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(275) Building hospitals

On this week’s show we are joined by Mark Taylor to explore the technology challenges behind building a brand new hospital.

Show Transcript (automatically generated so treat with a little caution)

Matt: Hello and welcome to episode 275 of WB40, the weekly podcast with me, Matt Ballantine, Chris Weston and Mark Taylor.

Chris: Hello everybody and welcome to another episode of WB40. We’re here again after maybe a week off. Yes, it was a week off. , I seem to remember I was away last week and couldn’t make it but now we’re back this week and we’re going to have a… An interesting conversation about all sorts of things, but particularly healthcare.

And, , we’ve got a guest who we’ll introduce you to very shortly. , but before we do that, I’m gonna ask Matt, as is my want, on these occasions. How was your week, Matt? Well, 

Matt: Fortnite, indeed. Yeah, Fortnite, indeed. It’s been good. I’ve been… Doing more experiments, been experimenting with, colleagues into getting people to think about the way in which we manage the work that we have with our clients above and beyond the work that we do to be able to deliver software for them.

So the thinking around the broader stuff, the strategic stuff, the, the value adding stuff, the bits that often when you’re caught up in the day to day of delivery, you don’t, get the chance to be able to raise your heads above the parapet to be able to think about. And being as it is my want, developing a new set of playing cards to do it, which I’m quite pleased about.

But I also invented a thing called the Emojilizer. Which is called that because it looks a bit like a graphic equalizer, but uses emojis. And, uh, we ran a session with about 40 people who work for a very big, very serious government client. And everybody got a lot out of it, I think, which was good. So that was last Thursday up in, , Manchester.

And, other than that… I have been, I don’t know, having coffee with people and working out how to get more statements of work because you know how I love a statement of work. Oh yeah, getting more statements of work ready and signed by clients. And I had a lovely weekend, mostly spent with my youngest son because everybody else had disappeared off to do more interesting things.

We went into London and looked at museums and ate burgers. So that’s, that’s a rough. , approximation of the last two weeks. First of all, are you feeling better? Because you were a bit rough last time, or rougher than usual anyway, last time 


Matt: spoke. 

Chris: Oh yeah, that’s right, a couple of weeks ago I was all COVID ed up, wasn’t I?

And I was feeling pretty, pretty grim, I have to say. Yeah, I feel a lot better, thank you, yes, much better. 

Matt: That’s good to hear. And did whatever you did last week that meant that you just let everybody down in the WB40 family? Was that good? 

Chris: All the ladies and gentlemen knew that I was unavailable, , and they’d have to wait another week, but they were fine about it, I’m sure.

 So last week, actually, I was, and it does seem like amazing that it was a whole week ago because it seems like only yesterday there was a Midlands Women in Tech event and a couple of other people from, , company were nominated. So we, we, we took a table and we went out and had a nice, uh, you know, uh, evening there and celebrated the women in tech thing in the Midlands, which was, , it’s always good.

, and yeah, I mean, it just, although it has been two weeks, it doesn’t seem like that because it’s been very, very busy. And actually one of the things I’ve been doing recently has also been, you know, kind of similar to you again, sort of. circling around and reiterating often the why people would do business with you at all as an organization and what they’re actually buying because you know people aren’t really buying whilst whilst the invoice says they’re buying technology services they’re not they’re really not you know they’re if you’re a in charge of technology in an organization and you engage a company to do something for you what you’re really buying is reflected glory in them doing a great job , and, and somebody taking away the, you know, the, the risk and the pain because you know that needs, you know, that work needs to be done and you can’t get it done yourself.

That’s, that’s the thing. And if you’re not delivering that, then, you know, it’s like the statement of work business. You go back, well, what was it the statement of work say? We did that and we did that. And you could argue we did that as well. Bollocks. Doesn’t make any difference at all. You have to, you know, if the customer doesn’t feel like you’ve.

You’ve done what you needed to do, then they, they won’t use you again. You know, and we pick up, work off the back of that because we, you know, run into lots of people who have had that experience with it companies. ’cause I mean, let’s face it, technology is a great place for, you know, exaggeration and, , you know, 

Matt: snake oil, charlottean and, 

Chris: and you know, hopeless optimism.

Oh yeah, we can do that, eh, three weeks, no problem. 

Matt: I think this point about though the being able to understand what you are truly delivering and the value that you are there to. Produce or to, to create or whatever. It’s also something that internal groups need to be able to do. And I see this again and again, where, , internal technology teams don’t realize that they also have to do that selling.

And often, you know, the sort of work that you and I do, we are selling to people who themselves need to sell, but they’re actually not very good necessarily at doing the internal selling and being able to understand. All of those complex relationships, especially when to be able to procure technology these days is as easy as to go onto the internet and to go to a URL and not even necessarily have to put in a credit card detail, that being able to be able to compete with that and be able to understand and allow your internal customers to understand why it is that you’re adding value is as important as external providers providing value to, you know, proper inverted commas, et cetera.

Chris: Yeah, well, especially given that the alternative is often to go to somebody who acts as if helping you out is causing them actual physical pain and you’re, just an inconvenience in their day. Well, guess what? They will go somewhere else anyway, but we say we have a guest, so let’s, let’s, let’s stop talking amongst ourselves, Matt, let’s, let’s introduce our esteemed guest.

 Who is this week is Mark Taylor and , Mark, , well. The hospital that you’re building, Mark, is called Met Midlands, is that right? 

Mark: It’s the Midland Metropolitan University Hospital. So we call it M M U H for short. 

Chris: M M U H. Gosh. 

Mark: Yeah, it was that, that hospital Carilion were building before they went into administration.

Chris: Oh, right. Was it, I think they were building one or two, weren’t they? They were. That happened and uh, that was a little while ago now, wasn’t it? That was three or four years ago. 

Mark: It was, yeah, I think it was in 2018. I think it was 26, 17, 18. 

Chris: Gosh, again, that just seems like yesterday. So we’re going to talk about health care, tech, you know, you’ve got this brand new spanking brand new hospital that’s being constructed in the black country and it’s gonna have All of the things that we can see the sort of standard in tech and in healthcare these days, but probably 20 years ago I mean certainly 20 years ago weren’t weren’t around and how people Get along with that tech how they have a navigate that world now that we kind of expect tech to be to be in our In all our workplaces and all our processes.

So yeah looking forward to that and we’ll crack on

so mark then let’s I think for a start off, it’d be nice to know, let’s talk a little bit about how you get, you got to where you got to in terms of how did you get involved in tech and in health care, which came first. 

Mark: Tech. Tech. I’m going to tech you through and through. Back in the good old days, I think it was about 12, ZX81.

So, when you did that show a couple of years, was it? When you went through all the different computers, which was the best computer? I was rooting for the ZX81 and then the VIC 20. But yeah, started then. , and then, then I went on, I left school, 16, and dropped onto a YTS course, so the good old youth training scheme, computing, using the, um, Amstrad CPC 64s, I think it was then at the time.

464, yes. Four, yeah, yeah, having a race to see who could, Type A to Z the fastest to see who could, because we thought that would enhance our careers moving forwards, but it’s there. It’s a skill. It’s not done too bad, yeah, yeah, I got there. I think from that then really I just moved into, my first job really was, From that was just data entry in a vending company, but I managed to get my lucky break, get into the computing side, then moved into healthcare.

Then about 1996, I think it was about 96, 97, dropped into healthcare as an infrastructure engineer. And I’ve just had various roles now through running the. running the IT side for Walsall Healthcare Trust. So I was just down, down the road from, from where I am. And then I moved across to San Juan about five years ago, delivered a shared cared record, which is where we bring all the data from all the different systems into one shared cared record.

So if you go to a hospital, they can see your GP details, no matter which hospital you go in across the black country. So we’ve got the starts of that in, and then took on the mantle of, of being able to. get the IT working in the Midland Met when we open. 

Chris: Well, you know, and say, at the cutting edge, I guess, I mean, there’ll be some interesting technology in the Midland Met, I’m sure.

Or certainly stuff that you wouldn’t have expected to be in such a Unit 5 or so years ago. 

Mark: Yeah, yeah, absolutely. So, I mean, I think one of the fundamentals of any… Any smart digital hospital has to be your, your infrastructure. So we’re just making sure that we’ve got robust and very comprehensive Wi Fi network, really, I think is the main thing.

But importantly, it’s not just a Wi Fi network we connect to, it’s a Wi Fi network that can detect where stuff is. as well, which I think is important. So we want to be able to track things around the hospital for many, many reasons to locate, improve efficiencies, find all of, all of that wonderful things we can do.


Chris: That’s really interesting, right? Because when I, I probably told you this before once when, when we’ve spoken, previously is I used to work in healthcare in sort of FM and things like that. And one of the things that Hospitals were always trying to do was locate where things were, right?

Wheelchairs, beds, stands, you know, porters. All sorts of different things that go missing in a hospital. Wheelchairs are often, I think that’s the reason that wheelchairs in hospitals, you can only pull them. You can’t push them because, or in many hospitals, that’s the case. Because otherwise, if they’re too useful, they just get taken home with.

Whoever happens to be sitting at the time, they go in the back of a big, big car and that’s it, nobody ever sees them again. actually tracking these, devices was a real issue, right? And, but of course, and everybody came up with RFID type, but it needs lots of infrastructure, extra infrastructure, and it was expensive.

So are you, are you looking at asset management in that terms, like bed movements and kit? Is that, or is it more electronic, you know, devices are going to ping kind of? Yeah. 

Mark: So what, what we, what I’m trying to get put in place is what I call a real time location service. So in essence, it would just be a layer which will enable any, any application wants to find something.

If it knows the idea of it. it can find it. So then therefore, if I have a, for example, we’ve got a medical devices system that wants to find where an infusion pump, a particular infusion pump is because if it’s up, it’s up for pre planned maintenance. So the type of system can then knows the ID of the pump, can talk to the interface layer.

Find out where it is. So it’s on Ward A1, for example, pop along to Ward A1 using then a local map that can then pinpoint more precisely where the device is. If you’ve got a wheelchair system and you want to locate a wheelchair, again, you just talk to that. So I’m trying to create those layers of tech to try and reduce down that technical debt that way.

Then. We can replace the tracking system quite easily if we need to because something better comes along in future without necessarily destroying all of the interfaces because it’s just a simple API call to find out what you need to find. you just extend it then on and on and on. We can, one of my favorite, two favorite examples are Uber for porters, like you say.

So we can track if we know where we are and we want to get a, and we want to get a patient from your ward. to down to imaging, for example, and they need a wheelchair. If you know where the porter is, you know where the wheelchair is, and you know where you are, put a layer of artificial intelligence on the top, put some digital wayfinding together.

And before you know it, you’ve got a way then of finding the best porter who’s just finished a job can go and get the wheelchair from a location, come and pick up the patient and take them down. So that’s the vision of where we want to get to in fullness of time. The other side is a bit like, you know, when you go to, sometimes you go to places like or in terms of Drayton Manor at the front of the queue, they’ll give you a token or and you hand it back when you get to the front and they’re just tracking the queue time.

Well, if we did the similar kind of thing in ED, we could track a patient through a particular pathway that might be running a little bit slow or not as efficient as we want. We can track them through the department and see where we go. So there’s, there’s many things that we can do, I think, with ACID tracking.

Matt: What are the technologies that you’re using to be able to do that today? Because for people who aren’t involved in that kind of world, our experience of knowing where things are is mostly driven by GPS.

GPS is very good, except it’s not very accurate. And it’s only really purposeful when you are using it outdoors, because if you can’t see the satellites, it’s bugger all use. 

Mark: So today, today, as we are today, literally they just use WhatsApp groups and it’s a case of who saw. Who, who’s the last one to see a particular device. So if you’re a physio and you need a, you need a hoist, there literally is a WhatsApp group and they go, does anybody know where I’m in this location? Does anybody know where the hoist is?

And then somebody says, Oh, I saw it last on board 23 and then et cetera. What we’re looking to use within, within, Midland Meta is we’re using just a Wi Fi network. So we’ve got HP as our Wi Fi network, and we’ve got their series five WAPs, which have the, the RTLS built into them. So we’re looking to use the technology with that, which is your Bluetooth, it’s your ping in, ping in out via the RFID tags, et cetera.

we’ll just use that then to, to provide the service and that then will deliver that location service, which other applications will talk to. So that’s how we, we’re looking to do it. Interestingly, it’s interesting you mentioned GPS. We’re, we’re currently doing a trial with, so obviously we, although we’re a hospital, we’re actually a community.

Trust as well. So we have paid. We look after patients, not only in the hospital, but in the homes as well. And we’ve had a lot of issues where we’ve had some medical devices misplaced. We’re not sure where they were. And we were continually having to, obviously, we still need to provide the service. So we’re having to buy new ones.

So we’ve, we put some GPS trackers onto the, onto these devices and we’ve not lost one since. So we, so we’ve, we can track it then in the community. What we want to do then is we want to actually actually know there’s a funny and well kind of funny anecdotal story in that we we couldn’t find a medical device and it was actually unfortunately the patient had passed away and it was at the undertaker’s.

So we actually had to find and we rang them and said, you’ve got a device. No, we haven’t says you have we can see. on the actual map and it was there. It had obviously, when the patient was taken away, that collected all the kit together and it had all gone. So we was able to, to relocate it. So that’s the usefulness of it.

one of the interesting tech advances I want to see is how we go from outdoor to indoor. So you’re right, once you get inside the building and I mean Midland Met is about 90, 000 square meters over nine floors, of which there’s two underground levels of car parks, and then. two or three levels then, which are absolutely GPS signals, not going to penetrate.

So actually, if we do bring a device external to internal, how do we track it? How does it go from that external GPS to the internal RFID based solution? So looking out for that now as well.

Chris: I’d say that the, in my experience, people are surprised often about how, how almost the most simple. Improvements could change hospitals, almost radically change hospitals and healthcare. Just like bed management, for example, if you’ve got like a, if you’ve got a facility that’s got 80 beds, just to pluck a number out of the air.

If you can’t, if you’ve always got like 20 percent out of action because they’re being cleaned or made up or 80 beds facility. You know, what’s 20 percent of 80? I wish I hadn’t chosen that number now. Uh, you know, 65 or something. Or something. You know, but you know what I mean? That’s, you, you, you, you’ve built this thing with let’s say 100 beds, right?

And now you’ve got 80 beds. in actuality. Whereas if you can, if you can… Through a slightly better process, change that to 15 percent rather than 20 percent that you’re missing. Then suddenly you’ve got five extra beds in your… Our bed in a hospital is a bloody expensive thing. If you think about the space you need, the real estate, you know, everything that goes around.

a hospital bed to be provided. If you can get five extra at any one time, it’s a massive difference. So, just those things about knowing where things are, what’s happened last, getting the right information to the right people at the right time. Things that we would consider relatively straightforward, but actually in the hurly burly of a hospital is, it is really still quite difficult to do, isn’t it?

Mark: It is, it is. And I think you’re right, knowing where, knowing where things are is. Can help massively in terms of being able to connect the dots. But I think what we want to look for, where we want to go is then we bring got, this is where we’d learn and start to look and bring the IOT into it. So. As I, you mentioned quite right there, we’ve got beds, so we’ve got about 700 beds, of which half are single occupancy rooms.

So, when a bed becomes vacant, obviously we have to do it, we have to clean it. So, if we were to merge into all of this then, Internet of Things, so, if we’ve got sensors in a room. And we’ve got housekeeping and they’re clean, they’re doing what they need to do. They’re cleaning their areas of rooms, et cetera.

But actually, if we had sensors and we knew that a meeting room hadn’t been used for four or five days, and we know that from IoT sensors, the bins actually have got nothing within them, why clean it? That saves time. If we, if we know that, for example, some toilet rooms that haven’t been, nobody’s gone in for the last few days, do we need to go in there and clean them as regular?

One could ask. But what that also then allows you to do is if you then start to layer on top of that, your, your application stack. So you’ve got your digital way of finding, you’ve got your intelligence scheduling. You could have a house cleaning person going around the hospital and actually a bed comes free on a ward.

And that bed might literally be just. By the lift up one floor and you’re there. So actually at that point, if you can get really intelligent, advanced, smart scheduling, you can then say to that client, actually stop what you’re doing now. Can you go and clean this bed, please? Because as soon as you clean, as soon as that bed’s cleaned, we can then get somebody new in there.

Meanwhile, I’ll distribute your tasks to somebody else and, and it’s all that. So it’s all around, and my prime driver is around how we save time. Because if we can save time for people and ultimately that manifests itself as better patient, patient care. 

Matt: From my, limited experience of working kind of scientific and, Healthcare environments.

One of the things that has always struck me is there’s kind of, there has been, I don’t know if this is still the case, but kind of two classes of the way in which I. T. has been used. You’ve got I. T. being used as part of general purpose I. T. systems and, and for communication and for information management and all the rest.

And then you’ve got, particularly kind of PC type devices being used as a part of a particular medical device. And one of the challenges of that management, and I’ve seen it in in healthcare also, so actually down the road from where I live, the National Physical Laboratory, where they have got loads of labs with loads of complicated and expensive bits of kit, many of which are Powered by a PC, every single one of which is basically completely bespoke and unique because the manufacturers don’t think of these things as PCs, they think of themselves as a part of the control system for their very special, very expensive device.

And as a result, there’s a massive challenge around like technology management, because you’ve got lots of semi managed devices, you’ve got lots of devices that you can’t do properly upgrade. Paths on because the manufacturers haven’t been able to keep up to date with the, you know, the windows operating system updates or whatever else.

And that’s ended up being an incredibly, both very complex environment to manage just at a practical level, but also a very potentially risky environment from a security perspective. And is it still like that? 

Mark: Yes, but we’re getting better. So I think everybody remembers probably back a number of years, the WannaCry incident within the NHS.

And that luckily I wasn’t impacted in my organisation. I was stopped all the emails, stopped all the websites, and we managed to get away with it. however, you’re right. There is, there is that linking of a PC. to a piece of kit to be able to control and therefore it’s classed as a medical device. It does become very tricky when you’re looking to try and do your updates.

We’ve got some, I mean, at our organization, we have some PCs that drive cardiology based operating procedures. So if that PC’s has an issue. You’re literally halfway through a procedure at that time where they’re doing things around the heart. So clearly we have to make sure that everything is secure and safe.

I think sometimes you just, you’ve, you’ve got to be practical, in that you’ve got to wait, you have got to wait for the supplier. But what you’ve tried to do then is you just try to isolate that kit off your network as much as you can. So yes, it’s required, but then you ask yourself, well, Which, how does it need to communicate and can you limit its communication to only what’s necessary?

Can you segregate it away from the rest of your, devices, et cetera. And we do a bit, probably a lot like, I mean, there’s probably other industries, obviously manufacturing, insurance, finance. I’m sure that everybody’s got these rogue. Pieces of technologies, which are just creating, a cyber nightmare. I think where it gets tricky is when you start looking.

is now have more smarter devices, which aren’t necessarily a PC. So they’re like a, you’ll have a medical device that actually is, has got exposure to the network. It has a working CPU running an operating system behind it. And actually what we’re starting to find is that those starting to be. to be looked at.

Now, they’re more difficult to get at because they’re not exposed externally. However, if somebody is able to get onto your network, they can then start hopping through those. It’s, it’s, we, we have the same problems as everybody else does. 

Matt: And I guess that, yeah, as you say, as more and more manufacturers add in connectivity as almost like a value add, as opposed to with any serious intent behind it, that that’s where it becomes really interesting challenges.

I know Chris, from your experience in the facilities world, that that’s been a problem for many years now. and I guess the other part of this then is the extent to which then those devices at a data level. You know, how well standardized or otherwise data interchange between different platforms is and I, from the look on your face, I’m imagining that that’s also a bit of an issue.

There is a, there is the role though, I don’t know if, if this is, super prevalent in the UK. I’ve certainly seen it in the health service in Ireland as the chief clinical. information officer, which is a, an interesting hybrid role, which is somebody who comes from a clinical background, but is there responsible for data effectively?

Is that something that we, we see a loss of? 

Mark: So the role I see as a chief clinical information officer, , as I know them are, is a clinician who has that clinical background and therefore has that ability to talk to other clinicians and they’ll, they’ll, because often you could be a techie who knows, but if you’re not a clinician, you don’t necessarily know it from their perspective.

So they’re a clinician who’s got a keen interest in IT, but also then. can take on and start to become your clinical safety officer as well. So the way that, the way that we use them then is to be, we can probe them for ideas. We say like, I’ve got this idea, what do you think? And they can go, sounds great, but you need to think about X, Y, and Z.

So then when you actually then speak into the service, you, it just helps you then, so you can bounce, you can bounce the ideas off to get that credibility. But then we also might use of them then. to like say as a clinical safety officer to look at the hazards of implementing systems. It’s a legal requirement for us to do that.

We’ve got to do a clinical safety case for going live with Midland Met. For example, we can’t just open. We need to show that we’ve reviewed all the risks. So although it’s very much a. It can be an IT based one. It’s also, it goes into the physical world as well, but yeah, they’re, they’re, they’re a growing breed and I think you’ll, you’ll start to see probably more CIOs come from that way in time as well.

I think you’ll, you’ll see some clinicians who will go down that route and they may reach a point in their career where they think actually, I quite like the idea. Quite into my IT, I’ll do my, I’ll do a supplementary course or informatics degree or informatics qualification to just bring me up to speed in that world and they’ll become that, that CIO.

So that, that’ll be an interesting turn, bit like finance was for many a year. 

Chris: Well, I hope so. I hope so. And for a long time, I’ve been a bit of an advocate of people almost taking the CIA role with an enthusiasm and an, I guess, an empathy and not just because they believe everybody in IT is an idiot and they want to sort them out.

But, you know, a genuine belief in what the technology can achieve, but not necessarily. Any experience in delivering it because if you’ve got the right people around you and you know, you know You know what you don’t know, but you understand your domain, you know, what that can be very very powerful Well, but the problem is is often it’s it’s a cruel world to be in right?

It’s it’s hard and on there’ll be people who will you know, delight in seeing people like that fail So it’s you know, you have to be in the right environment and you have to have the right culture in, in, in what you’re doing, but I think the more people who get involved in the management and delivery of technology who don’t understand how it works, the better in many ways, as long as they’ve got the right people around, 

Mark: I guess where I see that maybe struggle is in that horizon scanning side, knowing where to look, where the new technologies are coming.

And being a techie by background, we tend to naturally horizon scan ourselves, don’t we? We just naturally, I mean, I’ve come across one. earlier about, uh, was it a head teacher at a school? Is the deputy head or he’s going to be, he’s a chatbot. He’s like an AI. It’s a posh school. I just read it on the, the mail online.

I was like, crikey. So it’s just fascinating. Now, but you’ve mentioned taking that now to the next step. Actually, how long is it before avatar actually says hello? Um, And how can I help you and, and tell, you know, what’s your name, who you are and what, what, what you’re presenting conditions and how long is it before then AI and the, the data we collect and starts to become, really quite blurred between that human and that, and that AI, but yeah, I think horizon scanning possibly is maybe just the area.

Matt: I guess the other, perception I’ve had of, of what, maybe some of the challenges in delivery of technology within the health sector. system lie is around the number of boundaries there are. So in most organizations, a good rule of thumb is if you want to know where the pain points are, is the boundaries between professions, boundaries between organizational units, you know, it’s, it’s the, the, the edges of the silos is where the problems usually occur.

And within. The health system, you’ve got just a shed load of boundaries because of the way that the professions are structured, because of the way in which the, you know, nursing is a separate profession from the way in which the consultant and doctor structures sit. The, the, the consulting and doctors have…

medical specialisms that are very, very precisely defined. And just with that amount of complexity in terms of the way in which those different groups sit together, you know, you see it manifest.

You see it from the number of forms that get filled in when you go through. A hospital process because each group needs to be able to cover themselves and understand it from a slightly different perspective. And so there’s a lot of duplicate data gathering. There’s, a lot of data that is transferred maybe somewhat clunkily from one place to another.

And it’s a kind of, it’s the information systems are just a manifestation of the underlying complexity of the way in which just the healthcare industry operates. Are you finding ways to be able to start to be able to smooth the transfer of information across those boundaries through what you’re doing? 

Mark: yes, yes, definitely. So. We have in the health world, the equivalent, I guess you could call it SAP, but across healthcare. So we call it the, it’s got a couple of names, electronic health record, depends if you’re English or American, but electronic health record, electronic patient record, et cetera.

And these tend to then start to be, there’s, there’s, you get your big boys in the market who can deliver a lot of disciplines within their one. So you get your ED, you get your theatres, you can get your outpatient clinics, you can get all of your different specialities, but because they’re all inputting the data and they’re all viewing the record in the same system, it helps to, I guess, unblur those lines between Those, those sites, because you’re right, there are definitely between departments that can be, be an issue.

But I guess if they know, if a patient comes into ED and the ED consultant looks, reviews them, they run their doctor, run their tests, etc. But then they decide then that they’re going to admit that patient. By having ED on the same system as what the ward will be where who’s going to look after that patient when they are moved Then into the ward the consultant who then takes over that patient because it’ll be a different consultant They look on the system and then they can see that everything was Everything what’s happened to you whilst you’ve been in your hospital for that particular journey if you’ve been to the hospital previously They can also see then what if you’ve been in before I mentioned right at the beginning of it The intro about shared cared record and that shared cared record helps to then start to, connect to organizations together because that’s where as a health service we struggle.

That’s our biggest struggle. We. Once you’ve been into a hospital, it’s, we’re mandated that we need to send a discharge summary to your GP and we have technologies in place so that they, as soon as it’s completed, it’s then electronically sent. It used to be letters, which was scanned in and etc. But now we’ve, we’ve grown up now and we, we actually send it electronically now, which isn’t an email.

It is a system to system. So we’re really mature now. But, okay. The GP has all that data, but if I go to, I mean, my local hospital is, the Walsall Manor Hospital, uh, within, which is probably about five miles to my left, but then just two mile down the road to my right is Wolverhampton. And I say Walsall’s local, though it’s not classic just because it’s Walsall and Wolverhampton and Chris will understand the difference there.

I’m a Walsall boy, not Wolverhampton, so I’ll go to Walsall. But I think, but if I, If I was to be admitted into Wolverhampton after being admitted into Warsaw previously, they wouldn’t have known what was wrong with me. They would have had no clue. But now with the, now we’re starting to get these layers of sharing involved.

We are able to see between organisations. So internal to hospitals, it’s getting much better. there’s still a long way to go in some hospitals. They still have. disparate systems, which they try to bring together, but especially at Eritrus, we have one system which starts to bring a lot of that together.

Chris: When you, um, think about the, when this new hospital opens, Mark, when are you expected to open the doors? 

Mark: , hopefully the latter part of 24. 

Chris: Okay, so you’ve got a year, right? When it actually opens the doors, what do you think, , the leadership will be expecting from the tech team? in this hospital that they wouldn’t have been your previous establishments.

Mark: , I think we’ll have foundational layers in place, I think is the fair answer to that. We, we’re trying to, our overriding dream is that we open safely. So we, we ensure that we know where the patients are. So we need to configure our clinical systems because currently they’re in, they’re at Samwell Hospital on a ward called Priory and they’re in bed 22.

Well actually, when we move them, we’ll actually move them to another ward at Midland Met called A3. So we need to know where they are so we’ll have that in place. But what we will have in place is a good Connected infrastructure, which will then a digital strategy will then start to bring to life. So moving in next year is primarily focused around getting in safely.

If we can get digital wayfinding in, we will. If we can get a level of asset tracking in to at least track our medical devices, we will. But we won’t compromise moving safely to ensure that everything is right. I think that’s, that’s our primary driver. 

Chris: So in terms of improvements in. You know, the kind of smart hospital world where you’re looking for insights and the ability to make, you know, better decisions, smarter decisions based on what’s going on in that hospital.

Do you think that will take a little bit more time to roll out in terms of the, the management of the hospital? 

Mark: As we start to bring in other technologies such as like the, the IoT, digital twins, etc. to start blending it all together, then yeah, I think we’ll Then start to see, then start to be able to leverage.

All of those won’t too. I don’t think it be far. I think it’ll be within 12 months of us moving in that we’ll be able to start leveraging. ’cause we’ll have, like I say, we’ll have the infrastructure there. I’m just working through how we, how we get the right software in and then we can start to do, there’s a lot to do when you move, move.

We’re moving two hospitals into one and I guess we don’t want to, we can’t really over complicate it. We’ve got to try and keep it as simple as possible. It’s a massive logistic. Logistical, exercise and we don’t, we’ve got some tech in there, I must admit, I mean, we’ve got automated guided vehicles, for example, so we do have, we do have some, some layers of good tech in there, so that will take the, that will be one from our distribution centers up their own lifts up to the, up to the wards and delivering, delivering all of the, incoming bandages and et cetera into the wards and then taking away any of the waste.

Thank you. As well. So that will be a, that will be definitely a, a, a greater, but that’s more based around the building side rather than necessarily the, the operational side, which I’d like to say will come, will come later on.

Chris: I think that’s a fair point though. Right. And, and we, and the same conversation when we talk about complex legacy systems.

If you, if you want to modernize them, actually you shouldn’t, try to introduce new features at that point. You should get it to the point where, The new features are possible and then do the new features because actually getting that complex system to a point where it’s on a modern technology stack and everything still works and you can continue to operate is hard enough without, without complicating it further.

So I think that, that, that does make a lot of sense. But so I guess in terms of just healthcare, generally mark and the, the tech, the expectations around tech. And, you know, you talked about that community, you know, your community trust as well as a hospital. Do you see that there’s a thing recently in the news about virtual wards, apparently?

So Steve Barclay said, oh, we’ve got these virtual wards, or not none of the features of a hospital in the comfort of your own home. it’s, but we, you know, we are going to see more, domiciliary care and things like that. We’ve got an aging population. Do you think that’s, going to pervade further into, where a hospital becomes the centre of something like that.

Mark: Yeah, absolutely. I think it’s, it’s, there’s a term called, hospitals without walls. So which is, which embraces that virtual technology, virtual wards. So seeing patients in their homes, I think absolutely there’s, there is definitely a place for the use of tele telehealth monitoring, we call it. So you’re, you might be, you’ve been admitted and your length of stay might be determined to be five days currently, for example, because of the condition that you’ve got, but actually.

Days four and five may just be monitoring of you just to make sure that you, so we get you clinically stable and we just keep an eye on you and monitor you until we’re ready that you’re clinically safe then to, to be discharged. But if we were able to bring forwards that clinically safe. towards closer to the clinically stable bit where we’re monitoring you and actually we could monitor you in your own home.

It may mean that actually instead of going home on day five, you get to go, you get to go to your chosen place of residence in day three. And I say that carefully because sometimes, especially with the aging population that don’t necessarily always get discharged back to home. Sometimes they might go to a step down care, absolutely, or even a son, daughter, relative, that you sometimes you’d go back to there.

But if we can get you, if we know that your social health side is being looked after in the place where you’re going to go, and with this telemonitoring we could then reduce then how long you have to stay in hospital and we know it’s there’s lots of evidence to say that the quicker we discharge people the fast or the lung well actually conversely the longer they stay in hospital that you can then just pick up you know you pick up all the bugs etc and actually getting you home faster is better for you.

So yeah. Absolutely.

Matt: Fascinating. Mark, thank you for joining us this week. that was a really interesting Set of insights into what is a complex old world. what’s your seven days ahead looking like? 

Mark: , so we continue to meet with various suppliers around what the technologies we can, we can get in. We’re looking at, the possibilities around digital signage and digital wayfinding, another, another way of digital wayfinding.

It’s a program board this week as well. So I need to go along and demonstrate how I’m progressing and things are going well, which hopefully get the thumbs up. Then on Thursday, I’ve got some actual professional development. So I’m doing some leadership training. So that should be, that should be interesting.

We’ll see, we’ll see what comes of that. And then lastly, on Friday, we, uh, we’ve done a review with their national. Team around and the project as a whole and I’ve got to talk to him about our IT side So a couple of governance and a bit of development, which should be good. That sounds like a fan packed week 

Matt: How about you Chris?

Chris: Well this week is Birmingham tech week and I’ve got a couple of breakfast things. I’m going to In the next, in the next few days and, I’ll be keeping an eye on what’s going on there. We’ve got an interview coming out, with, Wend, our boss, who’s coming out onto the socials soon from, TechUK.

So, again, proud Birmingham business that we are. and I’ve got a day off on Friday. I’m going to decorate the front room. So, there you go. That’s, that’s my Friday sorted as well. Just need to go and buy the paint. So exciting. So what’s going on in your world, Matthew, in the next seven days? 

Matt: Continuing more experiments at work, and then we’re gonna go away for a few days because it’s half term.

So we’re gonna go to, I think, North Devon and see how wet and windy North Devon can be in the second half of October. My vote will be probably for quite wet and windy, but we will see how it goes. But I will be recording the show next week. That’s good. I like certain people. I’m glad. They find better things to do.

And then let everybody down. No. I’m a trooper. so with that, we’ve got a guest lined up. Can you remember who it is? No. Okay. Well, we’ll, we’ll have that as excitement for next week. in the meantime, Mark, thank you once again for joining us. 

Mark: That’s great. Thank you. I’ve enjoyed it. 

Matt: And, we will be back same time, same place, wherever that is, whenever that is, because it’s a podcast and it’s non linear, next week.

So see you then.

Mark: Thank you for listening to WB40. You can find us on the internet at wb40podcast. com and on all good podcasting platforms.

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