Keith McNeil, NHS Chief Clinical Information Officer

1. Which one are you?

2. Life is all about information
 The Big Bang
 DNA code

3. Data is the new crude (oil)
 Unrefined it cannot be used. It has to be changed into
petrol, plastic, chemicals etc to create a valuable entity.
 So to must data be broken down & analyzed for it to
have value
Michael Palmer

6. Simplicity
Alignment

7. The Digital Health Agenda
- the simple version
 Collect data at source
 Aggregate all that data
 Analyse it
 Use the knowledge gained to improve patient
outcomes and system sustainability

9. The What
 Every 36 hours c1 million patient interactions across
the NHS
 Capture the information from each & every one of
those interactions
 convert that information into 1’s & 0’s
(that’s why we go paperless!)

10. The What
 Convert all those 1’s & 0’s (data) into knowledge
“Endow that data with relevance and purpose”
Peter Drucker

11. The What
 Create learning/knowledge based organizations
“Individuals discipline their own performance through
organized feedback from this data”
Peter Drucker

13. The Why
 Improve patient outcomes
 Fundamental reason clinicians record patient
information is to enable them and their colleagues to
deliver better care

14. The Why - Safety
~1m admissions / year
with label of drug
allergy
PREVENTABLE
DEATHS

15. The Why - Sustainability
“The biggest threat to the American economy over
the next 20 years is not the global economic
crisis, it is the cost of healthcare reform”
Barack Obama

16. The Why
 Close the Gap
 Address the challenges in the 5 year forward view
 Enhance/induce system sustainability
 underpins delivery of high quality healthcare
 use of data to improve productivity and effectiveness

17. We simply have to do better
-we have to change the way we provide healthcare

18. The Why
 To deal with complexity
 To bring order to chaos…
 chaos is not random
 It is unpredictable because we aren’t sophisticated enough to
measure & interpret all the variables and variation in the data
Turn data into information…
information into knowledge

19. The Why
By collecting, aggregating and analyzing data, everyone
gets better at articulating their demand and reciprocally,
providing a service in response
Google, Uber, AirBnB etc

20. The Why
 Efficiency
 Intrinsically dependent on flow of information, which
allows:
 alignment of systems & processes
 avoidance of duplication & unintended variation
 Saves time!!!
 one of our most precious resources

22. The How
 Ensure that information is captured as part of the care
giving process
 Each & every one of those one million interactions

23. The How
 Record said information in a standard format(s) so
that it can be:
 extracted automatically
 interrogated intelligently
 applied effectively
Data is ‘encoded intelligence’
We need to decode it

24. The How
 How do we deal with complexity?
 The keys to dealing with complex system dynamics are
simplicity & alignment
 not over complication and silos!

26. Leadership in the Digital Age
Critical to dealing with complexity
 Allow ecosystems to become self-governing/self-
organizing
 Traditional infrastructure will shrink as platform
models become more prominent
 Less reliance on contracts and central enforcement

27. Leadership in the Digital Age
 Not about cost per se
 About finding the best way of creating value and
improving patient (customer) experience
 Define who does what best
 Who can contribute the most
 And where they sit
 Cost improvement flows from value creation

28. The Strategy…
there is a better way!

29. The Strategy
 Digital Maturity Program (‘Paperless 2020’)
 Based around NIB domains & programs
“Vision without action is a daydream…
…action without vision is a nightmare

30. The Strategy
 NIB programs
 Enable data collection from across the system
 Enable that data to be shared (appropriately) across the
system
 Encourage innovative ways of capturing data
 wearables, apps etc
 Create capacity & platforms to analyze data at multiple levels
 local, population, cohort, metadata sets, ‘big’ datasets
 Allow access to the knowledge that is created

31. Clinician-
Patient
INFORMATION
AGGREAGTED DATA
ANALYSIS
Corporate/HQ
business
intelligence
data bases
genomics
phenomics
metabolomics
diagnostics
therapeutics
population health
prevention
information/knowledge information/knowledge
clinical audit
quality progs
apps
wearables
EHR
standards - data sharing – security - patient ID – analytics - interoperability
PRECISION
MEDICINE
PRECISION
MEDICINE

32. The Strategy - principles
 Simple/understandable
“a child of 5 could understand this;
so will someone please go fetch a child of 5”
 Grouch Marx
 Aligned

33. Alignment of the Stakeholders
Corporate
HQ
Regions
X4
STP’s
x43
Provider
organisations
Clinical
Units
Individuals

34. Alignment of the Digital Maturity Program
Digital
Maturity
program
Domains
x10
Programs
x33
Individual
projects
Business
intelligence
SME’s

35. Where are we now?

36.  Sitting on a cusp ….. of uncertainty
“When we fish for absolutes in the seas of uncertainty, all we catch
are doubts”
Embrace the 80:20 rule!

37. Where are we now?
 IT in the NHS today…
When the tough gets going…
The tough go shopping!
…we have to have the courage to fail

38. Take a risk
… the rewards just might be worth it!
“Any man who can drive safely while kissing a
pretty girl is simply not giving the kiss the
attention it deserves.”
Albert Einstein

39. Where we want to be…
Good
Better
Best

40. Where we want to be…
 Exemplars
 Learning & knowledge based organizations at the
cutting edge of digital medicine, where
 individuals use data to drive their own Q thus improving
patient and organizational outcomes
 learning and benefits are shared across the system resulting in
 system sustainability and enhanced effectiveness leading to
 enhanced quality of care & improved patient outcomes

41. “We choose to go to the moon… not because it is easy, but because it
is hard,
because that goal will serve to organize and measure the best of our
energies and skills,
because that challenge is one that we are willing to accept,
one we are unwilling to postpone,
and one which we intend to win.”
JFK

42. Our future…and the future of
our patients
Depends on many things……
but mostly it depends on us!

43. So…

44. There are 10 kinds of people in the world…
Those that understand binary and those that don’t

45. “… and so we come full circle,
to the place from which we set out,
and see it for the first time”
T.S. Elliot