Learning from other countries’ experiences in digitising healthcare
While it’s clear that there are fundamental differences between different regions across the globe grappling with the challenges of digitising their healthcare systems, cross-border collaboration can stimulate new approaches and help stakeholders learn from the failures and successes of others.
To facilitate sharing of information, the HIMSS Foundation, in partnership with the U.S. Department of Health and Human Services' Office of the Chief Technology Officer, launched earlier this year an exchange programme with NHS Digital, England’s national provider of information, data and IT systems for health and social care. It aimed to leverage data and help providers tailor services according to emerging demand, creating an opportunity to build meaningful and sustainable communities that could later expand to global partnerships.
At the end of August, the 10-day visit brought health informaticists, data scientists and data strategists from the U.S. to NHS Digital’s headquarters in Leeds to identify new ideas for health data science projects.
Earlier this month, Healthcare IT News spoke to Joe Gibson, director of epidemiology at the Marion County Public Health Department in Indianapolis, one of specialists involved in the programme, about the experience.
This interview has been edited for length and clarity.
Q: Tell us, first of all, what sparked your interest in the initiative?
A: I was very interested in going to the UK and seeing how they approach some of the issues that we face here [in the United States] too. I am generally interested in how people organise their information systems and how they organise their analysis teams. I was paying particular attention to that.
Q: What were some of the key observations that you made on site?
A: I saw that they tended to form analysis teams from people with different, fairly deep technical specialties, rather than using an approach where everyone in the team can do a lot of things. I was also struck by the amount of focus, resources and staff that they put toward understanding the customer well. I repeatedly saw a commitment by NHS analysts to understand the customer, understand what the customer needed, and to make sure that what NHS Digital produced was understood well and was being used effectively.
Q: Why do you think there is such a big focus on this?
A: It really seemed to be the organisational norm, and I think it’s a culture that can be embedded within our organisation here as well. It might be an intrinsic reflection of the NHS model compared to the US model to organising health information. NHS Digital is incentivised to provide what most patients and providers find most valuable, while incentives in the US system are less patient-centred.
Q: And is this something that you’d like to apply in your work as well?
A: Yes, for me, NHS Digital's focus on understanding the customer was the most directly applicable takeaway, I will be changing how I organise my own resources so that I have people who are spending more designated, dedicated time around getting feedback from customers and what we produce and have a bit more time with customers so that we make sure that we really understand what information they’re most interested in.
Q: How different was what you learned on site about the healthcare system from what you knew before about it?
A: It was very different. Beforehand, my idea was that England had this unified system, the national health service, and I thought that there’d be a master data system where data came together and they could analyse it and do amazing things. And I was struck that there is no single NHS. There is an NHS England, there is an NHS Digital, there are all these different components, but there was no unified organisation. There were all these different organisations that coordinate with each other. The other thing that really surprised me was the lack of access that NHS Digital had to individual level data within the system.
Q: And did you hear of any initiatives trying to tackle some of these issues?
A: Yes, they talked a lot about plans they are implementing to improve how they receive and organise individual level data. They talked about the regional health care record repositories, similar in a way to the Health Information Exchanges that we have in the US, with data pooled together, to improve the sharing of data between health and care providers, while also making room for the NHS to be more efficient. There were a couple of discussions about social determinants of health as well, and they talked about social prescribing. In the US, we are also trying to figure out social determinants of health, how to measure them and how to measure their impact, and I’m fairly sure this is going to be one of the areas where we are going to have lots of discussions and exchange of ideas over the next year and beyond if we keep this exchange going.
Healthcare IT News is a HIMSS Media publication.