Liz Howarth: Perfect Patient Pathway

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Liz Howarth, Programme Director, Perfect Patient Pathway, discusses Sheffield's test bed programme and the work of its innovation hub to improve the lives of people with long-term conditions through technology.

This presentation was recorded at our Digital Health and Care Congress 2017 on 11 July 2017.


We’re really fortunate actually because we’ve sort of designed and built this what we call innovation hub which is a space, it’s actually in one of the hospitals in Sheffield, but in itself it’s quite interesting because I think it’s sort of created a different dynamic for how we’re working and as you’ll see on that slide, you know, alongside other colleagues up here, we link into sort of a clinical network of people helping us with the programme, a patient network, the innovators that we’re working with and we’re working with fourteen innovator companies at the moment and a sort of an expertise network which we’re reaching out sort of nationally and actually globally in terms of whose doing this, where they’re doing this, what can we learn from it.

In terms of the space that we’ve got as  a programme, we’re really fortunate because we are using it to sort of test things and simulate and try things out before we sort of launch full scale onto sort of real world, which is proving really valuable in terms of being able to pick up things really quite quickly and find out some of the issues that we may not have thought about to begin with that we need to tackle and tackle before we put it into that first GP practice, or we try it in a first clinic. 

And I think it has quite a different feel about it in terms of people, we bring patients into that space, we bring clinicians into this space and I just say to you, it’s an interesting sort of dynamic, the environment sometimes, when you’re working in programmes of kind of where you physically are. 

And this has come up, certainly yesterday and again this morning, we are part of a formal evaluation process to test the programme which is about the outcomes, it’s about the economic evaluation, but certainly as a programme we’ve recognised there’s other things that we need to evaluate and we need to evaluate as we go along, and it is about the project and the value proposition and being really clear about the innovators that we work with, what are the products and the value that they will bring to the programme, to the patients, to the outcomes that we’re trying to achieve. 

We’ve had to do and like I say, we’ve been able to do this in our innovation hub in terms of looking at the technology of, we might be starting small scale, but what would happen if we scaled up quickly, how can you respond to that?  Are we absolutely clear on some of the quality standards?  The other thing that’s been really interesting, which links to the clinical environment as well, was some of the technology, you know are we ready for it?  And you know, if you’re working in a GP practice which you found that not all GP practices have Wi-Fi, what are we actually going to do about that because this is a real way of testing.  So, you know, and it happens, so it’s really interesting in being able to kind of think about that and how do you evaluate that?

Come on to the clinical environment; again this has been really interesting in terms of almost the ideal; where would you want to do things ideally?  Then recognising we’ve got twelve months in reality to implement this and what is the best clinical environment and at the moment we’ve got a combination of doing things in primary care, in secondary care and in care homes.  Very different clinical environments for each of those and again we’re learning a lot.  Not just in terms of from a technical perspective and how people are using devices and adapting to change, but also it’s giving insight into almost daily life in some of the clinical environment.  Certainly, care homes which has been really interesting in terms of the reality of members of staff working in a care home and the pressure that they’re under, and that’s been really, really valuable learning.  Not just to say this with the deployment of the technology.

And as you’d imagine, we’re looking at then overall what are the benefits.  So, we’ve got formal evaluation, but we’re trying to look beyond that in terms of what are the benefits in terms of, and methodology and approach.  How we can replication this, how do you scale up what we’re trying to do and just a little bit, the final thing I’ll say about this is that what we’ve done as well as a team, within that sort of approach to putting this into place, is to work through a kind of very sort of rapid deployment process which starts with what are the problems we’re trying to solve? And that has been the starting point for every project that we’ve done.  It’s like what are the problems we’re trying to solve here?  And how do you quickly go through from innovator companies that may want to work with us and put in an expression of interest, how do you go through very almost rapid due diligence and what is the right due diligence when you’re trying to do something at speed, through to how do you test before you launch in the real world.

Like I say, we’ve done that in our sort of lab.  How do you get the right deployment plan in place to do something at speed which as many of us in this room may know, is really, really difficult because you are, it’s not just about the what, but it is about the trust, it is about the behaviours, it is about the culture change.  

And then I think for ourselves, we’re coming through to that and how do you best disseminate in terms of what we’re finding, the learning, the kind of capacity and capability that we’re building as a team that the test bed has a certain life cycle at the moment, but how do you then build that into other teams, into the STP areas, into the countable care systems in terms of an approach and a methodology that hopefully will build from the momentum that we’re gathering now.