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.

How to turn the Universal Capabilities within the Local Digital Roadmap – in the financial reality of the NHS.

Local Digital Roadmaps set out how to achieve the ambition of paper free at the point of care by 2020 for the NHS.  77 areas across the nation have submitted documents and assessed themselves against ten universal capabilities.  This has left many areas wondering how they can achieve this with tightened budgets, limited resource and tight deadlines.

Building towards an open source platform underpinned with open standards can help achieve the following universal capabilities.  

• Professionals across care settings can access GP-held information on GP-prescribed medications, patient allergies and adverse reactions
• Clinicians in U&EC settings can access key GP-held information for those patients previously identified by GPs as most likely to present (in U&EC)
• Patients can access their GP record
• GPs can refer electronically to secondary care
• GPs receive timely electronic discharge summaries from secondary care
• Social care receive timely electronic Assessment, Discharge and Withdrawal Notices from acute care
• Clinicians in unscheduled care settings can access child protection information with social care professionals notified accordingly
• Professionals across care settings made aware of end-of-life preference information

How?

By contacting Ripple we can help you access the following to help build your open integrated platform to deliver your Local Digital Roadmap Universal Capabilities:  

• tailor the open platform solution to your own individual requirements
• clinically led technology – built with clinicians for clinicians
• focused on user experience – helps to drive usage
• adaptable technology – use UI/middleware/backend in combination or separately
• future proof – built on openAPIs that are positively promoted by NHS England and NHS Digital with robust records architecture underpinning (openEHR)
• flexible – small or large scale

What next?

If you are interested/committed to collaborating, simplifying, standardising and sharing with others in an open manner, please get in touch.