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It’s encouraging to see Matthew Gould, the CEO of the newly formed NHSX is spending time at  

the clinical frontline before he formally starts in his post in July.  After reading Matthew Gould’s most recent blog, it’s clear his time so far with care professionals is helping inform his views; recognising that health IT is frustratingly clunky, siloed and way behind other sectors.

We recognise that there is some important new thinking and messages with his most recent welcome declaration;

“we’re going to focus on standards and platforms, keeping the centre as ‘thin’ as possible”. 

This shift is an acknowledgement that the health IT market is underperforming, one size doesn’t fit all and we need a new approach to health IT.

This latest initiative by NHSX, has a good deal in common with the work of the Ripple Foundation. In advocating user centred design, the use of open standards and open source for healthcare, and now this focus on the platform approach in healthcare, these principles resonate with us very much. This more open approach is a good fit with the clinical community too, where sharing knowledge and research for the betterment of health outcomes is understood as a public good. 

While we welcome this shift towards a healthcare platform by NHSX, our experience has taught us this is non-trivial challenge, so would urge NHSX to learn from others in this field tackling this same challenge, both in the UK and abroad such as the Global Goods initiative from Digital Square. 

The state has an important role to play in supporting companies tackle this fragmented market that is dominated by a few big tech players.  If done right, a platform based approach can help to stimulate new entrants to the market and drive innovation. 

One particular challenge NHSX will face will be finding the balance between coordination and control of platform development while letting innovators innovate at the frontline, to get the right information, at the right time, to help care professionals deliver the best possible care. 

What does the NHS mean by a platform in healthcare anyway?

We believe NHSX, should be working towards the definition of an open platform, as defined by Apperta Foundation and  therefore start the move away from closed platform/monoliths, which both Yorkshire & Humber LHCR and NHS Scotland are already working towards. 

Open platforms liberate both data and applications making them portable and interoperable across different platform implementations…. The open platforms approach is vendor and technology neutral, eliminates lock-in, facilitates innovation and competition, and forces vendors to compete on quality, value, and service”. 

Indeed the Apperta paper on Defining an Open Platforms, defines 8 core platform principles:

  1. Open Standards Based 
  2. Shared Common Information Models 
  3. Supporting Application Portability 
  4. Federatable 
  5. Vendor and Technology Neutral 
  6. Supporting Open Data 
  7. Providing Open APIs 
  8. Operability (as in DevOps) 

So as well as continuing to meet care professionals at the frontline, we, Ripple Foundation and Apperta Foundation, would welcome a conversation with Matthew Gould and NHSX colleagues to discuss our learnings and expertise in this field as well as to discuss strategic investment into open platform innovation via the 1% Fund to enable a small safe start, the iterative curation of common platform components and collaboration between the frontline and NHSX.

It was a great pleasure to meet the Health Secretary on his recent visit to Leeds after launching his new “tech vision” for the health service. I met Matt Hancock MP at the ODI in the centre of Leeds on Friday 19 October 2018 and talked him through our development for Helm – an open platform solution for a person held record.

I was able to share with him the UI/UX experience of Helm as it looks right now and was pleased to hear very positive responses both from the Health Secretary and his Chief Technology Advisor, Hadley Beeman.  Helm has been in development for a number of months to ensure that we’ve got strong foundations for people accessing and contributing to their own health and wellbeing information. It has involved passionate work from a number of highly experienced technical people as well as clinically direction from Dr Tony Shannon, along with strong creative development from Simon Gamester.

 

Helm benefits from a number of innovative technologies supported by Ripple Foundation, namely, PulseTile, QEWD.js and EtherCIS and is underpinned by the internationally leading open standard for healthcare,  openEHR.  It also conforms to the well received paper “Defining an Open Platform” by Apperta Foundation.  

The exciting journey of Helm being tested by people in Leeds starts very shortly.  People are at the heart of this product and they will now lead the way in its future development.  Users of Helm will be able to tell us what works and what doesn’t, what would be useful, what is missing and Ripple Foundation is very excited to be a large part of this new innovation with the city of Leeds, led by Leeds City Council.  The plans for Helm are for rapid expansion into the Yorkshire and Humber region. We will keep posting news on the Ripple Foundation website but do get in touch if you would like to understand more about our open platform approach for addressing some of the issues faced by Health IT.  

Thank you to ODI Leeds for supplying the photos taken during the session with the Health Secretary.

By Phil Barrett

Director

Ripple Foundation

 

Apperta_Defining_an_Open_Platform_SP

Defining an Open Platform – Thought-provoking collaborative document from the Apperta Foundation that we highly recommend reading.  

The paper has pulled together with the experience and knowledge from a wide range of clinical, health informatics and health system economics including our very own Dr Tony Shannon but also….   

  • Ewan Davis – Woodcote Consulting
  • Dr Ian McNicoll – openEHR Foundation
  • Dr Roland Appel – Maycroft Consulting
  • Silas Davis – Monax
  • Dr Rebecca Wassall – Apperta Foundation
  • Peter Coates – NHS Digital Code4Health

We believe that the thinking within the report is relevant not just to the UK and Ireland but across the globe so please share this document with colleagues.