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The National Health Executive Podcast is the perfect place to garner insights from across all aspects of healthcare, as we get into the crucial ‘whys’ behind the stories and how they can impact all of us to improve our work, our lives and the care and services we provide as an industry.
Tune in, discover more about our diverse and talented health sector and it may well spark the solution to help you see a problem or challenge in a new light.
There's been significant investments over the years in electronic scribing, and electronic health records. And the next step is really understanding how automation can become a key foundation. What we've seen over the years is hospitals will make an investment in a system, but they might not invest in the people. I think there's a real opportunity for sharing data sharing best practice, and working at scale to start driving economies.
This is the National Health executive podcast bringing you views, insight and conversation from leaders across the health sector, presented by Louie Morris
Hello, and welcome back. Today, I'm delighted to be joined by Ed Platt, who is the UK commercial director at Omnicell. We all know how important it is our staff can work with digital systems. Well, how important is it in your opinion that said digital systems can work with each other?
I think it's absolutely critical. I mean, if you look over the last, you know, 1020 years of the NHS, you see hospitals and trusts investing in large eddy electronic patient record systems or electronic prescribing systems, or data management systems. And invariably, when you start to look at how they can really be optimised and how they can really be used to the best of their value. There are gaps, I can give you some examples in the field that we work in, where you have, you know, an organisation that's invested very heavily in a in a health record system, yet it doesn't communicate with pharmacy management system. So a large element of the business case will have been around the introduction of electronic prescribing and digital solutions. Yeah, pharmacy end up in a position where they're having to manually transcribe prescriptions into their pharmacy management system, which whilst maybe not quite negating some of the the benefit does move risk and resource and workload into another sector. And I think it's also important when we start looking to the next three 510 years and beyond, you know, sometimes it takes 15 years, I think I read for the NHS to embed a new clinical service. So decisions that are taken today need to be very much taken with a view or in what's our 10 year five year strategy. And you know, is this aligned is this system able to integrate? I think you're seeing a lot more now, with the use of HL seven and fire standards, and adoption of things like demon decoding and JSON standards to allow for common identifiers, which means the ability and the ease of integration is higher. But there's still a lot of an awful lot of unpicking and legacy systems and challenges that need thinking about today. And not my experience as a supplier is often you know, it takes two companies or three, I should say, three parties to be able to integrate together you have the, you know, on the sale or the supplier, you have then the incumbent system that they need to integrate integrate with. And then you have the trust, understanding how that data flows. And if those three things aren't aligned, then you're going to struggle. And you know, quite often you find, unfortunately, that the due diligence, and the work isn't done to ensure that the best long term outcome is considered.
So in terms of interoperability from Omni sales perspective, you mentioned some examples, the where and how, and when do you think are the biggest opportunities to really leverage this for the NHS?
An ominous perspective, I would say it's around the digitalization of the medicines pathway. So there's been significant investments over the years in electronic prescribing and electronic health records. And the next step is really understanding how automation can become a key foundation in digitalizing medicines pathway. And what we're seeing now, which is really I think, starting to see really quite exciting is the D and D standards that I mentioned before, and the adoption of HL seven. And also, I think the growing awareness and the benefits of automation in the market is that more and more trusts are now saying we want to connect our prescribing system with our automation partner. And what happens there is that you start getting 3456 10 trusts all actually coming together and applying pressure onto the relevant suppliers to start delivering this because most suppliers or all suppliers will behave in a commercial way. And they probably don't want to develop a one off. They want to be able to develop something that is repeatable and supportable and puts in place a very strong foundation. So we're starting to see more trust going live and we're starting to go live as well with more integration with the different providers on the market and you think that there might be 20 different electronic prescribing or EPR providers on the market. That's a lot of different Types of integration to support. So with DND standards, we can start looking at common denominators, common naming conventions, and start to really look at how we can add value in that medicines care pathway. And that's that's really then about providing visibility. Because if you've got the interoperability, then you start getting the data. And if you've also got the interoperability, then you can start optimising the workflow. And if you're able to optimise the workflow, and the nursing and clinician staffs can see why that workflow is adding value to them, then the data can be relied upon. And then when you start getting reliable data, you can start applying analytics and machine learning. And using sort of predictive and prescriptive analytics to understand what you should be doing. So you know, for example, do I have enough doses available to support the administration's required for my patients? Yes or No? If no, then it can be quite straightforward to I need to make an additional supply for these critical meds so that I don't have delayed or miss doses. Likewise, you know, if we've got an increase in activity, or you know, there's a, there's a breakout of a seasonal flu or something like that, it allows a hospital to have early access and understanding of what's going on. And that early warning and early visibility allows them to, again, to take positive action, and be proactive, rather than reactive. And I think that makes a huge change to the level of service that can be delivered for patients, because ultimately, you know, we want to be putting the patient at the centre of what we're doing, we want to make sure that the medicines that they require the clinical supplies that they require, are there as and when they need them.
You mentioned earlier, you've gone live in a few places. Have you got any practical examples of how Omnicell has been able to help the NHS? Where did it happen? How did it happen? What did he do, etc.
Yeah, there's there's probably two, I think that would be really useful to mention. One would be the University of hospitals, Coventry, and Warwickshire. So they've got a large deployments of Omnicell systems pretty much on all their wards. And we were able to provide them some reports focused on COVID on medicines related to COVID. So what effectively Omnicell was doing was identifying when there was an increase in the consumptions of medicines related to COVID. And as a result of that, what the pharmacy department were able to ensure was that they did not have a single missed dose of a COVID medication during the entire pandemic. And I think if you put that in isolation, that's a really, really powerful story. And then the other one that I mentioned would probably be guys in St. Thomas's in London. And they were probably, you know, one of the hardest hit trusts, in terms of activity and admissions. And they were able to increase their number of beds, you know, over in a matter of days in their critical care, and flex their Omnicell solutions for both clinical supply management and medicines management. And that ensured that they were able to have the right product in the right place at the right time, and be able to engage and work with their suppliers to ensure that the suppliers were aware of what the demand was going to be. And really, again, make sure they were protecting both their staff, but also, you know, the patients who were being admitted, and we're going up. So I think in both instances, you've got really good examples and how the use of technology and the use of data coming from that technology protected and probably improved patient outcomes.
II mentioned the right place the right time. And that's become a bit of a mantra thing at chess, if it gets gearshift get it right first time. Yeah, it's become a real big thing for NHS, I suppose that's something that you would support as well, in our Michelle is getting it right the first time.
Yeah, I mean, I think there's there's a few things in that. So it's not just about the installation of technology and the use of data. It's also around the education and the change management. You know, what we've seen over the years is hospitals will make an investment in a system, but they might not invest in the people either to manage the system or the people who are going to be using the system. And that isn't just a process that happens when you instal something, but it's an ongoing year on year process, you know, that education, that recertification of training, that change management, really sort of embedding the services to support the technology is essential. You know, what, what we've seen in some customers where we've been learning as a business as well are thinking how best to do that, but in spending some of our early customers is that they start to maybe through change of staff or agency and blob agency and bank staff coming on is that the sort of the adoption and the quality starts to reduce. So it's really important I think that the private sector and the the NHS partner to make sure that that high level and the reason they invested in it is maintained and and continues. So you need to get the design the understanding of why are we doing this? What are we trying to achieve? You know what's The data quality that we're putting into the system, what's the data structure that we're using, really understand the why and the as is. And then to the point of, you know, gearshift. Make sure that when we implement and when we start building and executing this, that we do get it right, because I think if you get it wrong, or maybe, to be slightly fair, if you don't get it quite right, the energy and effort to go back in and try and amend and change, and, you know, cause correctively, like, is a lot harder and a lot more demanding.
Yeah, you mentioned investment now. And obviously, as a supplier, you know, investments are huge, you know, it's a huge deal. It's an entire point. But how important is from your perspective that the NHS continues to invest in technologies like this to drive outcomes, secure patient safety, but that's against the backdrop of, you know, there's no magic money tree, there's not endless amounts of cash. So how would you balance that? Do you think?
I think there's a few ways. I mean, obviously, I think any investment that the NHS makes, they need to ensure that they're managing and mitigating any risk. So you know, the first would be, you know, is the technology that we're investing in and installing the right technology for us. We talked about interoperability can integrate, can it work and optimise the systems that we're using today to kind of improve what we've got today, while also addressing problems and pain points that we've got. So we need to make sure we're putting and doing the right thing, we then need to make sure to go back to the change management piece that we were supporting the people. And we've got the processes, right to make sure that they adopt that. And then we need to be better at measuring the return on investment. So actually, understanding has this investment paid for itself. And how's it going to do that. And one of the things that we're doing in Omnicell is, you know, historically, I think we've sold our solutions as as a capital investment. And it tends to vary hospital to hospital, whether they prefer capital lease. But one of the new innovations we've introduced to really help the NHS deal with the lack and support, the lack of investment is around managed service. And that's where, you know, we provide the technology that the hospitals need to them. But we also provide the wraparound services, the data analytics and the support to ensure it is successful, and that it is a true partnership. And then from a return on investment perspective, what we want to do is make sure that that service, and that use of the technology actually pays for itself each year, year on year, and that we're doing that continuous improvement, and that we're looking at identifying new opportunities. And we're always challenging and trying to drive and improve and move forward. So I think it's both ensuring that the technology we adopt is the right technology, and it's being thoughtful in terms of what we're trying to achieve, and the reasons why we're doing what we're doing. But then the other part, I think is how can, the private sector will be creative to support the NHS and become a true partner, and actually be there at the coalface be there, supporting, you know, with with adoption with new starters, with education, and sort of not walking away and leaving the hospital to because we have expertise that we want to leverage and use that experience to, you know, the NHS has benefit. And I think that's the hopefully the recipe for success. And I think where that works, well, you really start seeing the benefits coming through like the likes of Coventry and guys in St. Thomas's,
I suppose it's about being future proof of the NHS, I think there's a Health Foundation report came out recently that predicted a major surge in ill health and 2040 point being, you know, these problems aren't going away that the NHS is always going to have to care for people. So if a partner can really will partner with the NHS for a long period, that's beneficial to them, obviously
100% I mean, I mentioned earlier that, you know, it can take 15 years to set up a clinical service. So, again, you know, what, what we say to hospitals, you know, a decision that you're making today, or technology you're making today to invest in, is actually a decision for 10 years, at least, you know, if you look at the typical lifecycle of IT systems and what have you in in the hospitals, and that shouldn't be taken lightly, it needs to consider where are we going to be in five years? Where are we going to be in 10 years? You know, what, what's the forecast around, you know, clinical vacancies? How do we use data better, I mean, if I, if you go to a lot of hospitals today, where if they're looking at data from their systems, invariably, it's exported into Excel spreadsheets, it's looking into the past, it might be taken from a number of different systems into Excel. And you have to be, you know, pretty creative with pivot tables and macros and things like that in Excel to be able to understand and make decisions, or at least what the under the data is telling you. And what you know, in the private sector can really help with is looking at that data and understanding how that can impact and drive decisions for tomorrow. And what the you know, the lessons of history can tell us but also what the integration we can do, can advise us and support us on when it comes to forward planning and looking to the future. So I think you know, as you said, when you look at you know, Patients are living longer, there's more multi morbidities that patients have length of stay are probably shorter, but patients are more medicines. It's more complex surgeries, more complex clinical vacancies are on the rise. We've still got elective recovery, you know, there's less cash in the system. You know, these are really, really difficult challenges and how can the NHS or hospital or an ICS system level really addressed them? And, you know, if you look now, the sort of the role of the integrated care system, and integrated care boards, I think there's a real opportunity for sharing data sharing best practice, and working at scale to start driving economies out of the system. And, you know, obviously, I think we're quite well positioned or very well positioned to be able to support us on delivering that in terms of going back to get it first, right, who right times, you know, why can't we understand that way of working in every hospital in that ICS? Why can't we have a best practice? How do we create KPIs that allow us to benchmark across the region? On what good looks like? And how do we bring up awards or other areas to those same standards? And how do we continuously try and drive forward and improve in what we're doing?
Absolutely. And correct me if I'm wrong, dad, but I was doing some research earlier. And I found that you're four years old from NHS patient safety strategy, and NHS England is estimating that it's so far helped save 500 lives per year and about 50 million in savings. And it brought me to think are the NHS is only sales goals just aligned is all about patient health, is that what we're talking about the end of the day,
I think it's how you balance and how you spend, you know, your your pound wisely. And I think often the first thought is, you know, we need to spend it on something that's going to save money. And that's the first thought. Whereas intuitively, if we spend it on patient safety, patient facing activities, or solutions or services, that are a natural byproduct of being more efficient, being safer, releasing clinical time, making sure we've got the right product in the right place, for the patient, that will naturally have benefits, and cash releasing. So not only will it cost, but it will actually, you know, have a demonstrable effect on patient safety. And, you know, we see that when we work with a lot of hospitals. And sometimes it's difficult because you know, not everything that is an issue is reported. There was the Jeremy Hunt commissioned article around, you know, 237 million medicine errors in the NHS each year, you know, and that still said, they felt that they were underreported, so a lot of underreporting goes on. So it's, you know, how can we put in place better systems, better processes to really address and drive that. And that then comes back to, you know, understanding what we're trying to do integrations and making sure we're sharing data so that people have early warning or early sight, and they can actually avoid them. I mean, it was a really interesting, I think it might have been in London, Northwest healthcare, where they have some of our systems under medicine was prescribed for a particular patient and on the Omnicell system, it said, you know, have you done this particular risk assessment. And the nurse then thought, Oh, I'll go and check, because I've had this prompt and found out that that risk assessment hadn't actually happened. Now, you know, what might that's that might have been picked up at a later stage, you don't know. But if it hadn't been picked up, then you don't quite know what the cause or what the outcome of that mistake would have been. And that error would have mean thing. So if we're able to put, you know those systems in place that stop and prevent and warn, but also, at the same time, if that saves clinical time, and then you know, as a clinician or a nurse, if I have more time to care for my patient, then naturally, I'm not going to make as many mistakes, I'm going to be able to deliver higher care of standard higher standard of care. And again, that might lead to you know, faster discharge times less readmissions, really helping to sort of improve and drive and optimise the service overall. So I think that, you know, the National Patient Safety agenda is doing some great is some great things. But, you know, the opportunity there is to really, you know, leap forward, I think now, because it feels like the bedrocks in the infrastructure are there to make some radical and significant changes.
Well, that's what struck me when I was I was doing some research but Omnicell is that of course, patient safety is is is the main factor, but the founding of Omnicell was and correct me if I'm wrong, he was somebody taking their loved one in to the hospital and then finding the way that the pharmaceutical products and treatments were carried and passed over was really inconsistent. I believe that's correct. And that then spurred them on to like Cray Omnicell and do all this. We said watch about the suppose the clinicians and helping them help patients is what I guess it's all about.
That story is about our CEO and founder Randall lips and quite right he was in hospital, his daughter was being treated and he was stood there and he noticed that the clinicians were looking For the products that they needed, I think they were looking for maybe sort of catheters and some other items, and they couldn't find them. And I think, you know, he then thinks to himself, you know, and it may be, it's fairly obvious when when you sort of sit here today talking, you know, there must be a better way of doing this. So he then, you know, went off to his carriage, I think, as a lot of entrepreneurs, did started developing the first automated dispensing cabinet, and brought that to market in 1992. And, you know, now we've got over 2000 systems in the UK, you know, and, and that story, and that, that observation still stands true today, you know, I can go to a theatre department or I can go toward and you can see staff looking for products. I mean, there's a great example, I was in a acute hospital a few weeks ago, and they had, I think it was an ophthalmology theatre. And they identified that the surgeon had been scheduled didn't necessarily have the right number of minutes to be doing the cases. So they had to find another surgeon who was down, I think, in a&e to come up and do the procedures. Now, this was only identified because the clinical staff had spent the first hour setting up and looking for stock to do their cases. Now, if that stock had been in the right place at the right time, then that missing all that news to the surgeon who is required could have been found an hour earlier, which means the clinical staff would have started their procedures on time, if not earlier, wouldn't necessarily have had to work through their lunch and would have finished earlier. So there wouldn't be as much overtime or burnout in staff. So it's these, you know, little sort of nuggets and stories that I think are really important when it comes to trying to frame the problem, but also, also the opportunity. I mean, how often can you go onto a ward, and you find, you know, nurses looking for particular medicines, they're not available, they have to bring down to pharmacy, you know, pharmacy then gets disturbed and distracted from what they're doing, that then gets sent up, or the nurses have to go down to pharmacy to get it. And from a patient experience or you know, if you're a friend or relative with a patient, you know, you can see all this going on. And it doesn't necessarily build the confidence that you want when everybody wants to be doing the right thing. They want to be caring for their patients, and we need to put in place the infrastructure to help them do that.
I just want to give you an opportunity, because we've gone all over on this sort of conversation, we've gone from here to there. If you want the listener to take one thing away from this podcast, what would you want it to be? What do you want to say? Headline sort of message? Or do you want it to be?
I think it's that the opportunity for advancing the digitalization of the medicine journey through a hospital is here today through the right systems, the right technology, the right services are on the right workflows. And there are pockets and examples of hospitals doing this today. And I think it's something that should be looked at, you know, at the national level, to really try and drive and institutionalise best practice when it comes to both clinical supply management and medicines management
is certain organisations do want to take up the offer, what would you advise them to do?
Get in contact with us on this, I'll probably also reach out to some of their peers who use the systems but, you know, we're very experienced, you know, coming to hospitals site, looking at their workflows, looking at the process, understanding the systems they're using, and how we can integrate with them. And then sort of designing that digital vision and putting together that roadmap in terms of how that can be achieved over you know, 1234 years. It was not going to happen overnight. And it is a journey, but it's about, you know, recognising that this is a partnership and leveraging the experience and the best practice examples that are out there in the NHS.
Thank you for listening to the National Health executive podcast. We'll catch you next time.
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