Health technologies

Earlier this autumn, I had the opportunity to visit the Hospital2Home virtual ward project in New York. Like other virtual wards, this project aims to reduce the risk of unplanned hospital admission for people at high predicted risk of admission. 

I was particularly interested to visit this project because it has strong partnerships with health care, social care and charitable organisations, and it cares for some of the most vulnerable people in...

I recently had the opportunity to visit the Toronto virtual ward as part of my Management Fellowship role working with researchers at the Nuffield Trust who are evaluating the costs and benefits of the virtual wards in Croydon, Devon and Wandsworth.

The virtual wards work just like hospital wards, using the same staffing, systems and daily routines, except that the people being cared for stay in their own homes throughout.

The purpose of...

Last month, the Department of Health confirmed that it was ditching its plans for a single clinical record system for England. Instead, IT policy will be devolved to local NHS organisations. On the face of it, this new emphasis on local flexibility may sound appealing but we should not forget the potential hazards that come with fragmented IT.

The original plan would in essence have created a single set of medical records for all patients, to which patients could grant access to clinicians working in any part of the NHS. The alternative we are now facing will be a separate, partial...

Last month, the Commons’ public accounts committee published a pretty damning report on the NHS National Programme for IT in England, Connecting for Health.  The committee’s analysis looked specifically at the development of a single care record.  This is a set of electronic notes for each patient that can – with the patient’s permission – be accessed by clinicians working in different parts of...

This week, the summary care record is back in the news.  At the moment, if you become critically unwell and are taken unconscious to an A&E department, the doctors and nurses looking after you will typically have no idea of your past medical history, your allergies or what medicines you are taking. This is because they usually have no way of accessing your GP clinical record....

This morning I logged in to my bank account on my smartphone, checked my balance, transferred some funds, and rated the service received for a book that I ordered online—all before my morning shower.  I then sent an email to my boss explaining that I would be late today because it was going to take me most of the morning, including travel time, to attend a ten minute follow-up appointment at my local outpatient clinic. Why is health care so far behind the times?

This was the topic we recently explored at a breakfast session at the Nuffield Trust’s 2011 Health Strategy Summit....

I was in Lisbon last week to speak at a chronic disease workshop run by the National School of Public Health.  Both the English and the Portuguese health services currently face a significant funding squeeze, and policymakers in the two countries see chronic diseases as an area ripe for potential cost savings.  However, in Portugal the focus is on different chronic diseases from those on which we concentrate in this country. Moreover, the emphasis in Portugal is on reducing the expected costs of these chronic diseases, whereas in the UK we tend to focus on preventing the...

Starting in April 2011, NHS hospitals in England will not be paid for “avoidable” readmissions occurring within 30 days of discharge.  As Trust finance officers begin steeling themselves for this change, they may be interested in a Canadian project designed to predict and avoid such readmissions. 

Known as the Toronto Post-Discharge Virtual Ward, the project borrows a concept first developed...

Good news stories don’t come around that often for Connecting for Health, the beleaguered national IT programme for the National Health Service in England.  But I think I might have found one in the making.  This month marks the mid-way point in a two-year project to build an “open-source community” for the NHS. 

For the uninitiated, open-source software is different from the “closed source” software that...

On 22 July, The Nuffield Trust held the first in our series of seminars focussing on ‘High Value Health Care’, in partnership with the Royal College of Physicians and the Cambridge Health Network.

Before the seminar began I heard a few mutterings from audience members about how comparisons between Kaiser Permanente and the NHS are so well known that they’re becoming a bit trite. 
 
However, by the end of Bernard Tyson and Jed Weissberg’s presentations, nobody could be in doubt that the NHS still has...