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The goal is to improve identification of certain patients through algorithms that produce tailored and dynamic risk scores, and make those resources available to VA caregivers and patients.

Gould, currently the director general for digital and media policy at the Department for Digital, Culture, Media and Sport, will join the unit this summer.

Fiona McDonald, director of data sharing and online patient preference setting for Great North Care Record at NHS, recently spoke with Healthcare IT News about what the U.K. data exchange initiative means, described some of her ongoing projects there and explained what patient-centricity means to her as a digital clinical champion. Q. Could you tell us about more about your roles as Director at Great North Care Record and Digital Clinical Champion at the NHS in England? A. I am a clinician with a background in nursing with 12 years involvement in national programmes developing and promoting the use of digital solutions to improve healthcare and patient experience. In 2018 I became the workstream director for collecting citizen preferences for the Great North Care Record. The Great North Care Record is a new way of sharing medical information across the North East and North Cumbria which is accessed by authorised health and social care practitioners. It means that key information about patients’ health such as diagnoses, medications, details of hospitals admissions and treatments is shared between different healthcare services including hospitals, out of hours and ambulance services, all of whom may all be involved in caring for a patient. Currently, local health services hold different and/or duplicate pieces of information about patients, as information isn’t easily shared between different organisations. Through sharing this information electronically via the Great North Care Record, healthcare practitioners can then use it to access the most current patient details, which are consistent and up to date, 24/7. Getting the public to set their own data sharing preferences is a founding principle of the Great North Care Record. We want people to be in control over how their data is shared. We need the public to understand how their information will be used and the benefits it brings to them, others within their community and those with similar conditions.  We want patients to actively opt-in to the Great North Care Record. The value of healthcare data is enormous for the NHS and for researchers. As a high-level strategic goal, we want to be able to unlock the data held in healthcare IT systems. Through doing this we can make the North East and North Cumbria one of the best places in the world to carry out healthcare research. To ensure that all considerations around safety, security and user experience are worked through, an advisory group has been set up, which brings together clinicians, information governance experts, academics and people who have led on projects from around the North East and North Cumbria specialising in setting up and gathering data sharing preferences. The aim is to produce a user-friendly mechanism for the people of the North East and North Cumbria to set their data sharing preferences. The group meets on a regular basis, and has already explored the issues, and bringing in real life experience, around getting individual’s permission to share their data for purposes beyond their direct care. At the same time, we are asking people for their communication preferences, so that researchers can contact people directly to participate in research studies. We want the region to be a consent rich research environment.  In addition, I am a clinical advisor providing clinical leadership and clinical engagement for the Primary Care Digital Transformation programme at NHS England.  Recently, a large element of this has been the introduction of a safe and secure way for patients to order prescriptions, book online appointments and access elements of their GP record, including test results, to support self-management of long-term conditions and improve health literacy. We want patients to be able to access validated information rather than rely on google searches. Q. The term ‘patient-centric’ is quite commonly used now in the context of healthcare – in your experience, what does being patient-centric mean and how can the use of technology empower patients? A. In a nutshell, the health service has historically been set up to support staff and clinicians, often not focusing on patient pathways, patient journeys or ease of digital access for patients. We need to focus on these and ensure that the technology enables safe services and easy access; to me this is the essence of patient-centric. Technology already in use in primary care allows patients to set or change a community pharmacy ‘nomination’, allowing electronic prescriptions to be sent securely from the prescriber to the pharmacy of the patient’s choice. Add to this the option of ordering prescriptions online, which provides a more convenient (24-hour access), and time saving (not having to visit the practice to make the request) solution for the public. The profession also benefits from clear prescription requests, which are safer, quicker and easier to process, and an end to end audit trail for prescriptions, from ordering to dispensing and collection. Providing patients with access to their own GP record, enables them to be more involved in managing their own care, and making informed decisions about the care they choose to receive.  They can choose to share their information with other care professionals, which is particularly useful if they need to be treated when they are outside their geographical area or abroad.  Fundamentally, we need to develop systems based on patients’ requirements, listening to their feedback and input, and avoid trying to shoe horn elements of technology into often disparate and out of date systems. Q. You mentioned in an article by Digital Health that “digital transformation would not happen in the NHS unless it offered more equal representation across its workforce” – what do you think can be done to encourage more women to take up leadership roles in the NHS? A. I believe part of the issue within technology is the terminology used. When we talk about IT, digital or electronic, the assumption is often a very ‘technical’ IT and male preferred environment. We need to change the language to include ‘clinical system’ supporting and enabling safe care.  There are a number of strategies that organizations need to adopt, including flexible working, senior and managerial positions offered at part-time or job share arrangements.  Managerial and senior leadership in all organizations should loosely resemble the workforce. So if there are 60% women in the workforce, then this should be representative, without of course, compromising ability and suitability.  The opportunities for development need to be broadened, offering not just training and leadership courses but shadowing, peer review, and mentoring schemes. Q. You are going to share on the topic, “The path to patient self-care and management using online access in England” at the HIMSS Singapore eHealth & Health 2.0 Summit in April. Could you tell us about two key takeaways/lessons from the session that can be applied outside of the NHS? A. "Never underestimate the amount of workforce engagement required and the cultural change needed." While some of the systems we have deployed could be described as ‘a no brainer’ to save time and improve efficiency, unless this is supported by engagement, business change and wide communication the system will not be utilized to maximum efficiency.  "What’s in it for me?" Think about your audience, and what they will get from the system. If this is for patients or customers it needs to be easy to use, reliable, and available when they want to use it. The usability needs to be excellent, it is said that an app will be used or discarded within the first 30 seconds after download, so workflow needs to be seamless.  "Why" is an often-overlooked element, and needs to be fully explored and easily articulated, many projects fail because the why has not been fully developed.  It may be a non-cash releasing benefit such as improving safety, security and convenience.  It could also be time saving, in which case toolkits such as easy to use time saving calculators should be made available to demonstrate this benefit. All these must be supported by interactive, searchable and to the point guidance documents, which allows for quick access to the information the user is searching for. Fiona McDonald is a speaker at the upcoming HIMSS Singapore eHealth & Health 2.0 Summit from April 23-24. Registration is still open and you can register for the event here.

The Digital Transformation Agency, set up to improve people’s experience of government services, has set out new requirements as part of a new Secure Cloud strategy, bringing more change around privacy and security policies for all industries including healthcare. The new requirements demand Australian software companies to complete a compliance process and accreditation before they’re able to roll out third-party services. The mandatory policy applies to any third-party that uses cloud services to connect with the Department of Human services (DHS) – this encompasses services such as My Health Record, Medicare, National Disability Insurance Scheme (NDIS), Pharmaceutical Benefits Scheme, and other forms of care. Macquarie Cloud Services Head of Customer Experience Phil Wallace said the move aims to lift security protecting sensitive health data and payments platforms, which is vital for healthcare as it’s responsible for more mandatory data breach notifications than any other sector. “Because of the sensitive nature of healthcare data, the DHS has always had to meet heightened security standards. The policy has two mandatory requirements, being DHS certification and that cloud providers must use sovereign Australian onshore solutions,” he said. “Cloud solutions can be complex and distributed by nature. By helping the industry move to new, more secure onshore secure standards, it removes the threat that one link in the healthcare supply chain could compromise sensitive data and payments for all users.” Wallace said a secure cloud strategy policy puts in place standard processes for organisations to follow, to enable an industry-wide compliance obligation. “Health technology is complex; products may be subject to a whole range of standards and protocols, some of which are still being defined. Getting the critical area of data storage security right enables organisations to start concentrating on the protocols in their practice.” Medical Software Industry Association (MSIA) CEO Emma Hossack agreed with Wallace, adding that privacy of patient information is critical for healthcare providers. “In the event that providers are using web-based solutions – and this will become increasingly common – then security of transmission and storage of health information is no longer a nice to have; it is essential. There is no privacy without security,” she told HITNA. [Read more: Why health orgs are embracing cloud to improve physician and patient experience | Why hospitals and health insurers are really turning to the cloud] According to Hossack, associated problems in the healthcare space aren’t to do with software, but rather, how it’s deployed and the security protocols around it. “It includes allowing multi parties to ‘share’ an individual’s password, which negates the benefit of access logs and weakens security and privacy,” she said. “This comes down to training; it’s an area which the MSIA will work with the Australian Digital Health Agency on this year to encourage all health organisations to continually train staff on the use of software – both in terms of functionality and security.” Hossack said this move is just the start of improving privacy and security in healthcare. She suggested that various divisions of healthcare band together to educate the industry about the changes. “Change takes time. Education about the importance of security for consumers’ privacy by the government and the whole health industry is the best way to overcome the challenge. Education by colleges and other peak bodies like the Practice Managers Association and nursing bodies responsible for accreditation and standards is also key.” Greenlight ITC CEO Mike Smith said policy is important, but healthcare providers that aim to achieve them on their own, with limited resources and constant change, will find it challenging. The managed service provider and cloud support partner to software companies servicing the healthcare sector has worked with medical billing experts and other healthcare software companies on compliance. “Many healthcare users face challenges just sustaining current operations in the face of aging assets, rising costs, the war for talent and growing complexity. When healthcare providers partner with local experts for compliant solutions, everybody wins,” Smith said. [Read more: The time for healthcare to embrace cloud, is now | Allscripts and Microsoft partner to build new tech for clinical research in the cloud] Smith said there are a number of other initiatives healthcare providers can take. They include:  Keeping abreast of new legislation or changes  Actioning on changes as soon as possible to allow as much time as possible for adjustment      Keeping customers and partners informed of changes throughout  Identifying efficiencies to offset rising costs  Incorporating other requirements like monitoring and backup when teaming up with a partner. “New legislation, constant change and more distributed modes of care are making it harder for practitioners to concentrate on helping people. Organisations should look to offload such compliance and security burdens to specialists, so they can free resources to help more people,” he added.

And in another AI collaboration announced this week, Siemens Healthineers is partnering with Intel to explore how machine learning can improve cardiac MRI diagnostics.

CDP will connect data sources so customers can create a more complete profile of their patients.

Royal Devon & Exeter and Great Ormond Street Hospital NHS foundation trusts also picked Epic as their EPR supplier in the past few years.

The National Coordinator talks 21st Century Cures, information blocking, Apple, consumerism, FHIR, open APIs and new business models he sees emerging amid the "overarching theme of human choice and freedom and dignity."

Here’s a look at how the cloud is changing the industry and top use cases for pharmaceutical companies.