It is the “biggest hospital building programme in a generation,” the UK government claims. Unveiled in 2019, the Health Infrastructure Plan offers £3.7bn in funding for 40 new hospitals.
Digital technology will be intrinsic to these new hospitals, the Department of Health and Social Care said at the time. “NHS’ infrastructure is not just about ‘bricks and mortar’ – it is also about the digital technologies and data sharing capabilities that are needed to provide better care to the public,” the plan states.
Six new hospitals have so far been given the green light, and 21 Trusts have received seed funding to develop their business case. To win a slice of this funding, NHS Trusts must prove that their planned facilities will be ‘digital’, as well as sustainable and economically viable, says Professor David Brettle, chief scientific officer at the Leeds Teaching Hospitals NHS Trust.
But what does it mean for a hospital to be ‘digital’? And how can NHS Trusts overcome long-standing barriers to innovation to make ‘digital hospitals‘ a reality?
What is a digital hospital?
The term ‘digital hospital’ does not have a technical definition and is not used in an official capacity by the Department of Health and Social Care.
Nevertheless, creating a ‘digital hospital’ is an explicit aim of many NHS Trusts. These include Leeds Teaching Hospitals NHS Trust, which is building two new hospitals on the site of the now-demolished Leeds General Infirmary, as well as Bristol University Hospitals, Oxford University Hospitals, and University College London Hospitals NHS Trusts.
There is little consensus on what ‘digital hospital’ means, however. One expert told Tech Monitor the phrase describes a “hospital’s capabilities brought about by tech”. Another said it is simply the opposite of an “analogue hospital”.
For Dr Jamil Anakkar, manager at Accenture’s health strategy and consulting practice for the UK and Ireland, the term is best understood as a collection of digital services that can improve patient outcomes and streamline hospital operations.
This includes “the outcome-focused clinical ability of the hospital, enabled by tech, and the operational side of the hospital such as the supply chain and staffing – all the cogs that work in the background to make the hospital tick and how that can be improved”.
“If you put all that together under one umbrella then that’s what you’d be really considering a digital hospital,” Anakkar says.
Leeds Teaching Hospitals NHS Trust’s digital transformation
For Brettle, creating a digital hospital requires a “whole system transformation”.
The new Leeds hospitals will incorporate location tracking to help doctors and nurses find equipment when they need it, he explains. “A third of nurses spend an hour or more per shift looking for equipment, which equates to 2.5% of our nursing capacity”.
By combining wearable devices with predictive analytics, the Trust expects to be able to cut the length of patient stays by up to 25%. And by equipping patients with devices that allow them to manage their own experience at the hospital, staff will be able spend more of their time on care, Brettle says.
But the transformation is not just about using digital technology; the Trust is also transforming its approach to innovation. To do so, it is developing a healthcare-focused ‘Innovation Village’ in the vicinity of the new hospitals, which, it hopes, will house an ecosystem of private sector partners with whom the Trust will co-develop innovative new treatments and services.
“We see this as having retail, residential, start-ups, big companies, engagement with the hospital, but on a campus so that we have that adjacency to clinical staff and patients,” says Brettle.
The first step in realising this aim was the creation earlier this year of an Innovation Pop-up, a co-working space for entrepreneurs and established companies, allowing them to work in close proximity to clinical staff.
What is holding ‘digital hospitals’ back?
This radical new approach to innovation will help the Trust overcome an enduring barrier to digital transformation, Brettle hopes. “We’re not renowned for our agility with respect to health, technology and innovation,” he says. “Our research is a well-oiled machine in the hospital, but within innovation, which is the adoption of these technologies into everyday use, we’re not so great.”
Cultural resistance to new technology is widespread in the NHS, says Anakkar. Hospitals will “change something that the department – doctors and nurses – has done as paper-based for 20 years,” he explains. “They then ask them to use an iPad or an electronic patient record (EPR) form and it’s not something they want to do.”
Legacy technology has also held ‘digital hospitals’ back, he adds. The technology that clinicians have to use in A&E or their GP practice is often “clunky, old and slow,” says Anakkar. “It doesn’t do what you need it to do”.
But the greatest barrier that NHS executives face in driving digital transformation, he says, is procurement. “The biggest issue holding them back is NHS procurement and the way the NHS buys services – it’s so restrictive.”
He is not alone in this view. “Too often procurement departments … look to innovations to produce short-term cash-releasing savings, rather than identifying where innovations can transform care pathways and lead to more efficient services,” a report by the Nuffield Trust found in 2017.
Integration with regional development
It may be easier for NHS Trusts to build truly ‘digital hospitals’ when their transformation is part of a broader project. The rejuvenation of Leeds General Infirmary, for example, is part of a regional push, dubbed Leeds Innovation Arc, that seeks to establish innovation neighbourhoods around the city’s major universities.
This is part of a broader strategy, named Inclusive Growth Leeds, which aims to bolster the local economy by establishing Leeds as a ‘test-bed’ for innovation. Health tech is a particular focus of this strategy, Brettle says, and the city is already home to NHS Digital and NHS England.
“All of this is underpinned by a belief that we can do something to better the region,” explains Brettle.
While not every region will be able to undergo this same transformation, the example of Leeds suggests that ‘digital hospitals’ may be more viable if they tap into their regional development strategies.
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