How are more digitally advanced health systems looking to close the gap between the ‘haves’ and ‘have nots’ for care providers in their networks? eolas asks Cerner’s VP of International Business Development Amanda Green, and Cerner Ireland Country Manager, David Clancy, for insights from their international client base.
What have you seen as the major shifts health systems strategy as they look to procure enablers such as electronic patient records and health information exchange products?
We’ve seen it all in the past 15 years, from building out small departmental electronic patient records or solutions, to national programmes looking to digitise entire countries. More recently though it’s been the somewhere in between, with a shift towards procurements across health networks.
And why is that?
Transforming healthcare isn’t easy and clients have learned what works well, and how to leverage that. It’s perhaps a generalisation but having too small an ambition can lead to poor value, or short-term throwaway investments, while going too large can lead to no return at all. Instead, health systems are increasingly looking to build on their successes to date.
How does this manifest in real terms?
Take the UK for example. When hospital groups in the NHS seek funding for digital programmes, they are strongly encouraged to learn and borrow from success stories in their region, especially where they are sharing patient care and clinicians. They place a greater emphasis on what’s worked well and who has delivered it. The hospitals that have delivered the success, and the teams that have become the experts, become one of the first ports of call when new sites look for investment.
Not everyone likes learning from their neighbours, though.
This is less and less tolerated. Funding bodies will pointedly ask hospitals or other applicants if they have visited local success stories, and if not, why not. For Cerner’s part, if a prospective new client shows reluctance to engage with the successes on their doorstep, then it’s not a good sign that we are the right partners.
That’s not surprising given that the major success stories we read about improving health outcomes and reducing costs have collaboration as a key theme.
Exactly. Funding bodies are increasingly asking not just how you are going to improve outcomes for your own site, but for the community that you serve. As a result, we’re seeing a shift from single site procurements, to ‘hub and spoke’ models, with regional healthcare providers with existing relationships coming together to improve healthcare delivery and investing in line with that model. It’s working too. For example, in northern England, the Great Northern Care Record programme brought together several acute hospitals, over 400 GP practices, and 200 community care providers to connect existing venues of care and collect and share relevant care information for a patient population of 3.6 million people.
For hospitals that do not have a modern digital infrastructure, funding bodies are encouraging them to piggy-back on what has been delivered in their region. For example, in the NHS, Imperial College Trust in London joined forces with Chelsea and Westminster to share an instance of Cerner’s EHR, with both London North West University Trust and the Hillingdon Hospitals Trust additionally joining in 2021. The four organisations serve 2.4 million people and can now provide seamless care for patients and for caregivers as they move between facilities in the region.
Does this mean companies like Cerner have to offer different solutions?
Yes, it’s an enhanced product mix, with our own products and integrating with what is already there. You have the traditional clinical EPR infrastructure, but on top of that place a greater emphasis on sharing information outside of the hospital campus. Clients want to spend less time on the acute hospital EPR so they take what’s already proven in their region. This gives them more time to focus on the patient journey and involving other care venues in their project, like GPs and other community care for example.
And patients, of course. It’s been exciting locally to recently start conversations with clients on where and how to incorporate the patient feedback into their care, regardless of where they are. This was far further down the agenda only a couple of years ago even though the technology existed. We can move forward with these digitally mature clients at pace as they have the EPR fundamentals sorted, and don’t want to start from scratch again.
What does this mean for Ireland do you think?
The appetite and need for digital-enabled change are there, and It’s positive to see the HSE conducting market soundings for certain related products and services, for example the community electronic patient record programmes and shared care record programmes. These must succeed, and to Amanda’s earlier points, perhaps a regional or group approach would be the most efficient and effective approach to these programmes.
Yes, especially if you have a strong ‘anchor’ in the region with experience of digital deployment, which allows other paper-heavy healthcare providers level up far more quicky than if starting from a blank sheet.
Almost anything is better than paper!