Danish health tech supplier, Dawn Health has launched a new app to help support breast cancer patients throughout their treatment journey.

The Cora BC app was developed in collaboration with pharmaceutical company, Novartis, with the aim to keep breast cancer patients informed on their treatment, while also giving them the ability to track their health with “clarity and insight into their experiences”.

The app is set to launch in Germany with plans to expand to the UK, Canada and Australia. Its capabilities include the ability to send medication and appointment reminders as well as personalised content that reflects the needs of the patient. The app can also be used for regular check-ins and visualising patient progress to help users “better understand their journey and feel more in control”.

Other areas of focus include educating breast cancer patients by offering access to key information and advice, while also allowing them to make diary entries in preparation for future consultations as a way to create “more productive and informed discussions with healthcare professionals”.

CEO of Dawn Health, Alexander Mandix Hansen, said: “Cora BC is more than a tool—it’s a step toward better care. By partnering with Novartis, we’re ensuring breast cancer patients have access to the resources and support they need to feel seen, heard, and empowered to achieve the best possible outcomes. This app reflects our shared commitment to innovation and patient-centric care.”

Dawn Health has previously worked with Novartis on the development of two other apps, including Ekiva MS, designed to support patients with multiple sclerosis and Ekiva PNH, designed to help patients with managing paroxysmal nocturnal hemoglobinuria.

Digital healthcare apps: the wider trend 

The NHS recently extended its contract with IBM to continue their work on developing the NHS App with the aim to “create a standard online way for people to access the NHS”.

NHS Cheshire and Merseyside launched a new app to help women across the region find trusted health information. It provides a “convenient one-stop shop for trusted sources of women’s health information”, including advice and guidance on periods, contraception, screening information, menopause, pelvic health, immunisations and pregnancy, as well as all other areas of female health.

EnrichMyCare, an app designed to help healthcare professionals document, manage and coordinate care for children and young people with complex needs, is to be piloted in West Yorkshire. Funded by Innovate UK, it aims to help improve outcomes by minimising health complications, enabling parents.

In a speech last month, Scotland’s First Minister, John Swinney, outlined plans around innovation, the Scottish health and social care app, Hospital at Home, and “better use of data”. On the Scottish health and social care app, Swinney noted the roll-out will start at the end of 2025, beginning initially in Lanarkshire.

NHS England has awarded two new contracts to support the “delivery of large-scale public facing digital services”, for NHS.UK and the wider portfolio including the NHS App and Login.

Technology consultancy company, BJSS Limited has been awarded a three-year contract valued at £37.5m to support the development of the NHS.uk portfolio. This includes working on the NHS App and Login.

Recently, CGI announced the share purchase to acquire BJSS, subject to regulatory approvals and conditions, which is expected to close in February 2025. It means 2,400 consultants and professionals will join CGI.

The second contract has been awarded to IBM to continue their work on developing the NHS App, with the aim to “create a standard online way for people to access the NHS”. This new contract extends their previous agreement, bringing the total value up to £65.5m, as they move closer to the June 2026 end date.

Last week, IBM announced its fourth quarter results, with Arvind Krishna, IBM chairman, president and chief executive officer, commenting: “We closed the year with double-digit revenue growth in software for the quarter, led by further acceleration in Red Hat. Clients globally continue to turn to IBM to transform with AI. Our generative AI book of business now stands at more than $5 billion inception-to-date, up nearly $2 billion quarter over quarter.”

Digital transformation within the NHS: the wider trend 

One of our recent HTN Now webinars, focused on the role of digital in supporting NHS reform. This included modernising services, shifting from hospital to community, and supporting the move from reactive to proactive care. Panel members shared their insights and experience on a range of digital projects, highlighting key details such as what worked well and their learnings.

We recently hosted an expert panel to discuss how general practice, PCNs, and ICBs can utilise data and leverage technology to support operational efficiencies and improvements across primary care.

An expert panel including Deborah El-Sayed, director of transformation and CDIO at Bristol, North Somerset and South Gloucestershire ICB (BNSSG); Dan Bunstone, clinical director at Warrington ICB; Stephen Bromhall, interim chief officer for digital and data at South East Coast Ambulance Service (SEC); and Laura Thompson, director of marketing at The Access Group, also joined us late last year to talk about approaches to tackling challenges from an ICS perspective; new models of care and pathway transformation; the role of technology in supporting the move from reactive to proactive care; and how a system approach can accelerate preventative care.

Digital messaging platform, Alertive secured £3.7 million from private investors to drive its UK expansion. The platform was developed to help with task management and communication within healthcare environments, and is currently being used in 25 hospitals across 15 NHS trusts, with a reported 50,000 users.

Last month, NHS England outlined its NHS cloud strategy, recognising the need for cloud to support modernisation, enable innovation and provide strong foundations. It focuses on exploring the current NHS cloud strategy and adoption plan, offering guidance on migration and exit strategies, policies and best practice.

By Highland Marketing 

The NHS is looking for a new chief information officer, and the Highland Marketing advisory board has been considering what should be on his or her ‘to do’ list.

Following the merger of NHSX and NHS Digital with the NHS England transformation directorate, and the departure of some high-profile digital leaders, the NHS is looking for a new chief information officer.

In the middle of March, NHS England announced that it had appointed John Quinn, the former head of the Medicines and Healthcare products Regulatory Authority, as interim NHS CIO. But there’s no indication when a permanent replacement for Simon Bolton will be found.

The uncertainty has contributed to health tech being – as one member of the Highland Marketing advisory board put it – “in a bit of a mess right now.” Against a paralysing backdrop of elective recovery, demand, financial pressure and strikes, providers and suppliers are trying to work out what the IT strategy is meant to be – and where the resources are going to come from.

As Andy Kinnear, a former CSU CIO who now works for Ethical Healthcare Consulting, put it: “We’re trapped between two worlds. We’ve got this exciting new world of digital that we see in other areas of our lives. And we’ve got this stale, old world of patching critical infrastructure and running after programmes that are run by people who feel a long way from the frontline.”

Quinn, and the new CIO when they are appointed, will have a lot on their desks, and the advisory board highlighted five of their biggest challenges as being to:

Reboot frontline digitisation: The frontline digitisation programme has been billed as an opportunity to complete the roll-out of electronic patient records to hospitals that was started 20 years ago by the National Programme for IT, while encouraging ‘convergence’ on infrastructure and core systems.

However, the Health Service Journal has reported that more than half of the £2.2 billion that was found for the programme in last year’s Autumn Statement has been clawed-back. And there is concern that, in some areas at least, the focus on convergence is skewing priorities in the direction of clusters of trusts adopting the same EPR from a single supplier.

Ian Hogan, chief information officer at the Northern Care Alliance NHS Foundation Trust, said: “NHS England is saying there are about 30 trusts without an EPR but, due to the reduced funding envelope, it looks as if not all will be funded for one. Where does that leave the rest?

“And if we can’t support 30 trusts to get an EPR, how can we support the other trusts to converge on one or two systems? You can make a case for convergence being the right thing to do, but at the moment it is just causing more confusion.”

Pick a future for the NHS App: The NHS has made a considerable investment in the NHS App but has seemed uncertain about what to do with it. Should its developers create their own information and transactional functionality? Or should they focus on providing identity and access services for third-parties?

Or should the NHS let the app become one of many digital access points? The current health and social care secretary, Steve Barclay, seems keen to see the app widely downloaded and used as a ‘digital front door’ to the NHS; and advisory board members thought he should push on.

Neil Perry, a digital health consultant who was, until recently, the director of digital transformation at Dartford and Gravesham NHS Trust, said: “The NHS App had something like 30 million downloads during Covid, so there is clearly an opportunity to build on that. And it should be a digital front door, ideally a nationally provided patient portal, from which the economies of scale would drive down cost and create standardisation. But more than a patient portal, key apps should be integrated and funded nationally, such as AI assisted diagnosis & symptom checkers that can reduce the overall burden on GPs, UTCs and emergency departments. All this would democratise patient facing tech across the UK.”

Advisory board chair Jeremy Nettle is passionate about this agenda. “I remember thinking, years ago, when we first heard that the ‘information revolution was coming’, that it was more likely to come from the public than the NHS,” he said.

“To some extent, that is happening, with the spread of GP apps and remote monitoring. But we need it to happen faster, because so many people are still ending up in hospital when they could be better treated elsewhere or staying in hospital when they could recover at home.”

Secure the med tech revolution: Medical technology is a hot topic. The government has just published the first-ever strategy to give UK patients access to safe, effective and innovative equipment ranging from syringes to medical scanners and from test kits to home dialysis machines.

Many of these devices will be connected to NHS networks or the public internet in one way or another, and Neil Perry argued there is an urgent need to think about how to regulate and secure them. “The med tech space is really important, but it is a hotch-potch at the moment,” he said. “There’s no consistent adoption, and the NHS needs to invest in making sure these devices are connected, data insights utilised and are made fit for purpose. This can really improve safety, efficiency, and effectiveness, reducing communication errors, increasing accuracy, and enabling faster diagnosis and escalation. I’d argue investing in a med tech Strategy or ‘smart hospitals’ would have a greater impact rather than refreshing a PAS and/or an EPR.”

Stop the talent drain: National leadership for NHS IT has been in flux since the merger of NHSX and NHS Digital was announced. But Andy Kinnear pointed out there have also been some high profile departures from integrated care boards and trusts.

At the same time, the NHS continues to lack the workforce and IT strategies that might help it to secure the digitally savvy clinicians, IT innovators and data analysts it will need in the future. Ian Hogan said: “This is one of the things that keeps me awake at night – alongside the old data centres, and the cyber security.

“The health service has had a cadre of IT leaders who are NHS through and through – I am probably one of them. But there’s fewer and fewer of us. Even when we recruit people, they do the job for a bit and then go somewhere else. It’s not just the money, or the hours, or the complexity. It’s the workload. You do 100-hour weeks to try and stay on top of it, and it’s just not sustainable.”

Reconnect with the frontline: This leads to the question of who the next, substantive NHS CIO should be. In some ways – the board argued – it might not matter. The present government will, almost certainly, be out of office within a couple of years. NHS England looks as if it will spend a good chunk of that time re-organising to cut costs and headcount.

Most of the national capital funding for NHS IT has been earmarked for frontline digitisation and then cut, so only small sums may be available for projects. Probably those that catch ministerial attention, like digital follow-up, or virtual wards, or bed management and patient flow systems – which are suddenly ‘the ‘solution’ for next winter.

As Andy Kinnear put it: “The political forces may be so huge that whoever takes on the job will have virtually no room for manoeuvre.” Even so, members felt it would help if the NHS could find a CIO with frontline experience.

“I think we need somebody who has been at the coalface; somebody who has a proper connection with what it is like to do the job in an acute environment,” said Ian Hogan. “Because it is just tortuous at the moment, and we need somebody who can bring a bit of realism to what is being demanded by the centre and what is possible.”

Pulling IT all together  

The advisory board was divided on whether the merger of NHS England, NHSX, and NHS Digital will be a good thing in the end. Cindy Fedell argued it would be because “we do need IT to be blended with operations” and also “when NHS England says something, chief executives sit up and take note.”

However, entrepreneur Ravi Kumar reiterated that, for the moment: “It feels like the whole digital agenda is on hold. Plans are announced, but nobody backs them up. And the leadership has gone, so nobody fights for that money. Instead, it feels like a culture of survival has taken hold.”

Andy Kinnear argued that while the hiatus continues, the best thing ICB and trust CIOs can do is “crack on” and “use the space to do things locally” – although he wondered where innovation would come from, with SMEs and start-ups finding it so hard to get a toehold in the market and at risk of take-over by bigger players.

Looping back to his opening point, he said: “There is the fourth industrial revolution going on around the NHS, and there is the moribund state of things within it. For me, what the new CIO needs to do most is to provide challenge about that, and to work out a way to get from one world to another.

“They need to start by acknowledging that the past five years have achieved very little, and they need to engage regional and local leaders to be part of the way forward.”

A step-by-step guide to managing the pandemic of multi-morbidity using population health management has been discussed in a blog for NHS England by Dr Helen Davies, GP clinical lead for community and population health management in Calderdale, part of West Yorkshire Integrated Care Board.

Helen explains that evidence shows that healthcare is best delivered as an integrated care system with person-centred care at its heart. She notes that data indicates how multimorbidity is driving demand and cost, with more than one in four adults in England living with two or more conditions, which leads to common issues such as reduced mobility, chronic pain, shrinking social networks, incapacity to engage with work, and lower mental wellbeing.

“To date, these problems have not been well addressed by services or research,” Helen states, adding that there is a tendency to organise services around single conditions, train doctors in specialties, and focus research on one disease at a time.

To address and help people with multiple conditions, Helen writes that innovative ways of intervening are needed which is why there is a need for a population health management (PHM) approach.

Helen shares her step-by-step guide to PHM.

Step one focuses on prioritisation. Helen says: “Use data analysis or community stories to find priority areas such as unwarranted high cost or high demand, or unmet need or inequality of care.”

The wider the linked system data is, the more informed decision making can be. However, “you need to get on with it using your ‘best available insights’. This can be cross referenced to compare against similar practices and areas, such as fingertips data and Joint Strategic Needs Assessment.

Step two is about identification. This focuses on using data analysis to identify a cohort in a priority area to find the best opportunity to improve the efficiency, equity and quality of care.

“This may include a particular condition(s), or more likely a group of conditions or just “comorbidity” or “complex needs” within a geographic area, a particular demographic (age, ethnicity) or those at risk of a hospital or care home admission,” Helen writes.

Understanding is the focus of step three. Helen highlights the importance of using a wide lens to include the broadest range of available insights, and to include the carers or patients voice to understand their specific cohort.

Helen adds how “seeing it from the patient or citizen side will address wider determinants of health and consider health inequalities. Use this broad view to get a clear picture of the existing resources and services.”

Step four highlights design of the new care model. Helen explains questions to ask such as what the needs of the cohort are; what outcomes you need in order to meet those needs; what activities needed to do to achieve them; and what skills and resources are needed to invest those activities.

Implementation is the focus of step five: the how, who, and what involved in making it happen.

“You need to ensure necessary buy-in from system leadership and stakeholder organisations for the support, co-operation and IG processes to deliver the plan. From the start of the plan, measure the outcomes and outputs including both the patient and care provider feedback,” Helen notes.

Finally, for step six, teams must expand and evaluate. Questions focus on reaching the target group; achieving the intended outcomes; what has worked well and what to improve; any changes needed to make; and how to scale up and share the plan.

Helen adds “involve all relevant stakeholders and the patient or citizen at every stage from information gathering, planning and designing to delivery and evaluation. Make sure to combine best laid plans with pragmatic delivery.”

Last year’s Budget set aside £2.1 billion for NHS IT, and the autumn statement confirmed the capital is still there, but it looks like most of the money is headed for Frontline Digitisation. The Highland Marketing advisory board considers how this pattern of putting money into health tech, taking it out again, shaking up the badging, and starting over impacts the market.

There was some anxiety ahead of the autumn statement about what Jeremy Hunt might have in store for health and care. In the event, the chancellor found a headline £3.3 billion for the NHS for the next two years, and £2.8 billion for social care next year, with another £4.7 billion the year after.

Perhaps as importantly, he didn’t axe some major capital projects. The money allocated to the New Hospital Programme, diagnostics, and IT in last year’s Budget is still there. However, that doesn’t mean the huge financial pressure on the NHS has been alleviated, or that there is lots of new, central funding for digital technology.

As Andy Kinnear, a former NHS CIO who works for Ethical Healthcare Consulting, told the Highland Marketing advisory board: “The autumn statement was better than expected, but only because expectations were in the cellar.

“The NHS is getting more money, but that is coming on the top of a decade of contraction. What it needs is investment. What it got is a settlement that takes us back to where we were and stops funding falling in real-terms for the next two-years.”

Budgets and priorities

Last year’s Budget identified £2.1 billion for the “innovative use of digital technology, so hospitals and other care organisations are as connected and efficient as possible.”

Allocation has been on hold, pending the autumn statement. Now it has taken place, the expectation is that most of this funding will go on the Frontline Digitisation programme, which will try to get all acute trusts up to a basic level of digital capability (level 5 on the HIMSS EMRAM maturity model, or an English version known as minimum digital foundations).

Neil Perry, director of digital transformation at Dartford and Gravesham NHS Trust, said: “I am hearing that Frontline Digitisation will be pretty much everything. There will be some money for technology in pots set aside for other NHS England priorities, such as diagnostic hubs, digital outpatients, and perhaps virtual wards. But that’s the priority.”

Tough times for innovators  

This pattern of NHS IT funding being announced, then clawed back or at least delayed, only to be re-announced, often with a new badge on it, is not unusual. Neil Perry described it as the “digital funding hokey-cokey” and argued that it distorts the health tech market.

“Delay is ok for the big companies – the big EPR-vendors – because they can just wait it out,” he said. “The small companies – the innovators – are living on credit, so any delay can push them under, or make them vulnerable to being bought out.”

Radiology expert Rizwan Malik said he was very concerned about SMEs. “I really worry that what we did during Covid to change mindsets is being undone,” he said. “During the pandemic, we had all these small companies come in wanting to help the NHS, and we told them that if they could prove their ideas, we’d work with them.

“They set up pilot after pilot, and now we’re bringing down the shutters.” Entrepreneur Ravi Kumar agreed. “The current situation is causing a lot of disappointment among start-up companies,” he said. “They go to CIOs and find that they are being asked to take money out of operational areas, never mind innovation budgets, and they just don’t buy.”

What next for big tech?  

However, even the big EPR vendors might not be all that happy. Soon after Tim Ferris came to the UK to head up the NHS England transformation directorate, there were reports that he’d suggested buying Epic for all trusts.

While this was never going to happen, Tim Ferris and his chief information officer, Simon Bolton, indicated that they wanted Frontline Digitisation to both level-up acute sector IT and “converge” the systems in use across hospital groups and, possibly, integrated care systems.

The market consensus was that this would suit the ‘megasuite’ or ‘single-supplier’ EPR vendors better than newer entrants with modular offers or data platforms to support ‘best of breed’ strategies. But now the rumour is that NHS England is rowing back, because of the costs involved.

Neil Perry mused: “I wonder what is in it for the big, US vendors. The implication was that there would be a good level of money going into levelling up, and now it’s clear that there won’t be as much as these companies were hoping, and trusts are being told there’s more than one way to HIMSS 5.”

The only certainty is uncertainty  

To add to the uncertainty about funding and policy, there is a general election due in two years. This means Frontline Digitisation money is only confirmed until 2024-5. Yet big EPR contracts tend to run for a decade.

In these circumstances, it wouldn’t be surprising if some finance directors balk at signing up with a single supplier. Which might provide another boost to the modular or best of breed approach.

If it does, the NHS will need both smaller suppliers and in-house expertise to deliver their strategies over an extended period of time. But if SMEs are under pressure, trusts are being asked to make ‘efficiency savings’ that tend to fall on any departments not on the ‘frontline’.

And, as Ravi Kumar pointed out: “If trust people vanish, all the good work that was done during the pandemic to build NHS IT capacity will vanish. Even if you get the money to run projects, the ability to execute them will vanish.”

Be clear about where the money is coming from

Almost every observer of the NHS and social care argues that they need a more stable policy environment in which to operate, with cross-party agreement on what they should be looking to achieve for communities across the UK.

This would make it easier for government to work with central and local organisations on long-term investment plans and for suppliers, including health tech companies, to draw up roadmaps that align with them. As James Norman, a former NHS CIO who now works as EMEA health and life sciences solutions director at Pure Storage, noted, the digital hokey-cokey has real consequences.

“The NHS is living in an environment in which it is constantly promised and then denied funding, to the point where organisations are reluctant to spend strategically when funding does arrive, for fear it will vanish again in future years.

“Confidence needs to be reinstated from the Department of Health and Social Care and NHS England, so that when a commitment to funding technology is made, integrated care systems and trusts can be confident they won’t get left with the bill a year or two down the line.

“Not doing that will just create more pressure in the system to focus on keeping the lights on; and take resources away from planning for the future and implementing those plans.”

However, with the Treasury on its third Budget in a year, the DHSC on its third or fourth secretary of state (with Steve Barclay doing the job twice), and NHS IT leaders bailing out of the merger of NHS England and NHS Digital, stability feels a long way off. If anything, it feels more likely that the digital funding hokey cokey will pick up speed. In this environment, the advisory board suggested, health tech vendors need to help potential customers by finding alternative sources of funding, such as research, or making use of the data in IT systems.

Or they need to find partners that can deliver change across care pathways and release genuine efficiency savings that can be reinvested despite the turmoil that surrounds them.

Darkest hour before the dawn?  

On the last point, Andy Kinnear argued that if there is any upside to the current situation, it is that things are so bad that change is an absolute necessity.

“Perhaps services have to feel the pinch to make them work together and do things in a different way,” he said, suggesting that shared support organisations, infrastructure, and implementing the kind of self-serve technology that is common in retail and banking might be good places to start.

“The downside,” he continued, “is that if the financial pinch squeezes any harder it could start impacting on things that are mission critical. So, I’m torn between seeing positives for the long-term and negatives for this winter. And the big question is how we get from one to the other without putting lives at risk.”

Blog by Highland Marketing 

The National Data Guardian, Dr Nicola Byrne, has shared a blog in which she discusses the planned NHS federated data platform along with the topic of public trust in data.

Dr Byrne begins by highlighting how the NHS has amassed “comprehensive cradle-to-grave information about tens of millions of us, whatever our social and economic circumstances or ethnic origin” since it began in 1948. This store of confidential data is a national treasure, she notes, and its collection is founded on trust.

She describes how the value of this data can only be realised if it is organised in a manner which enables the NHS to use it to improve treatments, services and care. Sealing it away where it cannot be used is of no purpose, but equally, making it available in ways that could damage public trust is counterproductive.

Emphasising the need for balanced judgement, Dr Byrne writes: “The importance of achieving the right balance is coming into sharper focus now, as NHS England begins asking companies to tender to provide a federated data platform. This ‘ecosystem of technologies and services’ will provide real-time, reliable insights to those making decisions about how care is planned and delivered.”

She strongly agrees with the aims and ambitions of NHS England’s federated data platform (FDP) programme, to improve “timely, meaningful access to high-quality data, visualised in a way that supports more informed decision-making by those empowered to use it” in order to improve health and care access, outcomes and experience for all. She notes that it is important for the FDP to avoid “common pitfalls around trust and transparency that have frustrated previous initiatives in this area.”

In order to support the programme, Dr Byrne and her team have provided advice in this area.

Firstly, Dr Byrne says that she has made it clear that NHS England “needs to allow sufficient time to listen to patients and professionals and then adapt plans according to what it hears.”

The programme must be transparent and always strive to provide clear and easy-to-understand explanations of the platform – “what data it will use, how it will use it, the benefits of the programme, and just as importantly, the risks.” Being open about this “provides an opportunity to meaningfully engage the public and build confidence in the system,” Dr Byrne writes. She adds that the FDP has subsequently provided assurance that it will carry out research with the public which will inform its communications and engagement plans, which will be shared with the National Data Guardian for review.

“I have advised the programme to develop comprehensive information governance guidance, clear governance frameworks and security measures for the platform,” Dr Byrne continues. “I expect that it will continue to engage with me on these matters.”

In addition, the FDP has been counselled on the importance of remaining mindful of the NHS core values. Dr Byrne comments that whilst her role is to provide guidance, ultimately decisions about the FDP’s procurement lie with the Department of Health and Social Care and NHS England. “To date, I’m pleased to say those running the programme have listened and responded thoughtfully to my advice,” she adds.

Dr Byrne will continue to stress the importance of the public and professionals alike having confidence in the FDP platform in order for it to succeed, and highlights the importance of “learning lessons from history to avoid repeating mistakes. The care.data programme failed when it could not provide satisfactory answers to a series of questions and tests set by (previous National Data Guardian) Dame Fiona, including key ones around transparency and the clarity of policy and communications.”

To conclude, Dr Byrne notes that the FDP’s work to support better health and care through use of data is “too important an ambition to fail” and shares her hopes that the NHS with “engage with these critical themes from the outset”.

When things go wrong, keeping quiet isn’t an option. What you say, and how you say it, are the key to safeguarding your reputation. In this blog, Highland Marketing’s co-founder, Mark Venables, looks at communicating in a crisis.

Crisis? What crisis?

The thing with crises is that they’re sudden, unexpected, and not under your control. You think it’ll never happen to you, then you’re part of the news cycle – and not in a good way.

In our sector, problems are pretty much inevitable. Think about it. Healthcare technology is tricky stuff.

Innovation means that you’re often dealing with first of type systems. No matter how well you’ve laid the ground, nothing fully prepares you for the moment when a customer goes live with a new system.

You’re also probably dependent on third parties, either for core technologies or to provide interfaces and data. They have all the same problems as you do, so you may suffer collateral damage.

Then there’s malign cyber-attacks, which can take down even the most carefully planned and monitored installation.

If something happens, your fault or not, it’s still your problem.

It’s a high stakes game.

To use the jargon, healthcare technology is “mission critical”. At best, system trouble means administrative delays, extra work, and regulatory scrutiny. At worst, it means serious clinical risk. There’s ample scope for even a minor problem to compound into a full-blown crisis.

The dangers are clear. Product rejection, reputational damage, and ultimately business failure. Worse is the clinical risk impacting customers and ultimately patients.

It would be fair to say that in this business, boring and reliable are selling features.

Don’t think you can hide.

Our sector is highly visible. Everyone is interested in healthcare, and most people in the audience have an opinion about technology. Journalists and commentators are looking for something to fill column inches and schadenfreude makes for easy stories.

You can’t hide, and saying nothing isn’t a good option. If you don’t comment, someone else will, and they won’t have your best interests at heart. Social media means news travels fast, and bad news travels fastest.

What can you do about it?

Over the years we’ve worked with clients to help them understand risk, plan for the unexpected, and respond rapidly. This is what we’ve learned.

Plan and prepare – and do it before the crisis hits.

This one seems obvious, but surprisingly few people get round to doing it. When you’re focused on making healthcare better, you don’t worry too much about what happens when you make it worse.

Keep a register of the risks you face and monitor the situation constantly. Asking the question, “what could possibly go wrong”, is a fundamental skill for project leaders, implementation specialists, and senior leadership.

Know your plan in the event of a problem. You need to identify your overall crisis lead and give them the time to draw up a plan. You also need to know who handles communication and make sure they’re trained to deal with the media.

It’s also essential to build good relationships with people who have influence in the environment you’re operating in. This could be journalists, policy makers, or customers. Having credit in the reputation bank means you have allies to call on when times get tough.

Own the crisis – react rapidly and control the message.

There’s a cliché amongst communicators that your reputation is built on how you cope with the tough stuff. Some people believe that a strong response in a difficult situation can actually enhance your standing with customers, prospects and influencers.

It’s not a theory I’d want to test to destruction but getting out in front of problem makes good sense.

People who do crisis management well are available, open, and empathetic. Of course, this doesn’t mean you should blow up minor problems into crises just to show that you care. What it does mean is that, when the worst happens, you need to be in control, move rapidly, and demonstrate your commitment to finding a resolution. You also need to be there, on the ground, with reassuring actions.

Apologising is good, fixing the problem is better.

Perhaps the most difficult thing is accepting the problem and taking responsibility. We all of us suffer a bit from hubris and, when you’re innovating, there’s a tendency to believe your own PR.

Going against an old adage, in crisis management, always apologise and always explain. This isn’t weakness, it’s honesty and empathy. Stuff happens and, if it’s your fault, you need to deal with it. This doesn’t mean empty apologies of the, “sorry you think you’ve had a bad time” type. It means being clear about the problem, explaining the causes in a way that makes sense to your audience, and setting out an action plan.

Of course, the real solution is resolving the problem or providing sensible workarounds. Good crisis communications can prevent damage to your reputation. Fixing, a problem can genuinely enhance your standing with a client.

Who you gonna call?

If this seems like a lot of time and effort, think of it this way, it’s all common-sense business practice, just like insurance.

Even if nothing goes wrong, the thinking and preparation means you’ll deliver a better service for your customers, and a better working life for your people.

One thing you do need to consider though is what support you need.

Dealing with a crisis isn’t business as usual, or at least it shouldn’t be. It’s likely you’ll need help, be that expert counsel, strategic messaging, or someone to handle tactical communications. One communicator I know always asks agencies who would be available to advise the CEO if something nasty happened on a Sunday afternoon.

Crisis planning and communication is one of the services we offer at Highland Marketing. Get in touch. We’d be happy to talk it through with you, even on a Sunday.

Dr Penny Kechagioglou, Chief Clinical Information Officer and Deputy Chief Medical Officer at University Hospitals Coventry and Warwickshire, wrote about embedding innovation in health and care in this blog for HTN.

The UK National Health Service is facing significant challenges due to the ageing population, and the higher cost of chronic illness. Population health challenges such as cardiovascular disease, stroke, diabetes and cancer are the major causes of mortality in the UK. What they all have in common is that they can be prevented or reversed by looking upstream and addressing risk factors such as obesity, smoking, poor nutrition and lack of exercise. This is currently worked up through a more joined-up approach to acute and social care.

At the same time, the NHS is on route to become one of the most digitally advanced healthcare systems in the world, through the roll-out of electronic health records, virtual care and telemonitoring. There is suddenly a huge opportunity to learn from organising and mobilising data about our populations; what works well in care and what does not work well, driving healthcare solutions forward which will maximise societal value. Prevention of illness and promotion of health and wellbeing in the community are key priorities for a sustainable future NHS and we need to leverage technological innovations to bring care closer to patient homes.

At individual patient level, understanding what matters most in their care and linking their experience outcomes from their care with their long-term clinical outcomes will improve quality of care provision. Digitising healthcare records and telecare are interlinked with efforts to educate our communities on better patterns of health seeking behaviour and on navigating healthcare resources more efficiently. Bringing complete medical records in one place and sharing records with patients will enable clinicians to work towards a more personalised care, whether this is around cancer screening protocols, social prescribing or emergency care.

At a population level, the systematic collection of real-world data which can be interpreted, analysed and actioned in clinical practice, can better inform clinical leaders about population health as well as healthcare system performance; are we achieving better health for our communities? Such data availability can lead to more appropriate allocation of healthcare resources to level up access to care and opportunities across all integrated care systems.

The key to the NHS sustainability and growth is the development of clinical leaders who have innovation at the heart of everything they do and who are encouraged to use their innovation and leadership skills to have an impact at provider and at system level.  Front-line doctors, nurses and allied healthcare professional are leaders and subject matter experts and their presence in positions of influence should increase, so that they can then drive the local and national innovation and research portfolios.

Today’s clinical leaders need to collaborate more with each other, talk more with academics who engage in organisational research and partner more with commercial organisations who produce innovative products and services that make real impact in healthcare. Innovation and the research that backs it up can influence healthcare decision-making and health policy and can solve real healthcare organisational issues such as hospital flow, elective operation list efficiency, emergency care demand and care personalisation.

The connection between segments of the healthcare sector, such as community, voluntary, private and public needs to be strengthened. Providers need to collaborate with non-healthcare industries such as banking and aviation industries. Learning from other industries about digital tools and automated systems for service prioritisation and provision can increase clinicians’ knowledge and skills for the purpose of spreading and embedding innovation within healthcare systems.

Dr Penny Kechagioglou, Chief Clinical Information Officer and Deputy Chief Medical Officer at University Hospitals Coventry and Warwickshire, kindly shared her thoughts on digitising patient reported outcome measures in a blog for HTN.

The UK digital transformation wave is mainly characterised by the roll-out of electronic health records and is an opportunity to transform patient care by collecting and analysing patient reported outcome measures digitally.

A recent study at the European Society of Medical Oncology open journal (Modi, 2022) showed that patient reported outcome measures are predictive of cancer patient treatment response and quality of life for physical and mental parameters. The knowledge of patient reported outcomes (PRO) and experience (PRE) measures can be valuable in the monitoring of individual patient symptoms in clinic or remotely in the community and also for aggregating and interpreting population health data.

The value of reporting patient outcome and experience measures within electronic health records and through patient portals will come from relating PRO and PRE measures with particular diagnoses, treatments, patient demographics and population health metrics. Such information can help clinicians prioritise quality improvement initiatives and can generate research on targeted and personalised treatments. Unlike other investigation results we capture within patient records, PRO and PRE measures are not routinely captured within electronic health records. Some of the reasons behind this gap may include the lack of appropriate integration of such data within the design of electronic health records and also the lack of standardised metrics to report.

The inclusion of patient reported outcomes and experience measures in the shared decision-making between clinicians and patients is key to the provision of patient-centred care and the continuous improvement of services. The focus should be on those patient cohorts and populations who are vulnerable and who have no easy access to report their outcomes, because of language and cultural barriers or digital illiteracy. The equitable clinical outcome recording amongst diverse populations will enable personalised and unbiased decision-making regarding care. PRO and PRE measures should cover diverse populations to ensure no action is made on biased data leading to patient exclusion. This is also particularly important in the case of research and clinical trials, where we need to be mindful of data disparities that may lead to exclusion of high-risk patients.

Another application of PRO and PRE data measures is in the understanding of the impact of diagnostic and treatment delays, as in the case of cancer diagnostics and elective surgical procedures. Such data can feed into new or existing clinical prioritisation tools to enable more informed decision-making and risk management. The random and inequitable allocation of healthcare resources could then be replaced by patient-centred, evidence-informed and health equity assessed decisions on resource allocation.

Involvement of patients and end-users in design thinking and the roll-out of electronic health records would ensure that the right reported outcome and experience measures are collected and analysed in order to improve services and shape the development of new value-adding services. Outcome collection around usability of and experience from services can be targeted to ensure patient compliance to cancer screening and diagnostic testing, clinic and vaccination appointments.

PRO and PRE measures should be incorporated in the design and implementation of electronic health records, engaging patients and the public in the process. The integration of such data digitally needs to be exploited by dedicated clinical and analytics team to ensure their value is realised in terms of improving patient care. Aggregating data at the population level will enable population health management and improvement in care at system level.