Leontina Postelnicu

Cambridge University Hospitals NHS Foundation Trust (CUH) has become the first NHS trust and the first Global Digital Exemplar (GDE) to be revalidated against the new Stage 6 HIMSS Analytics international Electronic Medical Record Adoption Model (EMRAM) standards that came into force at the beginning of the year. The changes were designed to reflect progress in the healthcare technology and information space during the past few years, with the Picture Archiving and Communication System (PACS) requirement, for instance, moved from higher to lower stages of the model (PACS is now part of the Stage 1 criteria, as opposed to Stage 5). New standards were also introduced to ensure that cybersecurity and disaster recovery were “fully recognised as important factors in a modern health service”, John Rayner, Regional Director for Europe and Latin America, HIMSS Analytics, told Healthcare IT News. “In addition, areas of compliance have been increased to raise the bar and to acknowledge the importance of having these critical services hospital-wide, rather than in a single clinical area. As a result of these changes, some hospitals are likely to find achieving the higher stages of the model more challenging than they did prior to January 2018,” Rayner said. Cambridge University Hospitals went live with Epic back in 2014 CUH, which runs Addenbrooke’s Hospital and The Rosie, originally achieved Stage 6 of the EMRAM standards back in 2015, following the creation of its eHospital digital transformation programme. Webinar: Applying Machine Learning to Patient Records to Improve Clinical Recommendations The HITN team visited CUH more than four years after the “big bang” go-live of their Epic EPR,  configured during an 18-month period to incorporate the trust’s clinical workflows and to support local and national guidelines, and found overwhelming support for its digital agenda. Their EPR is now reportedly being used by around 3,400 staff at peak times across all clinical areas, and Luke Bage, Senior Charge Nurse, told HITN that the system “continually seems to improve”.  “The Epic that you see at the beginning of the year is not the same Epic that you see at the end of the year,” said Dr Afzal Chaudhry, Renal Consultant and Chief Clinical Information Officer (CCIO) at the trust. After developing electronic early warning alerts within the EPR, launched in their Emergency Department in 2016 and across all adult inpatient areas at both hospitals in 2017 to ensure that nurses and doctors are notified if a patient’s clinical observations meet sepsis criteria, the trust has seen a 42 per cent reduction in sepsis mortality. In April this year, CUH linked Epic to the Cerner Millennium system used at West Suffolk NHS Foundation Trust, helping clinicians securely access clinical information about a patient held within each other’s EPR to improve quality of care, as figures show that nearly 30 per cent of their patients attend both trusts for treatment. The next month, through a digital primary care portal called EpicCare Link, a similar initiative was launched to help GPs and community nurses securely access clinical information about their patients from within the Epic EPR, currently available at Granta Medical Practices in Cambridgeshire. The Care Everywhere HIE functionality also connects CUH to Epic hospitals around the world and, once University College London Hospitals NHS Foundation Trust and Great Ormond Street Hospital for Children NHS Foundation Trust go live with Epic next spring, the trust will also be connected to them. CUH wants to become the first trust to reach EMRAM Stage 7 in the UK Meanwhile, CUH signed a £107m seven-year contract with Novosco in June to replace and strengthen its infrastructure to take account of “more mobile working, device integration, and accommodate telemedicine, whilst keeping the system secure, protected, and accessible”, according to Chaudhry. The transition process is underway, and the trust now has an ambition to reach Stage 7 of the EMRAM.  “The main things that we would like to focus on are a robust methodology for quality improvement informed by the use of data, so that we’ve got real data-driven analytics to help us understand where we have the greatest opportunities to improve patient care and to measure the beneficial outcomes of that in a sort of continuous improvement cycle,” Chaudhry said. Commenting on today's announcement, Dr Ewen Cameron, CUH Executive Director of Improvement and Transformation, added: “To validate against the new criteria shows how far we have come over the years since we implemented Epic and since our last HIMSS inspection. Our aim now is to further advance our use of technology to provide even greater benefits to our patients and staff and, as a result of doing this, become the first Stage 7 trust in the UK.” Only two other organisations have previously reached Stage 6 of the EMRAM in the UK, Kingston Hospital NHS Foundation Trust and St George's University Hospital NHS Foundation Trust. Twitter: @1Leontina Contact the author: lpostelnicu@himss.org

Former UK science minister Lord Drayson’s Sensyne Health has announced the commercial launch of the GDm-Health solution, developed to enable remote management of gestational diabetes in collaboration with Oxford University Hospitals (OUH) NHS Foundation Trust and the University of Oxford. GDM (gestational diabetes mellitus), a pregnancy-related disease, can lead to adverse maternal and foetal outcomes without close blood glucose control. Sensyne Health’s cloud-based product includes an app that connects to a wireless blood glucose monitor, transmitting data, including measurements or any other notes logged by patients, to a web-based clinical dashboard that care teams can access. It allows patients to speak to the professionals involved in their care directly, and the development of the app follows a two-year long clinical evaluation in the NHS for more than 1,000 women, according to the company. Global Digital Exemplar OUH and its fast follower, Royal Berkshire NHS Foundation Trust, have already made the solution available to patients and their midwives. Batoul Mustafa, who used the app during her pregnancy, said GDm-Health enabled her to have “more personalised antenatal care”.  "The overwhelming positive response to GDm-Health from the NHS and from women with gestational diabetes is testament to its clinically led design and the fact it is technology that is addressing an area of urgent, clinical need. We look forward to its wider adoption in the coming months,” Lord Drayson said. The three other NHS sites that will start implementing GDm-Health are Buckinghamshire Healthcare, Croydon Health Services and Milton Keynes University Hospital. “GDm-Health will allow us to provide more responsive and personalised care to our women with gestational diabetes and we are excited to be one of the first Trusts to implement GDm-Health,” said Erum Khan, Consultant Obsetrician and Gynaecologist at Milton Keynes. Sensyne Health is backed by Sir John Bell, Regius professor of medicine at the University of Oxford and author of the UK’s Life Sciences Industrial Strategy, and former NHS England national medical director Sir Bruce Keogh.

Genomics England has awarded a multi-year contract to Cambridge-headquartered Congenica to provide diagnostic decision support services that will underpin the delivery of the NHS’s world-first initiative to create a national Genomic Medicine Service (GMS). Created through a partnership between the Wellcome Trust Sanger Institute and the NHS, Congenica has established a footprint in the UK, US, and even China since launching, working on their 100k Wellness Pioneer Project. Its clinical genomics interpretation software Sapientia has been validated within the 100,000 Genomes Project, with scientists using it for clinical analysis and genomic interrogation to obtain actionable clinical reports, and the company's new contract to deliver the NHS GMS follows a “competitive tender process”, according to Genomics England. Health and Social Care Secretary Matt Hancock announced earlier this year the ambition to sequence five million genomes in the UK during the next five years, with all seriously ill children and adults with certain rare diseases or hard-to-treat cancers to be offered whole genome sequencing as part of their care starting from next year. “The UK has always been at the forefront of genomic medicine and the launch of the new NHS service further demonstrates this. “The experience that Congenica has gained in working alongside the NHS and Genomics England to achieve this, [sic] puts us in a strong position to expand globally and integrate genomics effectively into other international healthcare systems,” said Dr Andy Richards, Congenica’s Chairman. Towards the end of August, the firm announced that Wendy Britten was appointed as its new Chief Financial Officer, joining them from pharma giant AstraZeneca. “By working with Congenica from the start of the 100,000 Genomes Project, we’ve been able to provide high quality variant interpretation of genome sequences to the NHS, helping deliver benefits to patients at scale. “Now that we are embarking on the next exciting step in our journey to embed genomic medicine in healthcare, Congenica will continue to play an important role with Genomics England in delivering results to clinicians and diagnoses to patients,” said Professor John Mattick, Genomics England Chief Executive.

Bradford Teaching Hospitals NHS Foundation Trust will open an AI-powered command centre at the Bradford Royal Infirmary next spring, thought to be the first of its kind in Europe, through a partnership with GE Healthcare. The trust provides acute and community health inpatient services for approximately 500,000 people from Bradford and the surrounding area in England at the Bradford Royal Infirmary, where its Emergency Centre is based, and St Luke’s, along with three other community hospitals. The new air traffic control-style or NASA-inspired centre is set to provide real-time access to an overview of the 800-bed hospital to help inform decisions on how to manage patient care, with up to 20 staff monitoring a so-called “Wall of Analytics”, pulling data from existing systems. NHS under strain: system facing unprecedented demand With more than 96 per cent of bed capacity at the Bradford infirmary regularly used and 125,000 A&E attendances per year, the new centre is expected to reduce length of stay and the need for additional wards and beds, particularly during winter times. “Demand for services is growing at Bradford Teaching Hospitals every year. The command centre will enable us to optimise our use of resources and improve how we move patients around the hospital for treatment and successful discharge,” said Professor Clive Kay, Chief Executive at the trust. A report published last year by the European Commission found that - excluding beds in the private sector - the UK, Spain, Denmark, and Sweden recorded in 2015 the lowest number of hospital beds relative to the size of their population, with under 300 per 100,000 people, looking at EU member states. Analysis from independent think-tank The King’s Fund indicates that the number of NHS hospital beds in England has more than halved during the past 30 years, while the number of patients being treated has significantly increased. Speaking at an event organised by communications firm Freuds in London back in September, calling for better use of IT in the NHS, NHS England Deputy Chief Executive Matthew Swindells said: “We have a choice, either we reinvent healthcare or we build three hospitals a year. I don’t think building three hospitals a year is what 21st century healthcare looks like.” GE-developed command centres opened in US and Canada GE Healthcare has partnered with a number of healthcare providers to launch several command centres in the US and Canada. At the Baltimore-based Johns Hopkins Medicine, two years since the opening of the Judy Reitz Command Centre, the technology has been linked to a more than 40 per cent improvement in facilitating transfers for patients with complex medical conditions from other hospitals in the region, according to the supplier. These initiatives are different than existing transfer, bed management, and resource centres, the company says, because they are “multi-purpose and scalable”, managing “patient safety and experience”, including “predictive and prescriptive decision support tools, not just dashboards from IT systems”. “Command centres help to orchestrate the delivery of care across the organisation, bringing consistency to processes, prioritising actions, eliminating waste and predicting tomorrow’s pressure points,” said Mark Ebbens, European Command Centre Lead at GE Healthcare. Healthcare IT News reported earlier this year that GE spun off its healthcare business as a separate company towards the end of June, after recording more than $19bn in revenue in 2017. The total value of the procurement at Bradford Teaching Hospitals is estimated to cost around £5.5m, excluding VAT, according to a contract award notice published at the beginning of October.

As compliance continues to be a point of concern, we take a look at the implications of GDPR for UK health and care.

The National Health Service announced that Robert Coles will serve in the newly created chief information security officer role.

The National Health Service in England has announced two new innovator programs to accelerate the use of digital health tools that benefit patients and remove barriers slowing adoption of innovation.  NHS England is funding a small number of proven innovations through the Innovation Technology Payment (ITP) 2019/20, part of a wider effort led in collaboration with the country's Academic Health Science Networks. Solutions eligible for the programme have to be used in at least three NHS sites and demonstrate the potential for a return on investment within a year of deployment. A PUBLIC report published earlier this year, authored by former Health Minister Nicola Blackwood, found that partial interoperability and poor procurement practices were some of the key hurdles to selling new tech into the NHS, making the health service a 'challenging digital terrain'.  Recent innovations selected to take part in the ITP scheme include the HeartFlow FFRct (fractional flow reserve) Analysis technology from California-based company HeartFlow, which uses data from CT scans to create a personalised 3D model of the coronary arteries and then analyse the impact of blockages on blood flow to help clinicians diagnose coronary artery disease by eliminating the need for patients to undergo invasive procedures. Applications are also open for the 4th call of the NHS Innovation Accelerator (NIA), providing bespoke support, aimed at innovators whose solutions are addressing one or more of the following priorities: prevention and early diagnosis, mental health, and primary care. “These two programmes will allow exciting innovations to flourish and spread as NHS England is once again prepared to support innovators and foot the bill for a select group of products so patients can benefit faster,” said Professor Tony Young, NHS England National Clinical Lead for Innovation. Innovations supported through the last round of the NIA include Healthy.io’s Dip.io tool, a home-based urinalysis kit that turns a smartphone into a clinical-grade diagnostic device. The start-up, which recently received FDA 510(k) clearance for Dip.io, announced in June that it was partnering with the UK's Salford Royal NHS Foundation Trust in a project known as the ‘virtual renal clinic’. “Technology has the potential to transform healthcare and we must do all we can to break down the barriers that prevent patients from accessing the best possible treatment," added Health Minister Lord O'Shaughnessy.  Innovators have until 3 October to apply for the ITP programme and until 24 October to submit their applications for the NIA.  .jumbotron{ background-image: url("https://www.healthcareitnews.com/sites/default/files/u2231/Innovation-month-jumbotron.jpg"); background-size: cover; color: white; } .jumbotron h2{ color: white; } Focus on Innovation In September, we take a deep dive into the cutting-edge development and disruption of healthcare innovation.

Countries around the globe are dealing with legacy fax machines and the UK organization is looking to get rid of its devices by 2019.

The machine learning model uses 600 variables with patient's data whereas human-constructed models made predictions based on 27, researchers say.

The UK agency said the goal is to provide access to genetic testing to drive personalized treatments and enable interventions for the whole country.