皇冠体育app

I want to talk about 3 things today.

I want to talk about:

• the problem we鈥檙e trying to solve in digital healthcare
• the approach we鈥檝e taken to solving it
• and what the future looks like if we succeed

And I鈥檇 like to start with a story that illustrates the problem.

In 1904 a catastrophic fire destroyed most of downtown Baltimore. 皇冠体育app blaze was so bad that the local fire department was overwhelmed. Telegraphs went out to Philadelphia, New York and Washington DC, asking them to urgently send fire crews.

But when the crews from other cities arrived on the scene, they found their equipment was useless. Because their fire hoses all had different gauges. None of them had been designed to fit Baltimore鈥檚 fire hydrants. 皇冠体育app fire raged for 30 hours. Whole city blocks burned to the ground because the kit was not compatible.

When the embers finally cooled, 35,000 people found they were unemployed. Municipal officials in 1900s America would not have used the word 鈥榠nteroperability鈥�.

But, in the inquiry that followed, the lack of standardised, mutually compatible equipment was found to be at the heart of the disaster. At the time of the Baltimore fire there were 600 different types of fire hose in use across the USA.

People were well aware of the problem, but city authorities said the cost of moving to a nationally agreed standard was too high. 皇冠体育appre were always other priorities.

Sound familiar? 皇冠体育app manufacturers were happy with their little, local monopolies and didn鈥檛 want the competition. I hope you can see where I鈥檓 going with this.

Fast forward a century or so, when I arrived as Health Secretary almost a year ago, I found that technology in the NHS suffered the same structural problems.

Our patient record management systems were not 鈥� and are not 鈥� interoperable. Data does not flow to where it鈥檚 needed. 皇冠体育app fire hose does not fit the fire hydrant.

When a sick patient turns up in A&E at midnight, there鈥檚 no reliable way for the clinical team to get all the information they need. Even though it鈥檚 almost certainly held somewhere on an NHS system.

NHS clinicians want to be able to offer the best possible care, using the best possible information. 皇冠体育app fact that they can鈥檛 always reach that information is a source of huge frustration. I鈥檝e seen it over and over again. It鈥檚 also a source of unacceptable risk to patients.

Part of the problem is that it鈥檚 been extremely difficult to switch to a different fire hose. In both primary and secondary care our patient record management systems are often 鈥榝ull stack鈥� contracts. 皇冠体育app hosting, the data and the application are all built together as a single system.

It means that if you want to change that system in any way, it鈥檚 like swapping a crucial block from a Jenga tower. You risk the whole thing crashing.

It also means that when better, faster, cheaper tech is developed, the NHS can鈥檛 always use it, because we鈥檙e locked in to something that was cutting-edge when I was at university. Sadly quite a while ago now.

And poor data architecture is unsafe for another reason too. As the WannaCry attack showed 2 years ago, poor data systems are open to cyber attack too.

So what鈥檚 the solution? Last autumn, I set out my vision for technology in the NHS. I said I wanted our systems to be open and interoperable. Continually upgradeable. Innovating, iterating, always improving.

To extend the metaphor of the Jenga tower, we need to move from a Jenga world 鈥� where you can only build one way, very slowly and with great caution 鈥� to a Lego world 鈥� where you can build lots of ways, swapping new pieces in and out as often as you like, without breaking the underlying structure. You can tell I鈥檝e got kids.

This is not some unimaginable tech utopia, by the way. It鈥檚 how the internet works.

Your banking app works on any device. It鈥檚 not tied to a phone or an operating system. Updating it is easy and happens in the background. You don鈥檛 have to migrate the data because the data is in the cloud.

皇冠体育appre is no technical reason why NHS systems can鈥檛 work in the same way. 皇冠体育app problem is organisational, not technological.

It鈥檚 to do with legacy, with lack of skills and confidence, with a culture of risk aversion, with a belief that tech is the IT department rather than something fundamental to the way a modern organisation works.

I鈥檓 thrilled we鈥檙e starting to make some progress. 皇冠体育app biggest recent development is the creation of NHSX, our new tech transformation unit.

皇冠体育app purpose of NHSX is twofold. First, it鈥檚 about cutting through the bureaucracy used to stand in the way of tech transformation. When I came in to this role, one of the first things I wanted to do was make emails and not letters the default mode of communication between patients and the NHS.

Not too controversial, I thought. Surely this was low hanging fruit? It took me 7 months to get that decision agreed by all parts of the system. Seven months. Just to get to the end of the 20th century, let alone 2019.

So NHSX has brought together our scattered tech leadership into one decision-making point, giving them powers, the policy tools and the clout to get things done.

皇冠体育app second goal of X is to bring the mindset and practices of the internet to the way we deliver tech in the NHS. That means nationally agreed standards, locally-led delivery.

Commission what you want, but it has to meet our standards on cyber security, data access and interoperability. Otherwise we won鈥檛 approve the spending.

It means being open, collaborative and user-centred. Agreeing our standards with our users. Publishing them on the web. Open sourcing any code developed in the NHS.

And we are moving health and care away from private networks like N3 and HSCN, so that we can run all of our services across the internet.

This will open the ecosystem, so that charities will be able to build apps for patients with specific conditions, and the NHS can run off-the-shelf stuff that works well everywhere else. We don鈥檛 need everything invented here.

Today I can announce the next step on that journey. We鈥檙e launching our new GP IT Futures contract.

I believe it should be as easy for a GP surgery to switch IT provider as it is for a small business to switch bank accounts.

Under the new contract, providers will have to follow our standards on interoperability and data access. Systems will need to be continuously upgradeable. Patient data will need to be securely hosted in the cloud. If not, they will not get contracts.

Sick patients should not have to explain 鈥榳hy are you here鈥� for the umpteenth time every time they meet a new clinician, or cart round bulging folders of notes from appointment to appointment.

It is not good enough. Your medical records should be accessible from wherever you are the NHS, just as you can get to your emails from any device.

皇冠体育app new contract will help us deliver on that goal and will be in force from January. It鈥檚 an iterative process and we will continue to improve the approach to make sure it meets needs.

And we can only build the NHS of the future on safe, secure systems that we can rely on, and we can trust. Weak cyber security undermines that trust. We鈥檙e in the middle of investing 拢150 million to put in place new protections.

I can tell you that: over 100 NHS boards have now received training from GCHQ-accredited experts on cyber security threats and the actions they need to take to protect their organisations.

And, from today, we鈥檝e launched a new data security and protection toolkit that everyone in the NHS who deals with patient data must use: a single set of standards to help health and social care providers improve cyber security and carry out self-assessments to measure how well they鈥檙e doing, and how much they still need to do.

Through the use of free and open standards we will be able to rapidly share cyber threat intelligence throughout the NHS.

All this is for a purpose. Digital technology will fundamentally alter our relationship with the physical NHS. Remote access will change clinicians鈥� relationship with patients for the better. Technology won鈥檛 be at the expense of humanity.

By contrast, technology will put more of a premium on the human ability to explain, reassure and contextualise. It will mean more time with patients, not less.

For patients, digital transformation will mean less time hanging around in waiting rooms, more care at home.

In Surrey, NHS clinicians are providing monitoring and support for dementia patients in their own homes, in real time. Patients and carers spend less time making stressful trips to the emergency department.

Previously it鈥檚 where they鈥檇 go if the patient was having a bad night, because staff in hospital were a source of trusted advice. Now carers can get that advice at home 鈥� with clinicians able to remotely monitor the patient鈥檚 vital signs. It鈥檚 just one example. 皇冠体育appre are hundreds more.

One final point. 皇冠体育app NHS is a 1.3 million strong team of the most dedicated public servants in the world.

And this technology is going to change relationships. Build better relationships between colleagues working in different parts of the NHS. Build better relationships between NHS clinicians and patients.

Because, ultimately, that鈥檚 what it鈥檚 all about: people.

So that鈥檚 how I see the future of digital health in the NHS:

• greater choice

• more innovation

• systems that work, and systems that can talk to each other

• tech that saves time

• tech that makes life better

• tech that lets the NHS do what it does best: care for people

So let鈥檚 make it happen