“Back in Summer 2017, I was about to become the national Programme Manager for Atrial Fibrillation (AF) on behalf of the AHSN Network. I was responsible for driving the spread and adoption of a digital innovation across the NHS. So how was I going to become a digital leader?” asks Faye Edwards, National Programme Manager for AF Stroke Prevention. Faye is an NHS Digital Pioneer Fellow.
I was about to take on a national project to understand “spread and adoption” of digital single lead ECG technology for the detection of AF in primary and community settings. The technology was well supported by senior leaders, including Simon Stevens, and there were national press reports all about it. But there had never been such a wide scale approach to encourage the uptake of this type of technology.
The technology is brilliant at detecting Atrial Fibrillation, it is more sensitive and specific for AF than a manual pulse check and the benefits to patients and the NHS are huge.
But… I quickly realised that for the technology to be adopted and sustained more widely I would need to:
- Provide reassurance to the frontline staff who would be using the technology,
- Consider the many ways it would fit into primary and community care settings and
- Develop recommendations on how to use this technology which ensured data governance.
I learned through being inquisitive, asking, doing, and finding like-minded souls to support me and the NHS Digital Pioneer Fellowship was exactly the lifeline that I needed at the time. For me, the biggest gain from the fellowship was the ability to make connections. It connected me with others working on digital projects, meaning I could learn from their experiences. I was also able to call upon the support of my fellow Pioneers when I needed it, and I could help the other Pioneers connect with people I knew who would be of benefit to their projects. The wealth of experience of each of the speakers at the learning days and the quality of the mentors proved vital in enhancing my ability to navigate the thorny and complex issues I was working through, including information governance or contract negotiation.
My project is still underway. I have learned valuable lessons relevant to all digital transformation projects. As we move forward turning the NHS Long Term Plan and its digital ambitions into reality these are a few of my thoughts from my experience:
Supporting infrastructure: Many of these digital single lead ECG devices cannot work in isolation and require supporting tech such as a mobile phone or tablet computer to download accompanying apps. Access to Wi-Fi is still an issue for many, especially in rural areas and developing this infrastructure requires additional resource. These issues are simple to address but often overlooked resulting in the technology becoming redundant.
Behaviour Change: The importance of managing anxiety and providing assurance to staff when introducing new technology should not be underestimated. Associated changes to workflow and personnel can create huge resistance and must be considered. Clear communication, expectation setting and listening to feedback is essential, especially for those who may feel anxious about their current role.
Raise Awareness: To embed new technology in everyday clinical practice staff need an awareness of it, training on its safe use and assurance on information governance regulation.
Consider the patient cohort: AF increases in prevalence in those over 65 and those who have other long-term cardiovascular conditions such as hypertension. It is important to consider a wide variety of settings in which to use these devices that are familiar to the patient cohort, with targeted use of the technology to maximise outcomes.
Embed the change: Pulse rhythm checks should be a part of every patient contact especially for those at risk of AF stroke.
Contextualise the benefit and provide feedback: Providing feedback to clinical staff on the number of potential strokes avoided, lives and money saved as a result of them using this technology has increased engagement and sustainability enormously.
I have gained a great deal of support and experience as a result of the NHS Digital Pioneers Programme, and it has enabled me to navigate my way through many challenges, arriving at a process for introducing digital AF detection technology which has been adopted across the AHSNs. I am thrilled to say that in 2019 I’ll be part of the NHS Digital Academy, and being part of the NHS Digital Pioneers Fellowship has helped me achieve this.