Healthcare and technology have cultural similarities, says NHSX CEO

Matthew Gould, CEO of NHS technology arm NHSX, says his new role highlights both the differences and the similarities between technology and healthcare.

Drawing parallels with his previous role as a diplomat, where the cultural differences between the UK and other nations were apparent, Gould told the Healthcare Excellence Through Technology (HETT) show in London: “The healthtech world is right at the intersection of two really interesting, but quite different, cultures.”

Gould said that while technology usually forces a “failing fast, pivot if your product isn’t right” culture, healthcare is all about being “risk adverse”.

But he stressed that these differences, although important, should not overshadow the similarities that can help to ensure digital adoption by the health service – a “sense of impatience” and the need to be evidence and data-led.

Shifting attitudes towards digital within healthcare could be eased if it is made clear that patient outcomes will improve, said Gould.

“One of the most important things we can do is make sure that the data and the evidence is marshalled,” he said. “Because if you want to shift medical opinion, if you want to get practice to change, the best way to do it is through data.

“Technology and healthcare are both intrinsically problem-solving cultures where getting stuff done on behalf of your patient is prized above everything else.”

Before taking up his role with NHSX, Gould visited several healthcare providers across the health service, including hospitals, GP surgeries and care homes, to get a feel of the issues these providers were having with technology.

His visits revealed some of the common problems with technology in the NHS, including siloed systems that cannot talk to each other, slow technology that delays practitioners and other staff, and in some cases an inability to access patient data that could be helpful to treatment.

Some of these problems can end up putting patients at risk, said Gould.

In some cases, patients themselves end up creating their own “interoperability” by bringing paper files to appointments from several different clinics or providers whose systems cannot interact. “That’s a crazy way of doing it,” said Gould.

He highlighted the fact that the NHS has not always been good at telling the tech world what it needs, or what its areas of contention are, or scaling and innovating what has already been implemented.

Gould also emphasised ensuring that the technology delivered to the NHS is something its staff and patients “need” – pointing out that the tech sector is well versed in technology being delivered that doesn’t match what was asked for.

“We’re about making sure that both staff and citizens have the technology they need,” he said. “And in all this, ‘need’ is the key word. Because technology that meets the user needs of the NHS and the care system isn’t necessarily always the technology that innovators come up with or want to sell us.”

Gould said some of these problems will be addressed in the five core delivery missions of NHSX:

• Reducing the burden on clinicians and staff, so they can focus on patients.
• Giving people the tools to access information and services directly.
• Ensuring clinical information can be accessed safely, wherever it is needed.
• Aiding the improvement of patient safety across the NHS.
• Improving NHS productivity with digital technology.

Gould reminded the HETT audience about NHSX’s role in bringing together all the previous work from bodies such as the Department of Health and Social Care, NHS England, NHS Improvement and NHS Digital.

He said: “That split of responsibility, I think, has had the effect in practice of taking a really, really difficult task and making it pretty much impossible. Because the brilliant committed people, my predecessors who were trying to get technology right for the NHS, were having to spend a huge amount of their time managing this institutional complexity, and not actually trying to make progress on the task where, in substance, there’s a huge amount of agreement about where we’re trying to get to.”

But Gould also reiterated previous statements that NHSX will not be an “enormous empire at the centre” of the NHS that builds and mandates technology adoption.

“What I don’t want is any sort of misapprehension that the innovation is going to come from the centre or that we are going to sit in the middle and decree all sorts of brilliant innovations and build them ourselves,” he said. “What I want to do is for the centre to set the standards and to create the platforms so that innovation can safely flourish to create an ecosystem in which the best, most useful ideas can be more rapidly adopted across the NHS and social care.”

Previous approaches to digital adoption across the NHS have been disparate – across NHS trusts there are still thousands of PCs running Windows XP, and NHS England’s target of a paperless NHS by 2020 seems doomed to fail.  

The current NHS model has even been called “non-viable” in the past, with Matthew Swindells, former national director of operations at NHS England, claiming that the healthcare system would be “condemning people to die” without a focus on digitisation.

NHSX helps with things such as creating a set of standards for technology adoption, including how systems can interact, and a focus on platforms where a single build for a system or back end can be adapted for each use case.