Shit happens, deal with it.

I'm not a doctor. I'm not a nurse. I'm not a politician. I'm simply a curious individual. When I attend healthcare innovation events, I admit I'm not the smartest person in the room but I am one of the most curious at these events. I'm compelled to mention that the more I learn about the NHS, the more admiration and respect I have for the hard working men and women on the frontline, often working with limited resources and under extreme pressure. 

Paper, X-Rays and a nurse's first day at work

I'm curious about why I had to carry a piece of paper to the X-Ray department when I visited Accident & Emergency (ER room) in a London hospital last year. The triage nurse who saw me, decided an X-Ray of my elbow was required. A piece of paper was printed out, handed to me, and I walked down the hall, handed it into X-Ray, got my X-Ray done, and then walked back down the hall. I then had to knock on the door of the Minor Injuries Unit and 'verbally' let them know my X-Ray had been completed, and then wait outside to be called in. 

So, I patiently waited for hours after my X-Ray had been completed. The same triage nurse walked past and asked me, 'Have you still not been seen?'. Off she went to check, and then within a few minutes, I was called into the Minor Injuries Unit. When I asked the guy looking after me, why it took so long, I was taken aback by the response. My notes were in one tray, and were supposed to be moved to another tray by a nurse once I had 'verbally' let them know my X-Ray was done. The nurse hadn't moved my notes to the other tray. It was her first day, and she wasn't fully up to speed with procedures, I was told. A shrug of his shoulders, and a look on his face that said, 'Shit happens, deal with it'. Maybe we should have 'Open Data' that lets us know on what dates, there are new starters in the hospital? Someone can develop an app using that data that informs us exactly when to avoid the hospital. 

I understand that the NHS is looking to go paperless by 2018, that's still 5 years away. I'm curious why as a consumer, it was so easy for me to have a paperless office, and it was simply a case of buying a Doxie Go, an Eyefi SD card, a LiveScribe Sky pen, and an Evernote account. All bought on Amazon.  

Data driven decisions - Easy for supermarkets, difficult for hospitals?

I'm curious why the NHS isn't using predictive analytics to understand exactly who is most at risk of diabetes, heart disease etc and sending out a personalised series of messages? I worked at DunnHumby (who came up with the idea of the Tesco Clubcard to collect data on shopping habits) in 1997, looking after the data for 8 million customers of Tesco. Even all those years ago, they were able to profile the customers, segment them, and personalise offers for each customer segment. The level of insights from the data means that Tesco now can predict a couple divorcing, 6 months before it actually takes place. Target in the USA can predict when one of their customers is pregnant, all based upon their data. Maybe the NHS could do the same to reduce the rate of teenage pregnancies? [Note: UK has highest teenage pregnancy rates in Western Europe] Let's foster a culture in the NHS of using data to drive decision making and to learn how to optimise the communication strategy to target those people most at risk. 

NHS engaging with startups

Last week I was kindly invited to give a 5 minute talk at the NHS Entrepreneur's Day in London, hosted by Tim Kelsey and Beverly Bryant. We heard from Tim, Beverly and others on their plans for making it easier to do business with the NHS. My talk was about the Health 2.0 London Chapter I started last year, as well as the Health 2.0 Europe conference taking place in London, and what both the Chapter and the Conference can offer to entrepreneurs and SMEs wishing to innovate in the NHS. [Note: If you would like to register for the Health 2.0 Europe conference, you can get a 15% discount off the advertised prices by using promo code of MJ2013. The Chapter is free to join though, and the monthly events are free to attend]

I was seriously impressed that the NHS wishes to make it easier for innovators to engage with them. I'm glad they are building bridges with the innovators. Let's hope those bridges allow two way traffic, have multiple lanes and no speed limits. The event also educated me on the challenges, Tim, Beverly and others face everyday on the inside as they do their best to bring the NHS into the 21st century. I can empathise, having worked in a team looking at transforming Leadership Culture for 11,000 scientists around the world, when I was at GSK. Change within large, complex organisations that are heavily regulated does take time, at least 3 years, and sometimes an entire generation. However, one thing we don't have right now is the luxury of time. Every day that we sit and discuss how to spread innovation within the NHS, patients continue to be at risk. 

Ideas for engaging with startups

Moving forwards, I have 3 ideas for how the NHS could build upon their existing plans to engage with entrepreneurs and startups. 

  • Reverse hackathons! I'm not impressed by the majority of hackathons I have attended in healthcare. I recently came across a company in the States, called Prebacked. They ran an interesting event in May 2013, where the a US health insurer shared their problems and how much they were willing to pay for technology that solved those problems, and then the hackathon began. 

  • Getting more innovators from the private sector inside the NHS. I've been reading about the Presidential Innovation Fellows program that they have started in America. Perhaps NHS Innovation Fellows? I know some very talented people in the UK who could make a real impact on the inside. 

The vision for the NHS in 2078 - where is it? 

The NHS had just celebrated it's 65th birthday. I'm curious how the NHS will look in 65 years time, in the year 2078. I would be 105 years old at that point, if still alive. Whilst I appreciate that there are short term challenges to meet (and lots of initiatives underway already), we also need courageous leaders with a strong vision, who acknowledge that the decisions we make today will have an impact on generations to come. The proposal to create a National Health Service by Aneurin Bevan back in the 1940s was 'radical' at the time, and initially opposed by the BMA. I'm curious what type of health service we want our children and grand children to inherit.

What happens after 2018? 

I believe we are too focused on short term goals in healthcare, be it in the UK or abroad. Be it a politician thinking in 4 year electoral terms, a CEO thinking of their 3 year stock options, or a VC backed startup with their 3 year exit strategy. Not all of our problems in healthcare can be solved in just 3-5 years, and Digital Health, despite it's potential, will alone not be the panacea. Furthermore, 'Innovation' shouldn't just be this year's favourite buzzword to add spice to white papers. Solving problems in healthcare shouldn't just be the remit of senior leaders and entrepreneurs, everyone should be able to participate. Only by putting our differences aside, having candid and authentic conversations with a focus on genuine collaboration, can we even stand a chance of meeting the immense challenges that lie ahead of us.

If this doesn't happen, I'm curious if we will have to get used to a culture of 'Shit happens, deal with it'. 

[Disclosure: I run Health 2.0 London as a volunteer, but I do have commercial ties to Health 2.0 in San Francisco. Apart from this, I have no commercial ties with any of the products/services mentioned in this post]