S1: Ep 008: Supercharging the adoption of innovation across health and social care
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Paul Johnson:the Health Tech listeners. I'm your host this week, Paul Johnson. This is the podcast where we, tackle some of the trending topics, ideas, and best practice within health and social care. This week, we're speaking to Mark Fewster, head of product and innovation at Radar Healthcare. Mark started his career 18 years ago and has worked across the management product development, product management, business intelligence, amongst other things.
Mark Fewster:He's got awesome stuff.
Paul Johnson:He's got proven experience in delivering transformational business change across both startups and large PLCs, and has worked for Radar Healthcare for the past 4 years. Uh-huh. Feels like longer. Helping share our product as and bringing it into what it is today. Mac's focus is now on the future, bringing ideas from our partners and teams to life and looking at what innovation is to come in the industry.
Paul Johnson:Outside of work, Mark loves traveling, trekking, and nature, mostly bird watching. He also enjoys music, art, reading, and gaming, and spends his time at gigs across the country. Hi, Mark. Welcome to What the HealthTech. Thank you, Paul.
Paul Johnson:Okay. We'll get into a few questions. That's okay, Mark. So in March, we held a roundtable discussion
Paul Johnson:Mhmm.
Paul Johnson:All about, with so many ideas and emerging technologies in the NHS, how we support staff in adopting these exciting opportunities. We brought together key stakeholders involved the digitisation within the NHS to hear their experience of innovation, how it happens, the barriers, what the NHS can learn. So, Mark, I wanted to get your opinion on some of the discussions. And one of the key messages that stuck with me that came out, from one of the roundtable sessions, and we're just gonna play that clip now.
Roundtable attendee:As a clinician, you can tend to help 1 person at a time. The informatics community, the digital community, can help 1,000 at a time. This is why it is the space we've gotta be in.
Paul Johnson:That's quite a strong message, and something I think everybody should hear. You know, I mean, really a poignant message is saying, you know, a clinician can save a life, but the IT community can save 1,000. So it'd be great to get your views and your take on how we go about that. What do you see the barriers being?
Mark Fewster:Yeah. I agree. It's an interesting point. I think it's Mark the the broad kind of concept of technology in health care. So I know we kinda talk about this quite a lot internally at Radar, but everything from, you know, the information that's been captured.
Mark Fewster:So, you know, we've been speaking to people like the NER analyst, recently about some of the information they're capturing right the way through to things like wearables. So I think the way technology can help is more around obviously, at the point of care, you've got technology that that, you know, helps look after a patient or might kinda track vitals and things like that. But if you rewind it and think about the technology that's coming especially the types of things we use every day like your phone, wearables that people are now using, that can help predict the onset of perhaps, you know, some disease or something that I might have. So the technology there actually being something that helps prevent that person going into hospital and stops them having to, you know, draw on the on the health service or maybe draw on it in a in a slightly different way. So that technology, if used properly, probably can help serve people's lives because you get in an earlier you know, you're intervening at an early point in their care rather than waiting for whatever it is that they end up being in hospital for.
Mark Fewster:It's about prevention rather than treatment, I guess.
Paul Johnson:Yeah. No. No. It's a it's a really good point, because I think quite often people looking for the innovation, the sexy tech within the hospital setting. Yeah.
Paul Johnson:From what you're saying there, it is actually there is a genuine opportunity to apply technology to prevention, stopping people actually developing chronic conditions, getting into hospital.
Mark Fewster:I think if you look at if you look at tech in hospitals, especially, kind of, clinical tech, it it it is predominantly state of the art cutting edge. Obviously, it's kinda dependent on things like budgets and whatever, but there's a there's they've always been really good at innovating in terms of the the pieces of equipment that would be used in that kind of hospital environment or that care environment. And I think it's just how do you utilise almost the way technology is trending and going, and how do you kind of bring that into care, and how would you bring that into a patient's journey? You know, the the the devices we're using on a day to day basis can help inform how to deliver care to somebody if you if you're using them properly and expand that into the Internet of Things and all the different kind of pieces of information you might capture from things within the home. That again, you know, if that information is used properly, can help build a picture of an individual right the way through to how active they are to, you know, like, as I say, you know, what's going on with your blood pressure, your heart rate, your oxygen levels, all that type of stuff.
Paul Johnson:Great. So going back to the barrier kind of question then. Yeah. So it would seem that social care has a, you know, significant there's a significant opportunity here for social care. And something that came up in the round tables again was that communication between social care, the NHS, and that and and those interactions, whether it be through technology or people.
Paul Johnson:Yep. So if I suppose, what are the barriers then within social care to allow all that monitoring and to ensure it's interoperable with the NHS? Is it money? Is it
Mark Fewster:I mean, so yeah. Almost always comes down to money, doesn't it? At some point or other where, you know, the especially kind of social care, can you afford to, you know, kit yourself out with all this fancy fancy new equipment? But I think it's just a lack of that big picture view. And it because everything's siloed, because there is no overarching vision of what a patient's care should look like from kind of cradle to grave, and the route to purchase technology, the, you know, is that technology fit for purpose?
Mark Fewster:All of the different providers like us out there who are providing different pieces of equipment, how do you pick the right thing? I think the the barriers are more around the procurement, if you like, of making sure you're getting the right thing rather than the technology itself, if that makes
Paul Johnson:sense? Yeah. No. No. It does.
Paul Johnson:I think it is this it is highlighting this perceived divide with social care and the NHS because, I mean, this is me speaking, not so much coming from a round table, but it always you know, that the poor relation in health care is sometimes perceived to be social care, yet it has the opportunity to have the greatest impact. And if you looked at it holistically Yep. You would stop things going wrong, so that you don't have to spend lots of money to fix them, which is kind of what you're saying about the expensive, super high-techies in the hospital, because that's where it's needed to to save their lives. But prevention stopping those people getting to that stage.
Mark Fewster:And again, personal viewpoint is we measure the wrong stuff. We we we measure where the money goes, and we measure return on investment for one one of a better way of describing it, and it's all about waiting times and how long did it it's not about did this person receive good care or not. And if you if you start with that and then work your way back through it, you would say, well, actually, the best way to look after this person is to keep them in the home, and invest in some technology that monitors them in home, and checks their RI, and gives them, I don't know, video link into a carer, or, you know, whatever that piece of technology is. I pretty much guarantee that's gonna be cheaper than treating them in a hospital at some point. And then them leaving hospital, you know, having, you know, been been in a bed for 6 weeks, and then they go home and they have a fall, and then they're back in hospital again, and you start that vicious cycle.
Mark Fewster:I I think it it is it's it's there's not gonna be news to anyone, but it's a fundamental problem in how we picture how we deliver health care to people. We don't think of the patient outcome.
Paul Johnson:I think it's it's not just the outcome as well, Lee, because the other thing that always scares me again, getting into personal viewpoints, but I kinda get frustrated sometimes that we just say we straight away move to the point of patient, the name patient. Yes. Actually, let's why don't we actually try and prevent somebody becoming a patient?
Mark Fewster:Yeah. Absolutely.
Paul Johnson:So it's not just outcomes, it's quality of life, which again, technology has a potential part to play in improving people's quality of life.
Mark Fewster:And giving people responsibility, not so much for their own health care, but almost helping them make the right choices and things like that. So if you think of how you inform the population's probably the wrong word, but how you inform individuals about the best way to look after themselves and things like that and incentivize them. You know, if you can stop you can if you can teach people why, you know, good diet's important, exercise is important, you know, keeping yourself active physically and mentally is important. That, again, is gonna reduce ultimately how you're gonna end up delivering care to people because you you should end up delivering less care because people are fitter and healthier. It's it's that.
Mark Fewster:It's it's it's the whole system. It's everything from from almost how you teach people right the way through to how you end up using tech and things like that to monitor it.
Paul Johnson:We probably should, well, I say we probably, the government and policy, should listen to some of the commercial entities around some of the healthcare apps and where you are incentivized to exercise, you get discounts on healthy foods. Because they recognize that actually because they're delivering private healthcare, that by keeping you healthy, giving you a better quality of life. In actual fact, they benefit directly. So
Mark Fewster:I mean, we're unique in the NHS.
Paul Johnson:It's the same. NHS. Really. Yeah.
Mark Fewster:If you're in in the US, well, I'm gonna reduce my insurance premium by evidencing to you. I don't smoke. I exercise well. Blah blah blah blah. Are you paying it?
Mark Fewster:You're in a payment.
Paul Johnson:That's funny. Something that comes up quite often, not just in the roundtables, but, you know, technology can't replace people. Yep. You know? So how do you see you know, how would technology complement when people say that it's all down to people, you know, that face to face interactions, how can we supplement and complement that that side of things?
Mark Fewster:I mean, I I I agree. It's it's it's people, process, technology. And technology should just be the enabler for the other 2, so you don't lose a human element if you like. It should just there be to to be supportive. So, you know, again, personal view.
Mark Fewster:You don't wanna suddenly say, well, everything's gotta be online and nobody ever sees a doctor again unless it's over video and all that kind of stuff. It's you use the technology at the right times. So it's a bit like when you give him, you know, when you probably a bit of a techie word, but surfacing information to people. So use tech at the appropriate time within that patient's journey or within whatever the, you know, interaction you have with them. It might be the right thing to just pick up the phone to them and say, you know, whoever it is, give them an update on on, you know, a a booking or test results, whatever that looks like.
Mark Fewster:I'll send them a text. I'll do an online call with them. But then sometimes it's you want that first to first element, and ultimately, I'm not a clinician or, you know, but doctors, it's a personal thing. It's a one to one interaction to the per you you as a doctor or clinician and the person you end up delivering that care to.
Paul Johnson:I think it comes back to that. You know, he was talking about sexy, you innovative, this, you know, top technology and things like that. Actually, the biggest benefits can be derived from the most simplest of things in that commodity activity. Because it occurs to me that technology can pay the part of reducing this manual processes. So therefore, if we bring some automation through technology, then that's gonna give time so that people can spend time with patients.
Mark Fewster:Yeah. And do the and and all about the outcome for that individual. In the essence, you don't wanna be in hospital and a robot doctor turns up and kinda hello, man.
Paul Johnson:Yeah. Yeah.
Mark Fewster:It's you you still want that interaction with people, don't you? You know, you wanna know there's somebody there who's literally looking after you. Yeah. Yeah. It's just use it at the right time.
Mark Fewster:And some people process and technologies just to help.
Paul Johnson:Yeah. Yeah. I think just on the people thing, just before move off, that is is, I think it's inclusion of everybody in the ecosystem as well that I think sometimes lacks that when care pathways are being designed and things like that, do they always have the patient at the you know, is it patient centric?
Mark Fewster:Well, we're not it's everything. It's
Paul Johnson:it's evolving around that. And so so I think there's lessons for everybody to learn, you know, that having that patient at the heart of things, and not mapping that whole pathway, and including prevention, then that's gonna be important as well.
Mark Fewster:Yeah. And that that patient experience of he kinda, you know, a recent example of someone I know who's who who got diagnosed with cancer, and was basically back from pillar to post because the information wasn't shared between the different kind of local, you know, the different trusts who were looking after that that that person. And so that care got delayed, they were they were basically going, I have no idea what's going on. And and as a as a patient experience, man, it's not good enough, is it? And that's a that's a perfect example of how technology should be helping because why do they not know what the other one's doing?
Mark Fewster:Why isn't there a single patient record which is available for that individual to go? I wanna book an appointment. We've just put you an appointment. Here it is. Here's what we've seen.
Mark Fewster:We've just done your test results. Here's what your test results are. I mean, that's not rocket science there. Yeah.
Paul Johnson:Okay. Now that we've you and I have solved all the problems of the health and social care, will
Mark Fewster:will you get
Paul Johnson:okay. Getting a bit more specific in terms of but keeping on the people theme.
Paul Johnson:Yeah.
Paul Johnson:So within Radar Healthcare
Mark Fewster:Mhmm.
Paul Johnson:You know, something that, you know, we pride ourselves on is that, you know, user centered focus, ensuring that people are part of the process. Can you talk a little bit what that actually means when we say person centered design? What what's the process, and how do you apply that when you're defining what the next innovation, or how the system's gonna work as it may be?
Mark Fewster:Yeah. I guess, for us, it's user centered design. So it's about it's about kind of bringing those people in at the at the start of the journey to develop the product, which, I guess, includes understanding the the the starting point is what problem we try to fix. And then in a nice sense, understanding what that problem is comes from them not as we are, you know, we don't do it. We don't we don't we don't do that as a job.
Mark Fewster:We don't live in that environment. So it's it's that around well, actually, what what we're trying to fix here? What's the what's the what's the problem? And then as part of that journey of developing a product, it's understanding well, if we did this, would this fix your problem? And and it would fix it in an efficient way right the way through to us then developing the tech that does that and then involving them in the design of it.
Mark Fewster:So right the way right the way through to almost like prototyping where I'm sitting here, Paul, you've said to me, oh, I've got this problem what I wanna fix. And we go, well, look. We've designed this thing. Do you think this is a sort of thing that had helped you? And you go, well, no.
Mark Fewster:That doesn't quite work. Or, actually, you've completely missed the point or you've got the process wrong. And it's almost that iterative cycle of we're all we're always kind of ensuring that what we're doing is is put back through you as that customer or user to help inform the next bit of development that we do. And that, as I say, involves the design sessions, so we have workshops and things like that right the way through to what we call betas. So that'd be, as I say, you know, is is we've we've built a little bit of something there, Paul.
Mark Fewster:Why do you have a play around with it, see if it works for you? And that helps ensure that when we develop something, don't get me wrong, we don't always get it right, but it's it's much closer to solving that problem and delivering the value sooner as well. So it makes sure that actually when we develop something, we you know, if your if your problem is x, and actually it's really quick for us to fix 80% of that problem, We don't try and wait forever to fix a 100%. We go, look. You know?
Mark Fewster:This will fix most of your problem. Here you go. And it's that kind of ethos. And then from a usability point of view, that also helps with, well, this button's in the wrong place. It'd be easy if I clicked here, and, you know, I don't understand these things and what you're showing me.
Paul Johnson:Right. I suppose, just to be clear, I suppose as well as this is all derived off the back of the core platform and functionality that satisfies, you know, what percentage of people's general requirements? And then is it development? Is it configuration? What what's what's making these, you know, solving these actual problems?
Mark Fewster:I mean, if there was, it can be different. It could be an entirely new module. It could be something where we're building something specific to answer a a a problem that, you know, maybe it's kind of similar to what we do at the minute in terms of kind of compatible with products, or it could be, as you say, we we we understand that they've got a, you know, a problem that they need to fix, and so we configure our platform in the way it can be configured to just answer that specific specific problems. Obviously, the way we work is the way the product works, is it is almost like a toolkit that you can then kind of configure to fix different problems within an organization. Obviously, at the minute, health care.
Paul Johnson:So, again, from the roundtable, systems and how systems speak to each other, you know, that that came up a few times, and, I just wanna play a clip here.
Roundtable attendee 2:We are implementing innovation at ICS levels, and we are working with systems who want to push this forward. So, yeah, well, we're taking innovations that we're doing, and we are scaling them. But that has to near now sit within the footprint of the digital maturity or the digital plan for the ICS. Whereas we need we need to do to enable what Wrydom wants to do so that when you seize that patient to have that one record, we need all these systems to talk to each other. So we can't have the Wild West anymore.
Roundtable attendee 2:Yep. We need to feed that information so the clinicians have that information at their fingertips when they need to consult with a with a with a patient or, actually, when they need to make a decision about referring that patient somewhere else. So we're not making unnecessary referrals. And each ICS is gonna do that just differently. The cancer networks are gonna have their own network within the network as well.
Roundtable attendee 2:So they're all as well as being part of an ICS, they're gonna be part of a national cancer network to ensure we can get the best care for these patients with these highly specialist centers, which the Christie's one. You know, which the is another one. You know, you who specialize in really rare forms of cancer. So you know what the referral pathway is now. So there's gonna be systems within systems as well.
Roundtable attendee:Yeah. I'm just recommending that. Patients with cancer also have partners. These are done by. Right?
Roundtable attendee:And unless we take a patient centric view of care rather than an organization centric view of care, we will continue to make the same mistakes.
Roundtable attendee 2:Yeah. Okay.
Paul Johnson:So really makes a very interesting point here. It's this interoperability. It's not so we've got multiple organizations. We've got networks. You've got, you know, local authorities, we've got NHS, we've got all these different entities.
Paul Johnson:And then you've got from a how do you get that patient centric data to be shared amongst all of that ecosystem? It'd be interesting to get your kind of views on what's how should systems be built? You know, what when we say interoperable, what does it actually mean? Yeah. You know, from from your perspective.
Mark Fewster:I I mean, there's a few bits in there. First out, so technically, there's obviously standards. So, like, fire h l seven, that type of thing, where you're saying, actually, this thing that I procure, this thing I buy has the capability to then integrate with something else. That doesn't necessarily mean that then that integration then happens, so I think it's part of how you procure something. If if part of that procurement is you fundamentally need this thing to integrate with x y and z, then that should be what part of whatever that whatever that process is.
Mark Fewster:And perhaps you need evidence that that actually is gonna happen rather than ticking at first value of that. Yes. Oh, yeah. We can integrate with x, y, and zed. Actually, can you integrate with x, y, and zed?
Mark Fewster:And I think the standards and where to evidence us suppliers that we meet those standards. So things like DTAC, I think, is coming. That that type of thing where you've got you've got a way of helping make sure that whoever's in charge of procurement is making making those right decisions. But I think it it's probably bigger than that again in the sense of, in the NHS, especially, you've got all of these independent trusts who've also got independent procurement teams who don't necessarily have or there isn't a big picture in terms of what actually what are we doing collectively to implement technology? So this trust merger is another merges with another trust, and this one's got one electrodent patient record.
Mark Fewster:This one doesn't have one, but it's just about to procure another. And it it and then the the buffer to get them, suddenly, the 2 things are incompatible with each other. I mean, that shouldn't happen. You know, in the nicest sense, if there's if there's no communication about what things are being bought and for what reason, and there's no kind of overarching vision on what we're trying to do, then you're always gonna just bump up against issues where people bought the wrong thing for one of a better way of describing it. It.
Paul Johnson:Is that, is that an educational thing then? So because one of the thing that always occurs to me is that when when we start a partnership with a care organization, quite often it's people on the front line that are driving that demand. And so when people are procuring these lots of different systems because they might be solving other problems, And then so is it an education thing to procure right through the organization? Yes. Procurement, ensuring
Mark Fewster:Yeah. Yeah. Absolutely. And it's it's
Paul Johnson:And where where does that responsibility sit within the care organization? It's
Mark Fewster:Again, I think I I bring it up again, personal view. I'd I'd bring it up a level. If if there's just kinda a national standard that any supplier needs to adhere to, and that concept of interoperability, you need to have evidence you can you can do it. So, you know, if if if 2 EPR systems have to integrate with each other, then evidence it. And then, you know, you can be safe in the knowledge that if I buy x, it's gonna integrate with y.
Paul Johnson:Yeah. Something I I brought up at the I mentioned at the round table was, again, it's about this communication and ensuring that we've got these better established communication lines and understanding the impacts that social care, the challenges they have, and how they impact on the NHS. I'm just gonna play a short clip from Kate. She raises some interesting points.
Roundtable attendee 3:So yeah. Please, Kate. Excited about the future, and I think we've got a period at the moment as we're coming out of COVID. And if we don't grab it
Roundtable attendee:Yeah.
Roundtable attendee 3:All the barriers will come in. And I think, you know, I said about speculative design. You know? Going into hospital is not good for you. Full stop.
Roundtable attendee 3:You got an an old an elderly person. You put them in the hospital and, you know, reduce mobility, deconditioning, hospital acquired deconditioning. Yeah. And that comes in with a whole raft of things, you know, about perverse incentives. You know?
Roundtable attendee 3:We monitor falls, but we don't monitor deconditioning. And, you know, the impact of that might mean that a patient never gets to go home again.
Roundtable attendee:Yeah. And, you
Roundtable attendee 3:know, that's their home. Nobody goes on holiday and expects never to see their house again, but that's what happened can happen to an elderly person if they're going to hospital unnecessarily. So I think, you know, I'm excited. You know, Mercy Hospital in America is the first virtual whole hospital. And I just think, wow.
Roundtable attendee 3:And the fact that there's so much opportunities that we can do to prevent people going into hospital. And it's also about that kind of what responsibility do we have in that to, you know, the health inequalities. When you think about you know, in London, you might live in deprivation, but you've got lovely shiny hospitals around the corner. In places of rural deprivation, where's your nearest hospital? You know?
Roundtable attendee 3:Is it a big, shiny hospital? And so I just think there's a real thing about using this digital world to even things up and actually
Roundtable attendee:point is very well made because you asked yourself, why do you put people in hospitals? Alright? Well, because the expertise is there, the equipment is there, and the record is there. So if you can move the if you can move the record around because you've digitalized it, if you can deliver remote consultation for your diabetic consult or your cardiac consult, Right? And suddenly, you don't need that person in that care environment unless they have care needs.
Roundtable attendee:Now if you've got care needs, and that is you need to be dressed, you need to be washed, people need to come and visit your home. Alright? And and that's where we fall over because we don't have that workforce because we for numerous reasons, we don't value social care as a profession that that it can deliver.
Paul Johnson:So, fundamentally, Kent's point there is, you know, how can we stop, especially the older generation, ending up in hospital, reduce hospital administrations within elderly care? So it'd be good from a technology perspective. I know we were you touched on it earlier around Yeah. I monitoring patient wearables, those kind of things. Yep.
Paul Johnson:Do do you see this set on a path
Mark Fewster:to where Yeah. Yeah. I think that's it. I think it's you you wanna, where possible, you know, deliver care in in whatever the best pest place is for that patient. And in this case, that's at home, I guess, you know, because that's the place where they're comfortable.
Mark Fewster:So the more you can enable that care to be, you know, possibly remote of using different pieces of technology to monitor the things that you need to monitor. So look after that individual, you know, the the the better. And I think the the other point around kind of social care and and working with the kind of rest of the health care network. It's also again, I was I was at the same event as you and there was lots of speakers, lots of people who were kind of having those conversations. So it feels as if it's starting to, you know and again, probably the pandemic helped make people speak to each other and kinda start to create some of the some of these networks.
Mark Fewster:And maybe things like the ICSs will help as well. But it's back to don't see it as a disconnected thing, because it's not a disconnected thing. It's all part of the same problem. You know, The problem is just looking after an individual, what no matter how old they are or where they live in that, or where they are in that kind of journey. And that's, I think, that's the thing.
Mark Fewster:We we we disconnected the 2 things and and broke them apart. And now we've got to put them back together again. And that's that's you know, it's gonna be a task. I think technology will help in the sense of making sure people have got the right information the right time. So when somebody comes out of hospital or in into a care home, for for example, you've got all the right information and there's no delay in understanding what that person's needs are or even understanding, you know, are we the right care home, for example, to take this patient from this particular hospital, You know, we might not be set up to look after their particular needs.
Mark Fewster:Those types of things. The the way systems can help put somebody in the right place where it's the right place to care for them. I think that'll be that'll be where it can definitely help.
Paul Johnson:I suppose that that does bring back in the question about inequalities within health care, and I'll come on to a second. We'll we'll play a clip from Owen from the from the round table. But I suppose, you know, if you look at terms social care that I and maybe you you said that we've kind of pulled them apart, and there's the NHS and the the social care. There's inequalities in social care, I e, if you are wealthy, have money to pay for a certain level of care, then you can, you know, that that higher level of care or perceived higher level care will be delivered. Yep.
Paul Johnson:It might be that some of that is just cosmetic. So I'm not saying that, you know, there's there's differences in, you know, the quality of care that's been delivered. But there's perceived inequalities there. Whereas if somebody, you know, you know, is unable to have access to those kind of funds, then they're gonna be receiving kind of that state care. So, you know, there's there's a levelling up there.
Paul Johnson:But I just wanted to play a clip from Owen, that reads a little bit about inequalities and accessibility for everybody. Yeah.
Paul Johnson:I'm coming from here from a completely different,
Roundtable attendee:Yeah.
Paul Johnson:Yeah. Perspective. So as I said, so I work for an organization called the Race and Earth Observatory. So you can sort of, figure out which way I'm gonna come from. So one of the things we need to think about as part of these conversations is all the digital technologies that we're going to develop, are they going to benefit everyone?
Paul Johnson:So there's a really fantastic paper that was done by the strategy unit based in the Midlands, which you can look up. So it's it showed that, if you live in the most affluent area, you've got access to the latest, diagnostics. You've got more access to privately funded NHS care. You've got more access to diagnostics in general, and you've got more access to elective care. So if you look at the richest hospitals, this is where all this is happening.
Paul Johnson:And at times for, if you're coming out with these new technologies, it's easier to go where the energy is, where the money is, and say, you know what? I've got this fantastic idea. If I take you to a well funded hospital, you can think of anyone. Yep. There's a better chance of getting it done there because it's better funded and everything else.
Paul Johnson:But, actually, it might not be where the greatest need is. So a time that's that has to be part of the first thing you'd say, okay. Right? Where is the greatest need? You know, like, as an organization like radar, you say, okay.
Paul Johnson:Look. Here's the country. Look. How about if we go do something in an area or in a trust where no one is doing anything? You know, let's go and try and try and do it then, actually, get the biggest benefits.
Paul Johnson:Then the other thing is actually starting to look at, who's actually benefiting from all this technology. So if you look at, like, the NHS app as an example, there's some work we're doing. Please don't switch about this, chat. We actually don't know who's using it. We don't know which region.
Paul Johnson:We don't know which area. We don't know what ethnicity. We don't know what gender. So it could be like a really revolutionary app, but it could be benefiting only a section of society. And if we say, right, our delivery of care is going to be driven primarily through this app and we don't have a clear idea of who's using it, we might only end up increasing the inequalities that, that exist.
Paul Johnson:So part of the things we need to do when we start developing the technology, say, right. We put out this technology. Who's using it? Who's not using it? Who's accessing it?
Paul Johnson:Who's not accessing it? Then the last thing is, which I'm comfortable to talk about, who's developing the technology? So, 70% of the NHS is female. There are 12 men. On the third one, there's only 1 woman.
Paul Johnson:So for us, some of the work that we do in the race and art observatories is to always say right right from the start of the patients who are involved as part of the trial are the representative of the country. The staff were developing the technology at the representative of the country. Such roundtables are the representative of the staff, are the representative of the table. Just look at the list before I say, okay. I'll look.
Paul Johnson:We've got I've got 11 men. You know what? How about you invite a a few more women? Just some of those things. I think it's it enables us to make sure that everyone benefits from it.
Paul Johnson:I think that's my my key takeaway that let's try and make sure that everyone benefits from the technologies.
Paul Johnson:So, I mean, fundamentally, they were saying about this is making, you know, not just the richest hospitals, and making sure that, technology, everybody can benefit, and everybody plays a part of that. So that, I mean, there's many facets to that, including, you know, digital inclusion. You know, does everybody have a smartphone, you know, if we're going down smartphone technology. But it'd be good to get your kind of views on what, you know, what Owen said there, and also
Mark Fewster:Yeah. From a I
Paul Johnson:mean, I'm not perspective.
Mark Fewster:I'm no expert on it, to be fair. But from from the stats I have read, it's not as, again, as I understood it, it's it's places that aren't necessarily the richest. It's but there is a there is a postcard lottery, absolutely. But I think kind of Salford's one of the, places where you kinda get a better health care, and that's not necessarily one of the richest areas in the country. And I get I guess it's back to it's back to the the the patients from a geographical point of view.
Mark Fewster:I mean, you're gonna be delivering a very different service if you're looking after, you know, the the the Highlands and Islands of Scotland than you are if you're looking after kinda Central London. And in an Isis sense, if you're focusing on the patient outcome and not necessarily where the money's going and what that what those kind of KPIs are around that money, then you will be spending different amount of money in different areas because you're gonna have to provide a completely different level of care if you're, you know, having a send a helicopter to the Alijoa to get somebody to take her back to a hospital in Glasgow is very different than sending an ambulance from Central London to, you know, a mile down the road and picking somebody up and taking them to hospital. It's natural. You know, you're gonna have inequalities in terms of the amount of money spent. Doesn't necessarily have to translate into inequalities in the care that you deliver.
Mark Fewster:So it's that again, I think it's the you're what you're measuring.
Paul Johnson:Yeah. Yeah. I yeah. I think it is down to the responsibility of, you know, the the authority, the the the NHS, the social care providers in that region. Like like you said, geographically, there might be challenges around how you deliver remote care, things like that.
Paul Johnson:But it's interesting you mentioned, you know, at Salford. I know that, you know, Salford Royal, as an example, have an innovation department. I've actually was fortunate enough to visit there. Yep. And, one of the things that struck me when I spoke to one of the leads there was that, actually, their sole focus is to solve real life problems.
Paul Johnson:And their their mantra was, if it's not solving a problem, we don't look at it. Yep. So I thought that was kind of a
Mark Fewster:So we we we think in the same way. If it's not a real problem, if we're not fixing something that's actually causing anybody, you yeah. Move on.
Paul Johnson:Yep. Yep. Just coming back to the to the kind of people thing again, this is more from, like, the use of systems. Mhmm. So, you know, as the NHS has evolved, as social care has evolved, there's a lot of legacy systems in there.
Paul Johnson:There's, you know and there's you've got this user design. And then when people are being brought in there, you know, there's an expectancy to how people are gonna use these systems. That's a burden to train how, you know, intuitive these systems are. I know that it's something that you've looked to build into Radar Healthcare, in terms of, you know, how people can interact with the system, how they will be autonomously trained. But without putting words in your mouth, how how would, you know, what what does that mean to you, and how have you solved that problem within Radar Healthcare?
Mark Fewster:Yeah. I mean, it's back to that. Yeah. The the problem is you've got high churn rates, big turnover of staff, staff possibly English isn't necessarily a first language. There I I there's a there's a kind of broad bursting where people go that, you know, that that that they're not they can't use technology, which I disagree with if I'm honest.
Mark Fewster:I think, you know, people can people can use use technology. But a new system, if you've never seen it before, it's like anything, you know, we we we naturally, you know, we're naturally curious in terms of how we explore tech, you know, your phone or something that you're using. You don't tend to go off and read a training manual on how to use a new app or something like that on your phone. And what we try and do is, 1, make sure that the task somebody's trying to do is clear and simple and easy to achieve within the product. So that's the first thing.
Mark Fewster:But then we also also support it with inbuilt training. So rather than you going off enough to having to read or use a guide or have somebody having to train you, we have what's called a digital adoption platform. So you can almost get the product to walk you through the task you were trying to do in the 1st place. So for example, you might want to raise an let's see you wanna raise an incident and you wanna raise a fall, you've never done it before, you can literally just go into radar, click on, you know, click on a button, raise a fall, and it will walk you through all all the steps that you need to do. So you literally have never seen the system before in your life.
Mark Fewster:You don't need to have anybody train you. It will walk you through how to how to complete that task. And that combined with the usability and the design element should mean that actually not that the not that there's no, you know, there's no learning curve, but that learning curve is very much reduced, and somebody should be able to do whatever the task is. The task is, you know, should be as simple as possible.
Paul Johnson:I suppose do you see then, post an implementation, do you see reporting levels increase because now people have greater confidence to do that? Does that does that occur?
Mark Fewster:Yeah. If you look at customers when they come on board, typically, you you might actually see kind of a little bit of a dip to begin within the 1st couple of weeks as people kind of that maybe it's not kind of rolled out and then you suddenly see like the the the spike as people start to use the system and start start to report on it. I think there's a there's a couple of things to it. From a usability point of view, obviously, it's easy to report. It's how you're then communicating the fact that you've got this new system out and UI, that is the mechanism for reporting.
Mark Fewster:That tends to be where you see the the drop off.
Paul Johnson:I suppose that's and on the the kind of outcome of that is not only are you managing more effectively, but now you've got a richer data set that you can then act upon. Does that is that also a case?
Mark Fewster:Yeah. Absolutely. I mean, the point of the fundamental point of raising these things in the first place is not capturing data for data's sake, is if you don't have a mechanism behind it where it's helping you learn, understand, and act, and implement change so that you reduce whatever the thing is that was being put into the system in the first place. Then, you know, that that that is the entire purpose of what we're doing here is to create a system which, you know, feeds back into that loop of going people are raising it. You want people to be raising as much as possible because that's feeding your knowledge for one of a better way of describing it, but, you know, your perception of what happening in your organization.
Mark Fewster:You're then implementing, you know, ideally things that mitigate whatever those risks were in the first place, sharing those learnings. I think when we spoke to NLS about that thing of how do I make sure that I share the learnings in the organization so that I am reducing falls or incidents or whatever whatever that looks like.
Paul Johnson:I suppose that's it's a nice segue actually when we're just thinking about that data. I'm just not summarizing what everybody said and the total outcome from the round table, but some of the key takeaways were we've now got, you know, incredible amounts of data that can be put to work, you know, going to Kate's point. Yeah. We've got systems, organizations that don't appear to speak to each other Mhmm. But possibly have the capability to do so.
Paul Johnson:And then we've got a comment from Loy during the the roundtable as well, which was, it's taken a pandemic Mhmm. To drive the realization. I'm not even gonna say it's forced some people to innovate, but it's also kind of, you know, forced some people to realize that innovation is available to adopt it. But it'd be, interesting to get your kind of views as to how do we if you take those three key things, we've got lots of data, we've got this interoperability, and then we've got this kind of, what have we learned from the pandemic? How do we how do we actually move that forward and get
Paul Johnson:I think I'm
Paul Johnson:gonna translate that into something real.
Mark Fewster:So the technical bit of the data and the interoperability, park that first and again, I'm I'm gonna sound like I'm banging a drum here, but the outcome of what is it you want to know, and what difference is it gonna make to how you do things differently, And then work backwards from that. And then understand what information you actually do need or what things do need to speak to each other. Haven't it kind of been, you know, we've got all this data. We need to integrate with everything, and we need some, you know, throw it all into this big warehouse data warehouse, and we're gonna have all, you know, all that. You might not even need to do that.
Mark Fewster:What what you actually try to fix, and then that'll help you understand what it is that you're trying to or what data you need, you know, right the way down to are you capturing that data in the right way in in the first place? We see that with our customers. We try and help them visualize and think about the outcomes. So it's about Radar's about doing things differently as well. It's not about just ticking what system you already had and just, well, now we're gonna put it into radar.
Mark Fewster:If if that system or those things you were doing were making a difference, then you would have seen a reduction in events, and you would have seen, you know, better health care, but you're not. So actually, how do you how do you start with that? And now do you go, well, what should we deliver? We wanna deliver better health for people. We wanna deliver a better outcome for these people.
Mark Fewster:And let's pick an example of, like, reducing falls, for example. If I'm not capturing the data in the right way, that then feeds into things like analytics, that can then help you understand what's happening, and then you've got the mechanism again for, you know, implementing something to prevent it. And and understanding again where you've where you think you're making a difference, did it make a difference? You know, again, you know, we've put all these things in place. Did they work?
Mark Fewster:Did, you know, that focusing on that that problem helps drive what you need to feed it into it, which might be, but to do to know this, we do need to, you know, we do need to integrate with something, or we do need to capture this information, or we do need to bring in this from a different data source.
Paul Johnson:I suppose then that kind of is another takeaway that our perception that I've got is that in order for users with our healthcare to play a part in that, then we have to be a part of the discussions. Absolutely. Yeah. And, again, this is kind of a perception from my perspective is the distance and gap between suppliers, not our partners, because Yeah. When you you partner with an organization to help solve them problems as you've been explaining, then it becomes a very collaborative, you know, engaging process where we become intimate with the outcome, the challenges to make sure they've got something.
Paul Johnson:I think in more the whole journey.
Paul Johnson:Mhmm.
Paul Johnson:So right across, the NHS, social care, the whole ecosystem, You know, how do you see that suppliers, not just radar healthcare, all suppliers become a part of the discussion? Because it seems to me that if you don't know what's innovation is out there, then it's when you're going back to your saying, what is the problem we want to solve? If you're not aware of technology, then maybe you'll try and solve it in a, you know, in a labor intensive way, for
Mark Fewster:example. Yeah. Oh, you picked the wrong thing. Yeah. Well, this is the thing that I know about, and I'm aware of.
Paul Johnson:Exactly. Yeah. What you don't know. So how how would we how do we better engage as an industry? And it and it's two way, you know.
Paul Johnson:There's parts of suppliers to pay, and healthcare organizations, the NHS, NHS England, etcetera.
Mark Fewster:Yeah. I mean it is a tough one because obviously you've got, you know, us as a supplier, you have others out there who do similar things to us. So it's, you know, how it's kind of how do you create a community where actually you're sharing what you're doing in a way that actually you don't have an agenda, I guess. And I think that's probably the tough thing of, you know, how do you create, again, possibly kind of government level, you know, this thing of, well, how do we understand what's out there? How do we understand what is the art of the possible, for one of a bit better way of describing it.
Mark Fewster:Yeah. I don't I don't have an answer to that one, Paul. Sorry.
Paul Johnson:I mean, to be it's slightly unfair because it's a really challenging question. I mean, it ultimately I'm asking you what what's the silver bullet, Mark? So
Mark Fewster:Yeah. I I don't know. I think it's I think
Paul Johnson:it's probably less collaboration, isn't it?
Mark Fewster:Yeah. Yeah. Yeah. And it is but, again, as as suppliers in the same space, to be less selfish about what it is that you're doing, which is tough.
Paul Johnson:Yeah. Yeah. Something that occurred to me where I I'd seen big data applied in a really effective it was the first time I saw big data. I was working in the States, up in North Carolina. And, I got talking to somebody in a bar.
Paul Johnson:And, he said to me he was at college, and he was mapping out his career. He was asking what we did, how did you get into it, those kind of things. And then he showed me an app, and this app brought in all the trends and the available jobs, and what the salaries were, across the whole of the US. And so it was saying these are and then it looked at big industry, political, environmental impacts, and then it had some kind of algorithms that were saying, based on what's happening in the world, these are the trades, industries, jobs, and things that will become most relevant.
Mark Fewster:An example of of what's
Paul Johnson:And and, basically, it then pushed all this together to then present to to that person possible courses based on their interests, based on likely jobs that will be available at the time they graduate and come into the working life. Mhmm. And universities presenting those courses. And at which I thought it was a really great way. It was the first time I'd said, ah, that's what big data is.
Paul Johnson:Mhmm. You know, lots of things to give me to help me make a simple decision. I thought that was pretty cool. Okay, Matt. So this is normally where I would ask somebody, you know, what's your health, what the health tech moment?
Paul Johnson:Yeah. But because of your background, your role, you know, something you've seen where you've seen big data technology applied in a an effective way to solve a kind of problem?
Mark Fewster:Yeah. I mean, I've I've kinda not really I've not worked in healthcare for very long, as you know. Basically, come from hospitality industry, prior. I mean, other than the pandemic, obviously, that's kind of a quite big healthcare moment for me. I think and and my example is actually one that didn't work, but it's a good example of how you might look at data and and and usage.
Mark Fewster:So it's a goo it's Google, basically. And what they were looking to do was they were looking to understand the demand on, gonna simplify, but demand on the NHS based on flu outbreaks. And they were looking at people's devices, and looking for people searching have I got the flu, I think I've got the flu symptoms. And using that data to understand, actually, have we suddenly got a spike in flu outbreak in Central London for for argument's sake? So that that idea of, you know, bringing data in from completely something that you wouldn't even think of to be fair.
Mark Fewster:You know, somebody googling out, I've got flu symptoms, to help inform the capacity you might need in the NHS trust or A and E or wherever wherever they, you know, wherever others people they'll end up, you know, GP, where wherever. So I think that that was quite an interesting one. And that that way of using data from other areas, bringing that information into a central system somewhere to help you predict what's going on. Again, it's that preventative thing or at least understanding what resource might I need in future to cope with whatever whatever's happening. Because everything in the midst reactive, isn't it?
Mark Fewster:And and it's very hard to suddenly react when something's going on. As we saw with COVID when it broke out. Suddenly, you've got a lot of people turning up to hospital. Everybody's completely unaware of it and, you know, the it struggled. The system the system struggled naturally.
Mark Fewster:You know, if you can forewarn of that, I'll get as much notice of that as possible. Not saying it wouldn't still struggle, but at least you've got a little bit of an idea about what's coming down the line.
Paul Johnson:Yeah. No. No. It's, yeah. It's a great example.
Paul Johnson:I think the ICSs are going to have that challenge, I think, you know, and I hope, and I and I'm sure they are is focusing on prevention as much as, know, the actual delivery of care. Yeah. Thanks for joining Thank you. Mark. And thanks to all our What the Hell Tech listeners.
Paul Johnson:Next week, we're talking to Lottie Moore and Lee Davis from Public Policy Projects. Easy for me to say. They They have been at the forefront of policy debate of the future of social care, and we'll be talking to them about how they promote policy reform, their upcoming white papers, and how they are continuing to demonstrate policy influence. Don't forget to rate and subscribe wherever you get your podcasts. And if you have any questions, or questions for our guests, please email us at what a health tech atradarhealthcare.com.
