Clinician of the Month: Dr Harpreet Sood

Harpreet Sood: Digital tech is a great enabler for the NHS – but cultural change is the real challenge.

Dr Harpreet Sood, Senior Fellow to the Chief Executive of NHS England and front-line clinician is DigitalHealth.London’s clinician of the month this June.

Prior to his current position Harpreet worked in the US at Brigham and Women’s Hospital, where he also co-founded ‘MightyLungs’ a startup that used sensor and gamification to support children with asthma – encouraging children to take more responsibility for their condition.

In his current role, Harpreet is able to draw on a unique position working at the intersection of policy, clinical practice and technology to offer insight on the the real challenges and opportunities for change ahead as the digital revolution takes hold in healthcare. His ‘tripod’ role is an exemplar for the type of multi-dimensional expertise that the health & care system needs to focus on developing.

Here, Harpreet shares with us his perspective on driving change in health and care – and the importance of taking the long view and getting the workforce onside.

Care on the Front Line

Change is happening across the health system. So much has already been achieved but there is more to be done. We are living through an interesting time with transformation a key priority and a commitment of investment in digital health and informatics. Working with Professor Robert Wachter and colleagues on the Watcher Review has been a tremendous insight for Harpreet.

One of the things that has stood out has been the importance of clinically-led improvement, enabled by new technologies that is transforming the delivery of health and care. This is supported by technologies that are now available to manage populations at scale.

But momentum for innovation including digital health needs to come from all levels. This means investing in the workforce in upskilling them in informatics and digital health but also developing a cadre of leaders that are capable of large transformational change with the support of technology.  On this front, the CCIO Network promotes and supports the development of Chief Clinical Information Officers across the NHS. The network is open to all current and aspiring clinical information leaders. However from a workforce perspective, there is very limited development. Medical schools in partnership with key education bodies also need to take responsibility and include informatics and digital training as part of the curriculum. We had the same issue with getting quality improvement teaching in the curriculum a decade or so ago but now this features across most medical school curriculums.

From a national perspective, NHS England in conjunction with Health Education England has recently launched the  NHS Clinical Entrepreneur Programme – aimed at trainee doctors who have an idea for a commercial, social or charitable enterprise. The programme has been designed to support doctors who are keen to continue in clinical practice whilst developing their entrepreneurial ideas into reality – we need more programmes like this and promote flexible training.

The key thing from Harpreet’s perspective is that even though technology is a powerful enabler, on its own it cannot be seen as a magic bullet that solves all of healthcare’s problems. Deployments of innovative technology and digital health are rarely straightforward, and need to be given time – it is a transformational journey. This phenomenon is not restricted to the NHS – the complexity of technological change, or the ‘Productivity Paradox’ – is well known in other sectors. When organisations implement new technology, the resulting disruption means the changes are often quite unpopular and can take a number of years for their full potential to be achieved – hence the paradox.  But digitising effectively is not simply about the technology, it is mostly about the people.

That’s why staff training and upskilling is so important and the hearts and minds of a workforce need to be brought on-board. The workforce need to understand the importance of what they are doing and why the transformational journey is important.

The Population

As with upskilling a workforce, a health system will also benefit from a population that is tech-savvy too. The enormous potential for technology to make a difference and empower the lives of patients and public in general is lost if the wider population of patients and care-givers cannot access it. In general we are seeing a technology inequality gap. Despite the fact that two thirds of the UK adult population now own a smartphone, the ‘UK Report on Basic Digital Skills’ (2015) reported that 23% of the population still lack basic digital skills – a potentially significant problem for an inclusive health service that is placing ever greater emphasis on digital interactions.

Far from being bystanders, Harpreet sees the NHS as having an important role in this agenda. The NHS has been working with partners such as Dot Everyone and the Tinder Foundation, to make a positive impact on the level of basic digital literacy across the population.

The NHS Widening Digital Participation Programme for example was started in 2013, reaching over 235,465 people in the first two years of operation, and has now trained 140,892 people to improve their digital health literacy and to use transactional services online, such as booking appointments and ordering repeat prescriptions. The scheme works with the hardest to reach communities giving them the skills and confidence they need to access online health information, with notable successes amongst homeless, older and vulnerable people.

Summary

Harpreet has used his experience of being a clinician and technologist to drive forward certain NHS policies with colleagues that will help patients and the public to get the best care but also create a workforce that is trained in informatics and digital health.