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www.jrc.ec.europa.eu Contact Automatic Identification and Data Capture Technology Focused Scenario Thinking in the English National Health Service. A novel approach for Technological Foresight (Hussein et al., 2014) has been deployed by combining Scenario Thinking with Technology Roadmapping. The purpose was to develop a multi divergent technology roadmap based on a series of alternative future states for AIDC technology in the English NHS. An Action Research methodology was deployed for its iterative nature, with a series of workshops and interviews conducted with the NHS AIDC Healthcare User Group. In this setting, the applicability of the novel Scenario Thinking informed Technology Roadmap was examined. Mohsan Hussain Email: [email protected] 5th International Conference on Future-Oriented Technology Analysis (FTA) Engage today to shape tomorrow Brussels, 27-28 November 2014 1. Set to 30 years: Established through Pre-interviews through a mix of the following questions: • When does the environment become uncertain? • Determine the point in the future where existing knowledge cannot help us analyse the environment? • How far into the future are resources being committed? 2. Top 12 Uncertainties (40): Level of rationed healthcare Level of ‘capital’ budget to adopt new technologies for NHS hospitals Health of the population in terms of obesity, mental health, aging issues Level of availability of Energy resources Level of quality online Patient records Level of privatization of healthcare services Migration of people from different parts of the world Level of global technology regulations Level of care expected cyber attacks Global adoption of the same data standards across healthcare Fluctuations in technology regulation 3. Reduce Factors & Specify Ranges 5. Check Consistency of Scenarios – Consistency Matrix Uncertainty Low High Level of rationed healthcare No rationing All care is free including free prescriptions Like US – emergency care only; rest through insurance Allocated budget, patient decides, with optional top up Level of ‘capital’ budget to adopt new technologies for NHS hospitals Minimal/noneFunded through revenue, or distributor and manufacturer ‘Mandated/dictated /central /ring fenced capital budget. Health of the population in terms of obesity, mental health, aging issues High obesity etc. problems Causality of these of problems; shorter life span Population well With Increase in taking ownership by each individual Level of availability of Energy resources Depleting stores of current resources Shift to different resources and possibly renewable New technology/sources on line. Less resource intensive Level of quality online Patient records what is on line is poor (setting aside what % online) lack detail; incorrect records Much better than now; more detail, correct coding (clinicians do better; done in a timely way, correctly coded) Level of privatization of healthcare services As now. Limited private provision of some care support services, some hospitals (but still free at point of use) Outsourcing Fully privatised care provision. Mixed economy Migration of people from different parts of the world Current net migration; similar level of impact on services as now – all people are treated Health service has the ability to cope Much more inward migration and strict limits on who get what care Health service does not have the ability to cope Level of global technology regulations No global regs, because of political barriers and lack of desire Global guidelines and standards with free flow of information if driven by patient safety agenda (superbugs etc drive political will/mindset) Level of care expected As is now – post code lottery. NICE influence People will expect higher levels of care than of today Level of Cyber attacks Happen and people get put off on line records Lots of them, but people accept the risk because they value the benefits Global adoption of the same data standards across healthcare Non – as is – change --fragmented driven by patient safety agenda: a future requirement of the Global society Fluctuations in technology regulation Non – as is Manual processes overtaken by tech driven by patient safety agenda: a future requirement of the Global society 4. Choose themes & Develop Scenarios – Theme Matrix 1. Set the Scene & Planning Horizon 2. Generate Uncertainties 3. Reduce Factors & Specify Ranges 4. Choose themes & Develop Scenarios 5. Check Consistency of Scenarios 6. Present 3 Scenarios Technology Roadmapping Framework Scenario Planning iHealth insider Care records quality deemed “ excellent” and “ Shareable ” Technology regulations achieve worldwide harmony with only a few late adopters and maverick states. Fluctuations in Healthcare information sharing and standardization is largely a concept of the past with the initiatives driven by the WHO enjoying worldwide success. More… Standards And Regulations HOME NEWS INSIGHT iHi Live 2030 JOBS iHi DH drives local and national tech partnerships The Government increasingly is looking for private partnerships to deliver IT for the N H S More… A ccurate, standardised, shared responsibility, patient grants access More… Health assessment and screening programmes excel Programmes including the Well being- Educational Programme, Incentivized healthcare and Active Lifestyle Projects initiated in the 2018 have had positive impacts on the general health of the population. In a recent survey of NHS patient’ s expectations, the expectancy of receiving the very best possible care is rising. A DH comment on the survey concluded that the service that the NHS now delivers is world leading and credited its partnerships with private Expectations continue to rise as level of healthcare in India, Brazil and China increases M igration sees a decade of year on year decrease M igration has decreased in terms of numbers every year for the last decade. However, migration in terms of the number of different countries has increased. More… General health stabalising After decades of decline in the general health of the population, 2030 marks a stabilisation over the last decade and due to screening, preventative and active lifestyle measures there is hope to reach the top 10 WHO standings in the next few decades. iHealth insider Care records quality deemed “ excellent” in new review Technology regulations achieve worldwide harmony with only a few late adopters and maverick states. Fluctuations in Healthcare information sharing and standardization is largely a concept of the past with the initiatives driven by the WHO enjoying worldwide success. More… Standards And Regulations HOME NEWS INSIGHT iHi Live 2030 JOBS iHi DH drives local and national tech partnerships The Government increasingly is looking for private partnerships to deliver IT for the N H S More… A ccurate, standardised, shared responsibility, patient grants access More… Health assessment and screening successful Programmes including the Well being- Educational Programme, Incentivized healthcare and Active Lifestyle Projects are starting to show signs success. Their success has been catalysed by government initiatives such as raising taxes on processed food. However, class division in terms of the scale of health standards continues to grow. More… In a recent survey of NHS patient’ s expectations, the expectancy of receiving the very best possible care is rising. A DH comment on the survey concluded that the service that the NHS now delivers is world leading and credited its partnerships with private healthcare providers for this increase in quality. More… Expectations continue to rise as level of healthcare in India, Brazil and China increases Healthcare tourism reducing Healthcare Tourism is reducing confirms a NAO report on the issue but migration from different parts of the world represents its own challenges to the NHS. More… General health of the population in decline Dispite recent success of lifestyle improvement programmes the general health of the population has declined as the UK drops out of the top 20 WHO rankings. More… iHealth insider Data quality and completeness issues persist Technology regulations have remained largely continental and healthcare technology standards have followed suit. More… Standards And Regulations HOME NEWS INSIGHT iHi Live 2030 JOBS iHi Local adoption of IT - DH only advises Centralised attempts for nation wide technology adoption have been decreasing over the last two decades with the DH acting as advisory, supporting bodies, rather than driving mandatory implementation. More… Localised systems continue to hold records with limited national sharing. Data quality issues and missing data are accredited for decreasing confidence in the NHS. M any patients opting for private healthcare. More… Government criticized over increased rationing of healthcare services The rationing system, where each person is given a ‘healthcare budget’ each year and the cost of further treatments must be covered by additional insurance. More… In a recent survey of NHS patient’ s expectations, the expectancy of receiving the very best possible care is rising. A DH comment on the survey concluded that the service that the NHS now delivers is world leading and credited Expectations continue to rise as level of healthcare in India, Brazil and China increases Healthcare tourism continues Healthcare tourism increasing over the last 20 years with the government being criticised for poor information management in regards to those who may only visit England for healthcare treatment. A DH statement read “the current landscape with disparate IT systems with incomplete and often poor quality data is the priority. A new information system to deal with health tourism would take a considerable portion of public spending” . More… General health of the population in decline The general health of the population has declined over the last 15 years as the UK drops out of the top 20 in the WHO rankings. Past Year 1 Year 3 Year 10 Vision External Internal Business Strategy DH/ NHS England gains mandating rights and takes the lead. Working with large, successful customer information organizations (i.e IBM). Define what the NHS is actually responsible for? I.e. public health, physiotherapy. Policy level change Health Assessment and Screening programs to be a priority for the NHS agenda. Qualified persons making decisions. Planning for the healthcare system over a longer term than the current election cycle. Rationing/Sharing a budget for each person of healthcare costs. Centralisation enabled on decisions of all aspects of the healthcare system. Local requests can be assessed by DH A singular decision making process. Mandated IT standards by DH. Products/Se rvices/Syste ms Relevant stakeholders informed of centralized system change. Roadmaps produced to bring clarity for the path to Centralisation. Pre-emptive screening for major diseases. Delicate balance in Broadbrush/highly targeted screening. Central Systems available with multiple interfaces depending on type of person/organizations using the system. Centrally developed database for identification of products and shared standards between proprietary systems Pre-emptive screening for major diseases. Centrally governed systems. Migration systems for paper. Policy level change implemented by systems. Working with stakeholders on technology and information standards Getting away from any paper processing. Product identification/ information management systems shared by the healthcare industry Technology Home monitoring. Further papers for stakeholders of specifics of technology. Central Systems available with multiple interfaces depending on type of person/organizations using the system Home monitoring Home monitoring. Visibility to the general public of episodes of care ie audit tools. Technology products and systems guided by the DH Resources Subject matter expertise, not clinical leads dealing with other aspects such as information standards. Technology capability assessment projects. Applied product development research Industry led tech project but with health service collaboration. Contracts with multi purpose interface system providers. Working level staff involved with the design of the system. Decision making staff decide which staff members require access to which interface. What each staff profession is actually responsible for. i.e clearer scope of what each professional role Industry led tech but with health service collaboration Industry led tech but with health service collaboration. Working with similar stakeholders to today but with more user groups CONCLUSIONS: 1) The combined model produces successful scenarios from which a roadmap can be developed by the participants/researcher. 2) The new model both compliments each foresight technique and alleviates some of the inherent weaknesses, namely the lack of strategic output of Scenario Planning and the inability of Technology Roadmapping to integrate long term uncertainty. Dr Stathis Tapinos Email: [email protected] Dr llouise Knight Email: [email protected] CONCLUSIONS Continued: 3) Practitioners/Managers are able to combine macro level thinking with micro level, actionable planning activities despite multi-organisational setting and perspectives. 4) The model deployed can be used in other technology settings where understanding of the long term macro environment is required but actionable planning activities are desired as an outcome. 5) From an AIDC perspective, the scenario thinking informed technology roadmap defines the business strategies, services, technologies and resources both the NHS itself and its partners will require over the short (1-3 years) and longer term (10 years +) to enable AIDC technology to reach its potential in cost savings, patient safety and supply chain efficiency.
