My visit to eHealth Week

I just thought I’d share my thoughts on the UK eHealth Week event that I attended. There seemed to be a good turn-out at the event and I got the opportunity to listen to some excellent speakers. They shared their views on digital health and how the NHS’ ‘Global Digital Exemplars’ (GDEs) are using new technology to create a positive digital experience for patients and improve healthcare outcomes.

In terms of some of key themes that were being addressed, I picked up on the following broad discussion areas:

  • Involve the patient in the solution design
  • Data security
  • Interoperability & sustainability
  • Collaboration with innovative SMEs
  • Skills & strong leadership

Involve the patient in the solution design

I listened to a number of talks in Theatre 2 which was the NHS Digital: Nursing stream and it was great to hear the likes of Deborah El-Sayed (Director of Digital & Multi Channel Development for NHS England) , Dr Victoria Betton (mHabitat) and Rafael Sorribas (NHS Digital) all mention that successful digital health assets all have one thing in common – they’ve been built with significant input from the HCPs and patients that are going to be using them. Victoria Betton provided some great examples of how digital tech was being used to improve communication between HCPs and young people, and signposted her audience to an Ofcom report titled: Children and parents: media use and attitudes report 2016

We also heard from the inspirational Molly Watts, who suffers from dual sensory impairment and she delivered a great presentation on how health tech and in particular smart hearing aid technology has improved the quality of her life.

Rafael Sorribas, gave a detailed account of how the NHS are trying to tackle ‘digital disruption’ and why it’s important to “integrate around the patient” when designing a digital health ecosystem. Along with Rachel Murphy they also spoke about the new NHS Choices; the Beta version of the new Health Apps Library and how the NHS are now looking at collecting more clinical evidence surrounding the performance of various health apps listed.

Cyber-security and data protection

As you can imagine there was a lot of debate around the challenges of securing patient and clinical data and whether or not ‘The Cloud’ was a safe place to be for the NHS. @CLARUSecure posted: The private nature of health data means #healthcare organisations find it hard to benefit from #cloud storage & processing resources #EHWK17

It was amusing to see that the Security & Counter Terror Expo was also taking place at Olympia on the same 2 days. In fact one guy tweeted: Last time I was at London Olympia it was old job – counter terror expo. This time #EHWK17 health digital. Common theme is #CyberSecurity!

With patient health data being worth ten times more than your credit card data on the black market it’s one area the NHS can’t afford to get wrong. Joost Bruggeman from Siilo even touched upon the dangers of using WhatsApp on the unplugged stage.

Interoperability & sustainability

Another topic that drew a lot of interest and generated much debate was around interoperability and building sustainable digital platforms. Once of the main IT challenges that the NHS faces is that many Trusts use legacy IT systems that have not been built using Open Source software. The absence of standards that mandate interoperability between digital health solutions and devices impedes innovation and economies of scale. This also prevents the NHS’ investments in technology from being well utilised and limits the scalability and sustainability of such solutions. It was great to hear one GDE talk about what ‘digital transformation and maturity’ looks like for them and how they are leading the way in using open source software and creating patient focused digital platforms like MyHealthLocker

Collaboration with innovative SMEs

Being a small business owner I was delighted to see a good number of small businesses showing off their health tech at the show and to also hear how some Trusts are making it easier for innovative micro businesses to do business with them. Kate Warriner (Healthy Liverpool Digital Lead) from the Liverpool CCG stated “we’ve actively engaged with local SME digital agencies to help implement our digital transformation plan”. She talked in detail about the digital assets they’ve had developed, such as their E Sepsis system and the audience particularly enjoyed the highly entertaining Healthy Liverpool Programme video.

Skills & strong leadership

As we know change doesn’t happen easily without strong leadership and a well delivered training programme to help up-skill staff and end-users.

It was great to hear Steven Roberts, Strategic Transformation Director and Vice Chair at Barclays UK close the show. As we know there are many similarities between the financial services and healthcare sectors, namely they are both highly regulated and they handle a lot of highly sensitive customer data. He spoke about how their Eagle Labs are an example of how technology can be used to benefit service users and how they are helping their customers and colleagues with the move to ‘digital’.

My closing thoughts

In recent years, health tech has evolved significantly. Without doubt users are increasingly relying on a multitude of health tech to help manage physical and mental conditions, prevent disease and share information with doctors and consultants. There is still a long way to go for the NHS and there are some complex challenges that still lie ahead in respect of security, interoperability and measuring health app quality but I came away from the event feeling more confident. I saw tangible evidence that real progress was being made by the NHS in adopting health tech especially by the GDEs and hopefully they’ll be able to create a digital roadmap for other Trusts to follow. And for a small digital healthcare agency like us, it was great to hear how the NHS is engaging with the SME community and making the procurement process more small business friendly. This is a real positive for small specialist agencies like ourselves as it gives us the confidence to keep on investing in digital health R&D and training – because we can clearly see that there is real commercial demand for our skills, services and products from healthcare organisations like the NHS who want expert help with their digital transformation.

Thanks for reading, @DamonL

BTW – Why not download our latest white paperHow mHealth is improving health & social care

Connecting your medical app or website to the NHS : The N3 Network

N3 logo

Many ideas for medical pp development and healthcare web design projects we deal with are based around some interaction with the NHS but integrating with NHS services and facilities isn’t always straight forward. One of the barriers to entry is the NHS N3 network. N3 is the broadband network for the NHS which connects all NHS locations and over a million employees. It connects hospitals, GP surgeries, pharmacies and many other service providers to securely facilitate sharing of healthcare data including sensitive patient records.

If your app, website or service needs to interact with NHS data then you may well need to be connected to the N3 network. As specialist providers of health related apps and websites, Genetic Digital’s customers often fall in to this category with web services we develop (which are often the backend of an app) requiring access. However, just to muddy the waters somewhat, N3 connectivity isn’t always mandatory (which can be true for non Patient Identifiable Data only); some NHS trusts have a more relaxed approach than others depending on their internal IT policies and configuration.

So who needs an N3 connection? There are no hard and fast rules but, broadly speaking, if you want to exchange data with an NHS trust (or trusts), especially sensitive data such as patient records, then you’ll need to be on N3. Even if it’s not a requirement if you are offering an on-premise solution, it’s often a commercial advantage if you can offer it. Given two competing services, an NHS trust could well choose one that offers services via N3 over one that doesn’t.

One point worth noting is only traffic from England can flow over the N3 connection so you can’t manage the service from an Indian call centre for example or push or pull patient data from Scotland, Wales or any other country. Knowing where your data resides is vital in applying for your accreditation to connect to N3.

How do you go about connecting to the N3 network? It’s a multi-step process with the first being deciding who you will contact to request access. For this, there are two options, one is to deal with the HSCIC direct (the N3 service provider) and the other is to deal with an N3 commercial aggregator. Dealing direct the process tends to take longer and commercial aggregators are organisations who have been granted power by the HSCIC to vet, assess and grant end user access requests to N3. This latter route is often much quicker and enables you to work with experienced staff who can offer direct support to help complete the required documentation.

Once a request is made there are then two parts of a pre-assessment questionnaire that need completing:

  • The HIGCAP – an eight question form asking about the nature of the connection, name of the company making the request, contact details, ISO certification status etc.
  • You then need to get a sponsor to complete their portion of the form – a sponsor is a responsible individual within an NHS organisation who will vouch for your connection application, for example, a senior manager with knowledge of your project.

After the above two are completed they are assessed for pre-approval. Once pre-approved you move on to:

  • The LCA – Local Connection Architecture questionnaire – this is a comprehensive break down of why the N3 is required – what the connection is for, the type of data etc.

If using a commercial aggregator, a meeting or conference call is usually had to discuss the LCA and help complete it. Once completed to the satisfaction of the provider, N3 approval is granted and a connection is setup.

Once an N3 connection is setup, the end user (our client for example) is obliged to complete the IG Toolkit. This is a process similar to ISO27001 certification which ensures procedures and policies are in place to prevent misuse or negligence of the N3 connection and associated service. They have until the end of March to complete it, so, if access is granted on the 30th March they have 1 day to complete it, if access is granted on 1st April they have a full year. Yes, this is odd. Because of this, completion is not strictly enforced and can (and does) take longer to complete. However, ultimately it needs to be done annually.

What type of connection would I need? For our customers, the need is most often for hosting a server which can connect to N3. Commercial aggregators such as Redcentric own their own data centres with a direct connection to the N3 backbone.  Once approved, our clients can host their servers, either physical or virtual cloud based, in the data centre and their app or web visitor traffic flows in over the public internet and out over the N3. To ensure integrity of the N3 service, you are obliged to utilise a managed firewall that monitors and filters all traffic that crosses over the N3 boundary.

If your service is connected outside of a data centre, in a pharmacy for example, then, in addition to the N3 connection and firewall, you would need to purchase a broadband connection from the commercial aggregator at rates comparable to standard DSL providers.

What about the costs? There are no direct costs associated with obtaining an N3 connection but, like all network connections, there are ongoing costs for using it. There is a minimum 3 year contract and costs increase depending on the speed required. Connections are sold in increments of 1Mb/s which, despite sounding slow (a domestic high speed broadband connection is upwards of 50Mb/s), when dealing with low traffic levels and small packets of text data often used in apps, the basic 1Mb/s can sometimes suffice. Additionally, there are costs for the firewall, hosting in the data centre if necessary and costs for an external DSL connection if required. In all likelihood there would also be consultancy costs associated with completing the IG Toolkit.

In summary, there are commercial benefits to having an N3 connection available to your service and in many instances it will be a necessity. But it comes at a price, both financial and administrative so the decision to apply shouldn’t be taken lightly and should be based on your specific needs, requirements and business opportunities.

Thanks to Redcentric for their expert N3 knowledge that helped shape this article.

To find out more about how Genetic Digital’s expertise in developing healthcare and pharmaceutical websites and health apps could benefit your project contact us now.

Digital Strategy Workshop

digital-dna-test-smallAre you prepared for the digital healthcare revolution?

As digital and mobile technologies continue to evolve and grow in popularity, the healthcare and pharma sectors are having to quickly adapt in order to meet the demands of the modern day patient and healthcare professional. But in order to develop a sound strategy and allocate resources to digital projects senior management and marketers need to understand the effectiveness of their existing digital initiatives. To help them do this, Genetic Digital is offering a tailored Digital Strategy workshop, which we’re calling the Digital DNA Test. The session will involve a study of your organisation’s current digital presence (on its own and in relation to your competitors) across three key areas:

3-As1 – Assets

We will assess how well you’re taking advantage of digital and mobile assets like websites, apps and video (inline with compliance).

2 – Acquisition

We will assess how well you’re using digital channels like search engines & social media to acquire & retain customers.

3 – Analysis

We will assess how well you’re taking full advantage of analytics tools and if you’re capturing the right metrics to help measure and improve performance.

To help guide you down the right path, we will set up a simple traffic light decision filter that will aid in prioritising your findings.

  • Green – Continue your current course. Monitor and look for incremental improvement.
  • Yellow – Pause and assess. Adjust based on priorities and capacity.
  • Red – Stop and fill gaps. Change strategic/tactical direction based on objectives and budget.

To learn more:

European Commission to adopt a Green Paper on mobile Health

Today, a Green Paper on mobile health (mHealth) will be published by the European Commission. mHealth covers all medical and public health practice that is supported by mobile devices. This document will launch a community discussion process that will continue until 2 July 2014.

Covering all practice supported by mobile devices – including tablets, smartphones, and other wireless devices mHealth also includes wellbeing and lifestyle apps that connect to sensors and other medical devices. This is an important and emergent part of eHealth where Information as well as Communication Technology is used to improve services, processes and health products.

The Commission will be looking at several issues surrounding mHealth:

  • Data protection
  • Patient safety
  • Users trust
  • Input to the delivery of healthcare of the highest quality
  • The level at which this should be applied e.g. – national, regional, or EU wide.

As well as the Green Paper, European Commission direction will also be given through a Staff Working Document, to those involved in app development. This will analyse existing EU legal frameworks currently applicable that are applicable to wellbeing and to lifestyle apps.

There is no doubt that mHealth can help to tackle some of the challenges that our healthcare structure faces. And according to a report by PWC mHealth could potentially deliver €99 billion in care costs by 2017. It is a fast evolving field with the potential to improve healthcare quality and improve efficiency by offering support to professionals in healthcare and in the area of patient treatment. It will also facilitate continuity of care. Some estimates show that as much as 30% of time spent accessing or analysing information could be saved if medical professionals used mHelath-based technology. Remote monitoring facilities could help many more patients live independently supported by technological monitoring systems. Despite this potential, the uptake of mHealth, at present, remains restricted in EU countries and healthcare authorities may look for more confirming evidence before they are prepared to adopt mHealth more comprehensively.

Some criticisms have been:

  • Lack of observance and transparency might make users wary of placing their trust in these apps, which may impact on market development.
  • Insufficient knowledge among developers with regard to the legalities applicable to lifestyle and well-being apps.

It is hoped that the Staff Working Document being issued with the Green Paper, will raise awareness amongst app developers of the rules being imposed by the EU surrounding issues of data protection, and will assist them in determining whether the legislation is applicable to their app, or not. It will also issue consumer directives.
At Genetic Digital we have been in the vanguard of this new technology and we were asked, as trail blazers in this field to take part in an interview on the subject being covered by BBC News.

Some of the areas of concern have been:

  1. How mHealth can be aligned with national health care strategies
  2. Technology/Interoperability standards
  3. Data protection and security
  4. Regulation and compliance keeping pace with development
  5. Getting patients and HCP involved earlier during solutions
  6. Lack of evidence of economic or clinical benefit – (it is worth noting that before email became widespread Intel surveys showed that most people claimed not to want it.)

The era of mHealth has arrived.

Stage 1
At this first stage consumer friendly products link fitness to general wellbeing as seen with Jawbone/Fitbit.

Stage 2
Apps and mobile connected devices permeate the medical field (we have entered this stage)

Stage 3
Mobile, wearables & data-collection devices mesh together to provide the backbone for optimisation & customisation of preventative health, medical treatment & hospital processes.

This is new and exciting technology and the release of the Green Paper is a step to its validation. In years to come will we wonder, as we do now with email technology, how we ever managed without it?

View the Green Paper

If you’d like to respond to the paper visit the EU website where the paper is published

Obtaining funding for your digital health project

biomedical_catalyst_programmeWe often get approached by individuals who are often healthcare professionals or research students looking for expert help to turn their innovative digital healthcare business plan into a tangible and commercially viable product. However, many of them struggle to progress their business plans to the next level as they lack the capital required to invest in product development. Many small businesses and entrepreneurs will be painfully aware of high hard it can be to secure a loan from a bank or attract private funding from an investment firm or angel investor. So what other sources of funding are out there for healthcare innovators?

I recently attended a workshop called the Biomedical Catalyst Programme (BMC). The event which was organised by the Digital Health Special Interest Group in partnership with the Technology Strategy Board (TSB) gave attendees the opportunity to hear about the BMC funding programme and how it is relevant to innovators in key areas of Digital Health which clearly address unmet clinical need. The objectives of the workshop were to learn how the BMC programme works, explore the types of projects that could fit the programme’s investment criteria and understand some of the important considerations for exploiting products and services into the healthcare sector.

It was interesting to hear that at present only 4% of projects that receive funding are in digital health. I was astonished by how low this figure was, but felt reassured to hear that the TSB panel stated that they want to encourage more digital health investments. To learn more about the scheme visit: www.healthktn.org/digital-health

If you have an idea for a new digital healthcare product and need some expert digital development and marketing assistance to help you bring you product to market, then get in touch. You may also find our white papers and other resources such as our App Business Planner useful documents when producing your business plan.