Can I “Skype” you? No. I’ll see you here in a couple of weeks

Image for post
Image for post

Okay. I have a business meeting with a collaboration with some great US engineers around blockchain, and I ask them for an initial meeting. “Can I use Skype to catch-up?”, “No, you’ll have to come and meet us in a couple of weeks, as we don’t support video conferencing here”. Seems a crazy way of doing business, but, in the UK, this is what we still have with the NHS.

So you are ill, and you just want to have a quick 10 minute chat with your GP. All of the on-line material tells you that you must see your GP as soon as possible. But you’ll have to drag yourself — in an ill state — onto the bus (or drive when you are ill) and into the waiting room, and probably infect lots of other people on the way. There’s also no guarantee on how long you’ll have to wait for an appointment, too. The old adage goes … “You’ll either be dead or cured!”.

By the way, I use “Skype” … as many in the NHS do … as a generic term for video/speech conferencing, but many would want to use What’s App as this is the app that we often us now for mobile phone/video conversations. There are also amazing amazing video conferencing suites which integrate with mobile technology.

I observed the NHS for around 10 years when my mother and father and law were being treated for various things. While the staff were amazing, the processes were terrible. Not once — as a carer — did I ever feel part of the process, and I never felt that anyone was really looking after all the illnesses that they had (holistic care). It seemed there was a pin-point diagnosis every time, and and it was one specialist for every element of the treatment.

I could tell you a few stories — about how my father-in-law’s cup had a barcode, but he didn’t — and how my father-in-law went to three appointments with a specialist and each time they were cancelled when he arrived at the hospital — and how my father-in-law had “Do not resuscitate” on his records, and that no-one had discussed this with the family. We often, too, went to the hospital and asked where “John Smith” was (which was my father-in-law’s name), and ended up at the bed of another John Smith. For my mother-in-law, a taxi was used to ferry her record from one hospital to another. I could go on, but I won’t.

We all know the poor track record of the NHS in the adoption of IT, and where the Connecting for Health programme — after an investment of over £15 billion — was cancelled. So it’s great to see Matt Hancock trying again to push technology as a key priority, and he will start to define stands in the usage of technology across the NHS, including the usage of Skype and the barcoding patients. It seems so simple. We often use video conference and What’s App in our own lives, both in work and home life, but in the NHS, it just doesn’t happen. When I asked, I was told it was to do with security, and then I said I would fix whatever the problem was, and I never heard back.

For barcoding — yes … barcodes (not RFID) — most of our retail operations could not function without scanning, but, in the NHS, it is still seen as an alien feature, and has failed to scale in any meaningful and consistent way. Luckily, we are involved a great project with Spiritus, the Data Labs and NHS NSS, and which aims to integrate RFID into the asset tracking using Blockchain methods [here]

Matt announced technology is his passion and he already uses an app to communicate with his constituents. He identified, in his first speech as the Health Security, that the coverage of technology was patchy, and that it needed to be most consistent across the UK, and that one way of reducing to burden on GP is to use Skype for quick catch-ups for their patients.

But Matt perhaps sailed into political waters with his praise for the Babylon on-line service, and where citizens could catch with on-line GP:

Image for post
Image for post

This type of approach is likely to meet strong opposition from those who say it is the first step to a privatised NHS, and also that those who are healthy would switch to this service, and leave GPs with increasingly burdened for those with the most chronic of conditions. But the advantages of the Babylon service does look attractive to many with busy lives — a video consultation within two hours, or a face-to-face appointment the same day or next day (every day except Sunday).

Something has to change, especially in supporting an environment for innovation, and to reduce overheads and improve the overall process.

The resistance to technology (and change) in the NHS has held back health and well-being in the UK. Perhaps many of the problems in the past have been caused by systems have been badly designed — typically by not incorporating health care professionals in the design — and that has forced the push-back? There has also push-back where technology has been seen as replacing certain staff duties. Other industries have coped with this change better than the NHS, and the long-term goal should be to improve the whole of the patient pathway, and make it more integrated and reduce mistakes.

When it comes down to it, the NHS is precious to most people in the UK, and any criticism of it is never taken well. But it needs to push itself into a modern era, and fit around around citizens rather than forcing them into its traditional practices.

My great hope in Scotland is the DHI, and which is the entity which could really produce solutions that will work for both citizens and health care professions. If you are interested with are integrating next generation technology at our simulated hospital at Sighthill, Edinburgh, and where nurses will be trained on using RFID tracking for devices, and in the integration of data for the patient pathway.

Here’s a graphic I did a few years ago, and I still think it is relevant:

Image for post
Image for post

And, while we are at it, can we have an electronic record for all our kids (and that is owned by the parents):

Image for post
Image for post


One thing I know, is that if it is the NHS v Tech, there’s only going to be one winner, so we need to make sure that it isn’t a battle, and that technology is integrated for the benefit of health and well-being, and that both health care professionals, health care providers, and citizens feel the benefit of building a modern health care infrastructure.

When we developed Cloud4Health — which has since developed into an amazing spin-out company (Symphonic) — we were told that the greatest problem with the adoption of technology is that your mum is not going to use a computer. My Mum is now the greatest advocate of the iPad of anyone I’ve ever seen, and uses it on a daily basis. The “age” barrier is dropping fast, and, also, there’s a whole new tech-savy (and busy) generation coming through. We truly need a system fit for the information age. The industry sector that will grow most in the next few decades will be health care and well-being, with many more staff being employed, and we need a way to make sure that the whole things works well.

Professor of Cryptography. Serial innovator. Believer in fairness, justice & freedom. EU Citizen. Auld Reekie native. Old World Breaker. New World Creator.

Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store