Digital Agility in the NHS

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Strategy, planning – including business cases, simulation and modelling and procurement.

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Many NHS and associate care providers face an ongoing challenge from investing millions on major healthcare IT systems only to find that by the time they have been rolled out that evolving needs of an organisation and its patients have rendered it either obsolete or requiring significant optimisation.

Digital agility is becoming more important since healthcare organisations cannot afford the impact of waiting so long for a large-scale digital solution, such as an EPR, to become available.

Consider this question to why is it important? Can organisations wait up to two years (which is typical to move from business cases, through procurement and implementation) before starting the process of starting to realise the benefits?

Many digital health systems are implemented and then become part of the fabric of the healthcare organisation using them. The prospect of changing them fills many with dread, even when they might not be fit for purpose or are hindering the broader adoption of technology enablers that improve efficiency, drive integration and deliver better patient care.

Legacy systems, particularly ones that an organisation manages most of its activity such as a PAS or an EPR can become inhibitors to Trusts moving forward with improving digital maturity. This isn’t simply a question of interoperability. It is about configurations, how they are used, training and sometimes being unaware of their capabilities.

Has the global digital exemplar program helped? Partly, but I think many of the blueprints produced will only go so far in addressing some of these issues and even then, they will likely need significant tailoring to make them work from Trust to Trust – the variables between Trusts will dictate this.

However, replacing them is simply too costly, too time consuming and there is a lack of resources to effectively manage the change program involved. This leads to self-limitation in being able to adopt new technologies and the pace of change is slowed.

What happens during that time to plan for, procure and implement a new enterprise level system, like an EPR of in terms of improving digital maturity and clinical care? NHS organisations are not in a position to wait that long while facing constant pressure on resources, budgets and having to adopt new models of care and meet integrated care initiatives.

The answer has to be to try and have your cake and eat it. That is drive on with improving digital maturity but consider improving digital agility as well. This means providing focus on building around and utilising as much of the current and legacy infrastructure and systems already in place and then create a plan to fill gaps, improve workflows and governance alongside targeted investment.

This creates an environment where change is manageable, benefits are quickly released and realised, and sustainable solutions are delivered in the most cost- effective way.

There is undoubtedly a middle ground where investing in digital agility can deliver real benefits (including the ever-elusive cash releasing variety) alongside the large scale, evolutionary jumps often seen as the only way to improving digital maturity. Don’t get too distracted by those big shiny baubles!

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