyone?

@robblagden

Rob Blagden works for 2gether NHS Foundation Trust in Gloucestershire as Deputy Director of IT, he is also the Trust’s Lead Governor.

Rob was recently elected to sit on the first Alumni Committee for the Digital Academy.

Can small improvements really make a difference?

For my Digital Academy project I decided to make small changes to our IT support processes to improve the service received by our busy clinical and medical colleagues. Could small improvements lead to significant benefits?

“There is evidence that small scale quality improvement can lead to significant benefits. At a time of high demand and financial pressure the NHS should equip staff to discover these low cost high impact opportunities.”
(The Kings Fund, 2017)

In the NHS big changes are high risk and can take time to gain approval and acceptance – I believe small changes are an effective way to make transformation happen more quickly and simply.

User experience should guide culture change (Gartner, 2015) and I wanted to try and understand the impact on user experience to help focus our improvement efforts.

I believed the benefits of improved IT support would be:

  • happier colleagues with less stress caused by IT problems
  • better support services who listen and show empathy to users
  • empowered colleagues able to use IT more efficiently to achieve better patient outcomes

42% of users were unhappy with the responsiveness of IT
Only 50% of calls were answered in under 30 seconds
Over 20% of calls were never answered.
Average resolution for issues not solved at the time of the call was 10 days.

Capacity
After spending time on the IT Helpdesk I quickly realised the service didn’t have sufficient capacity to meet demand. I believe that good IT services should be sufficiently resourced to provide the responsive service needed by users. The best IT services have low call volumes because they deliver systems which are relevant and reliable – designed with the user in mind.

Generification
A shared service approach requires the support of multiple customer organisations with many systems and differing priorities. This has the potential to dilute quality because it is unlikely that one member of the team has extensive knowledge of all user contexts and priorities. This reduces empathy and understanding and requires excellent knowledge management to mitigate.

Complexity
The NHS uses many solutions in the delivery of care which itself is often complex and uncertain. The plethora of systems and services requiring support in our NHS is huge and extends to hundreds of different products.

Supportability
Legacy systems are a big issue with some essential systems running on unsupported platforms. The old systems make support, maintenance and system updates a significant challenge.

Funding
If digital transformation is to make the difference it promises, investment in technology programmes will need to increase. National initiatives often offer capital but with more services becoming pay as you go there is a need to ring fence more revenue for digital services.

People
A whole lot of people depend on technology in their day to day role. It’s these ‘users’ of systems who should be at the forefront of influencing the future digital solutions. Shadowing and understanding what makes life better (or worse) is something all IT professionals should prioritise.

Peer Group
In our Peer Group we had many discussions. The support from my Peers was a real help – it was useful to gain insights from others experience. Growing our digital communities to provide support and share best practice is essential.

Small Changes
After thinking through the challenges with my team we made a number of changes to try and reduce the need to call for IT Support. These included:

  • Floor walking to provide face to face support
  • Spending more time with system users
  • Automation of frequent tasks
  • Self service solutions to empower users
  • Analysing service performance
  • Focusing of top 10 support calls and developing workarounds
  • Looking at the ‘real impact’ on clinical services
  • Influencing change in service provision using the data

Outcomes
Whilst the outcomes have made a difference there is still much to do. The Digital Academy learning has taken me on a journey that has changed my approach in many ways and provided tools to support me in delivering change that really works.

Often in IT we tend to just focus on solving the problem rather than understanding the user context and whether our solution is really the right one.

Seeking to properly understand all perspectives and how they were formed can make a real difference to how we see a situation and how we respond to it.

Using this understanding and empathy in change programmes, and making co design a reality, will be key in future projects because I know it will improve engagement and outcomes. 

Can one small change transform healthcare IT?

Yes 100%. Getting IT staff closer to the operational business was a great decision and I know my users think so too.

At home we all use IT and utilise software and services with minimal need for support – this is the future the NHS needs to aim for.

We need systems that are
Simple, Inclusive & Responsive

Our clinical colleagues who deliver frontline services really are remarkable. It’s about time IT better supported our doctors and nurses.
It’s about time IT was remarkable too.

So, I’ll keep finding changes that make life better and I hope to look back in five years and see those small changes really have transformed healthcare IT.

Incremental small changes will add up to a big difference if we keep making them happen each week.

What will your next small change be?

My Digital Academy Journey

Residential 3

Whenever people ask me about the Digital Academy, I always respond by telling them it is the best learning I’ve ever done because it offers input from world class experts on the latest trends in our industry combined with relevant history and evidence which is all closely aligned with my real-world job of implementing digital transformation within the NHS. 

Systems and technology are essential tools to support the NHS to become the organisation of the future that citizens need.  The Digital Academy is equipping me with understanding, tools and skills to enable me to be play a key part in that. The course has been mentally challenging and made me focus on my own personal development. I’ve read more books in the last 10 months that in the previous 10 years but all that hard work has added value to who I am and I how I operate.

The Digital Academy has challenged my approach towards delivery of new systems and I am becoming a facilitator of transformation rather than someone who sees implementation as my final goal. People are 90% of the key to successful change and finding new ways to engage our staff, patients, service users and carers will be critical to our success; the current module is radically developing my thinking around human centred design. Previous modules have refined my understanding of the complexity, challenge and economics that influence health and care, encouraged new ways of delivering programmes of change and provided a wealth of tools to help analyse and present information.

My efforts during the first year of the Digital Academy will reward me with a post graduate diploma and from April 2019 I will be progressing to the final year to complete the full MSc in Digital Healthcare Leadership. This wasn’t a tough decision…

Residential 2

So why the MSc? 

Right time– Today more than ever the NHS is on a vast programme to utilise digital systems to transform health and care. Almost all other industries have been disrupted by technology and have improved the experience and outcomes for users whilst also generating new efficiencies and scale. Just looking at what Netflix has done for film or Spotify for music – these examples demonstrate that (whilst these disruptors have left casualties along the way who didn’t transform) the outcome for end users has been better access to film and music and improved exposure for artists and small studios. The high street needs to find its own revolution in the wake of Amazon and ecommerce and in the future the car industry will look totally different to the norm of today. We need to similarly disrupt our NHS, to involve patients in their care more transparently and we need to improve outcomes and access.

Health and care has embraced technology over the years but hasn’t kept pace with the rate of change in the rest of the world – it’s time for that to change. Hancock’s vision for NHS was clear in his policy paper The future of healthcare and the NHS Longterm Plan released in January 2019 also places digital transformation at its heart. The MSc will give me the opportunity to take on a significant project to help bring about digital change in my part of the NHS and it will support me in analysis and research and I hope findings which influence systemwide change and transformation.

Right course– The Digital Academy is a fantastic organisation which has been setup incredibly quickly in response to the Wachter report and it places the UK front and centre on an international stage regarding health and care learning and development. The Digital Academy is run by people who understand the transformation agenda in the NHS, who listen and react to changing needs and who can relate course material to the reality of my NHS world. I don’t think there are many MSc courses available which are so closely tied to the NHS technology agenda and this makes the DA MSc a unique learning opportunity which is relevant and engaging for my industry. It’s also the best value for money MSc that exists and I’ve asked around so I know this to be true.

Follows on from the diploma– I’m in a learning phase of life and really enjoying it. I hope I can continue to be a lifelong learner but whilst in this intense phase of development I want to complete my study and achieve the MSc qualification. I could come back to this in a year or two but there is a high likelihood life will fill the space I found for the Digital Academy and I won’t come back to complete the course. So, I want to finish what I’ve started now.

Peer Group 7

I feel privileged to have been given the opportunity to participate in the first cohort of the Digital Academy and want to continue this journey with my new-found peers and I want to help shape the future of NHS digital transformation. I want to use my MSc project to create new best practice, to share it widely and practically demonstrate the purpose of the NHS technical vision is to deliver improved care for our citizens – and that includes me.

@robblagden

Rob Blagden works for 2gether NHS Foundation Trust in Gloucestershire as Deputy Director of IT, he is also the Trust’s Lead Governor. Rob was recently elected to sit on the first Alumni Committee for the Digital Academy.

Imperial War evening