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Advances in technology can help to change patient care for the better and Jeffrey Wood, deputy director of ICT at Princess Alexandra Hospital NHS Trust, is fulfilling a long-held ambition to turn digital transformation into a life-changing process.
Wood recognises that his career history is more varied than that of most IT executives. After starting out in the Royal Navy, he moved into the private sector and worked for a range of companies, including a series of financial services firms. After working in local government, and a six-year stint with Essex County Council, he joined the trust in 2018.
“At that time, local authorities and health organisations were starting to have more joined-up discussions,” he says. “I started to get involved in the health side of things. My wife is a nurse, and seeing the frustrations and problems she has on a daily basis, I felt I could do something positive.”
Wood was given the opportunity to put his plan for proactive change into action at the trust, which includes the Princess Alexandra Hospital in Harlow, the Herts and Essex Hospital in Bishop’s Stortford, and St Margaret’s Hospital in Epping. He says the past few years have involved creating a more technology-enabled organisation.
“A lot of the early years when I joined were about restructuring the IT department and putting in place some big changes to make us more agile,” he says. “And then, when Covid-19 came, I was glad we’d started all that work because it paid off. Everybody could take laptops home, so our technology was working a lot better.”
Wood’s team is now pushing on and thinking about how to take advantage of a whole host of technological advances, from headsets to holograms to mobile devices.
“There’s so much more that can be done and that we’ve still got to do,” he says. “We’ve got so many plans and so many ideas. It’s all about moving us into the digital age.”
“We’ve got so many plans and so many ideas. It’s all about moving us into the digital age”
Jeffrey Wood, Princess Alexandra Hospital NHS Trust
As well as serving the local area, the trust’s hospitals deal with patients sent from London. Princess Alexandra is also the designated hospital for Stansted Airport. The trust is currently building a brand-new hospital on a brand-new site in Harlow.
“That gives us a lot of ability to do proofs of concept, to make some changes and invest in technology, so that the new hospital will be the most technologically advanced in Europe when it opens,” says Wood.
In fact, the trust is already undertaking pioneering trials. One of these involves a Microsoft HoloLens proof of concept, which is intended to create a virtual ward round. The technology would mean that instead of 10 or 15 people standing around a bed talking to the patient, the trust would only need one person to go out and talk to the patient using a headset. Everyone else would be able to see the conversation via personal devices.
Wood says the technology could provide a boost to training processes. He gives the example of maternity wards, where the only effective way for junior staff to get to grips with work requirements is to see what happens in practice.
“When there are complications, you have to call somebody in,” he says. “Having half a dozen people standing around a patient who is giving birth is not ideal for anybody. The HoloLens just gives that advantage. If people come across something, they can go for a second opinion almost immediately.”
Wood’s team also hopes to tie the technology to its continuing development efforts around electronic health records and its collaboration platforms, including Microsoft Teams.
“Staff will see all the data in front of them,” he says. “They won’t have to go back to a computer. The information will be there.”
Taking the strain virtually
Another pioneering trial includes the introduction of a holographic virtual receptionist. Wood says his team is currently working on this project with a range of technology partners. The project was due to go live last year but was delayed because of Covid.
“Hospitals can have difficulties with language barriers,” he says. “This technology gives us a facility to augment our existing receptionists and allows people to be directed around the hospital in their own language. Because it’s a hologram, it’ll be able to do sign language as well.”
Wood says the long-term aim is to create a kiosk where people interact with the hologram and are automatically directed to the right location in the hospital. By allying the virtual receptionist to human staff, he expects to reduce the strain on people at the front desk and boost their productivity.
Some of the projects Wood’s team has been involved in during the past few years, such as the introduction of electronic health records, will provide a platform for further advances. Major infrastructure work also included ripping out a 1989 telephone network and replacing it with a cloud-based, voice-over IP system.
Wood says the trust’s developers are investigating other areas, including how they might exploit robotic process automation. What is clear, he says, is that the rate of transformation is significant, with “massive amounts of change”.
Overcoming significant challenges
These technological advances are a huge step forward when compared to the level of digitisation Wood inherited when he joined the trust in 2018. During his time at the organisation, he has helped to oversee a multi-pronged digital transformation programme that covers hardware, software and data.
Four years ago, more than 65% of the trust’s hardware was at least seven years old, despite the organisation having a five-year IT refresh policy. There was also a heavy reliance on desktops rather than laptops. Wood and his team met these challenges head-on.
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The trust has moved to Microsoft Office 365 and, like so many other organisations, has become a heavy user of Teams. During the past two years, these investments have helped to ensure patient care has been prioritised at a time of crisis – but that process also meant a great deal of hard work for Wood and his team.
“Covid put the focus on IT and showed how technology could assist in the crucial work that the trust undertakes,” he says. “But, of course, that meant a lot of my staff were working six or even seven days a week, and sometimes 10-hour days, myself included, to try to assist and push things out.”
Those IT developments included providing support to patients and families in the most challenging circumstances. “We were using iPads so that people at home could talk to their relatives in hospital in a socially distanced manner, which was tough,” he says. “It was an end-of-life situation for many of these people.”
Maintaining IT equipment was also a challenge. Covid restrictions meant some wards became out-of-bounds areas. Some of the IT team’s office space, meanwhile, was turned into clinical space to help deal with the influx of patients.
“It was a really tough time,” says Wood. “The team worked incredibly hard and I’m very proud of everything they did.”
Creating a new approach to service
Another key project during the past year has been the introduction of tighter IT service management (ITSM) across the trust through the implementation of Freshworks technology.
The trust is using the cloud-based ITSM platform Freshservice. Wood says the technology allows the trust to improve the management of its hardware assets, boost the quality of processes associated to the procurement of new kit, and give staff with IT issues the opportunity to self-serve.
His team used to receive hundreds of IT requests every day, some of which involved common problems, such as password resets. Now, the Freshservice software redirects users to a site where they can complete an automated password reset. The platform also holds frequently asked questions to guide users when they have other IT issues.
The platform provides analytics data, which Wood’s team is using to hone its self-service approach. Now, most IT problems are dealt with automatically by users, which means healthcare staff are not held up by IT problems and the technology department can direct its resources to areas that have a direct impact on patient care.
“The one thing we use the most as a department is our IT service management tool,” says Wood. “Having the right tool in place to help us get through all the change processes that we’re undertaking just makes everything much easier.”
Pushing new advances
Two years from now, Woods envisages that a lot of the trust’s pioneering proof-of-concept work will have transitioned into an accepted way of operating.
“The pagers and bleeps will be gone, and we’ll be using iPhones and iPads to communicate,” he says. “There won’t be that stigma, like there was in the past, where nurses were not allowed to carry phones around with them.”
The trust is exploring how the Apple Watch can be used to keep nursing staff informed and updated. Wood explains that nurses aren’t allowed to wear any items below their elbows, so the trust is replacing key fobs with new ones that include Apple Watches. “Using this technology, nurses can be communicated with so much more easily than before,” he says.
As the trust has already replaced its phone lines with voice-over IP technology, Wood says another priority will be to ensure high levels of resilience across the network. His team also aims to replace point solutions across the trust – which currently number as many as 300 applications – with a single, integrated electronic health record.
“There won’t be pieces of paper lying around here, there and everywhere, which is a major problem for an organisation like ours,” he says. “I think digitising and automating a lot of what the trust does will give us a technological platform that is ready for the new hospital.”