The Hampshire and IOW Digital Transformation programme is a key enabling workstream of the STP. As part of discussions at the programme board, we recognised the need to ensure that useful digital health innovations were identified and shared across the geography while also ensuring that innovations which are adopted fit with the overall digital transformation strategy rather than the piecemeal adoption that has happened in the past.
We had already established a Clinical Digital Information Exchange (CDIE) group which brought together clinical information leads (CCIOs and GP IT leads) from all of the partner organisations across the STP with their CIO counterparts, across both primary and secondary care.
We used this group to set up an Innovation Hub, comprising a mixture of primary and secondary care clinicians and information technology specialists, supported by the AHSN. This meets monthly to identify new innovations, assess them in terms of how clinically useful they are in practice, and shares a regular report with the information exchange group. Criteria for assessment of innovations vary depending on the innovation but each is assessed overall in terms of readiness to implement, cost of implementation and what the evidence basis is. A big challenge with setting up the hub was in making sure people are aware of it across the whole local health system, and then in widely sharing the outputs of the group. We addressed this by ensuring that stakeholders from across multiple different health organisations were involved in the group, so that they could bring back their point of view, and also share the outputs back to their organisation.
This approach worked well when the hub assessed e-consultation software. Some areas had already started to use this in GP practices and had shown some good results. We reviewed what they had done, and this led to a STP-wide implementation of a single system for e-consultation, meaning patients get a consistent approach and reducing the cost to the NHS. A challenge here was in ensuring that the group was able to answer questions about how the technology could be applied in different settings, or with different populations.
The innovation hub also tackled implementation of myCOPD. The challenge here was to ensure that we took advantage of national Innovation and Technology Tariff funding to implement a digital therapeutic. There was a surprising amount of resistance, and desire to ‘test out’ the system despite there being good evidence of its effectiveness. The innovation hub was able to share learning from local areas who implemented the system so that others could follow on quickly. People seem to trust local, independent evidence rather than that produced by the company selling the software.
We have shared the work the innovation hub is doing widely to ensure that anyone wanting to share new innovations can get them discussed and the innovation group now has a long list of things it has reviewed. The outcomes of these reviews have varied from identifying further work to be done before they can be adopted, through to developing implementation plans within the STP.
Our innovation hub seems to be working well for Hampshire and Isle of Wight, but we’re always keen to improve what we are doing, so what approaches have you taken in your area?
Dr Mark Kelsey