RCP Appoints Clinical Director for Digital Health

Tim Locke

Disclosures

August 06, 2019

The Royal College of Physicians (RCP) has appointed its first clinical director for digital health. Dr Wajid Hussain is a consultant cardiologist and cardiac electrophysiologist at the Royal Brompton and Harefield NHS Trust in London.

   

Dr Wajid Hussain

He is also associate chief clinical information officer at the Trust, represents clinicians’ views on the IT committee, and is involved in its digital transformation programme.

He also obtained a diploma in digital health leadership at the NHS Digital Academy and is now in the midst of his masters focusing on outpatient care in digital health.

Dr Hussain spoke to Medscape UK.

Q&A

What does the new role entail?

Primarily it is the response of the Royal College to say, we know that digital is going to transform healthcare in the next 5 to 10 years. We need someone who will help us formulate a strategy on how we will interact with it.

Obviously, there's been a lot of work on it already. But let's try and bring it all together into one central place within the Royal College, and then to represent the views of the College, and importantly, the views of members and patients to the decision-making bodies that are going to determine where things are going to go.

My job is really split into two as far as I can see.

One is within the Royal College, to create a strategy, a structure, a platform for different people to communicate about digital, and then to create a coherent vision of that within the College. Secondly, to represent the college externally.

Are colleagues within the College excited or concerned about the technological future, or a mixture of both?

Absolutely, there's both. There is complete acceptance that this is the future. I don't think I've found anyone who doesn't accept and welcome that this will occur. But there's also a lot of concern about how it's going to happen. What does it mean for doctors and patients? Are we going to be partners in this? Is this going to be done to us? Or are we going to be part of it?

We're very keen that physicians shape the future and make sure that it works for patients and physicians in the right way. Rather than an externally imposed agenda. That's why we want to work with NHSX and NHS England to try and shape the direction of travel.

I've met no one who doesn't agree that this is an important strategic role for the Royal College, which will affect everything.

The College has fairly distinct directorates, like the Care Quality Improvement Directorate, Education, and Research but all of them recognise that digital is going to be key.

In England, the Health Secretary and the NHS appear to be going all-in on a technology-driven future . Is everything in place to achieve that?

One of the big things that you hear from a lot of physicians is to say 'we can't even get a bed for our patient, why are you worrying about the latest new app?'

And purely on IT, 'I can't get my, you know, my Electronic Health Record system to work, why are we concerned about artificial intelligence and machine learning?'

But I think what we have to recognise is that this is going to happen, with or without us. It's a global phenomenon. And the two things are not mutually exclusive. Trying to make sure there is a bed, or that the electronic health system logs on, or that our computer works, does not exclude being involved in the stuff that's going to happen with artificial intelligence.

The Topol Review [into the NHS technological future, Dr Topol is also Medscape's editor in chief] was incredibly optimistic.

You need something to aspire to, you need to say, this is the roadmap, there might be some bumps along the way, but this is where we're going to go.

It focuses a lot on the upside. If we can improve efficiency, reduce some of the drudgery, then it actually gives us time to care. I love that concept.

We need to show people who think computers 'make my life difficult' that this is going to help you improve your life, make your care better.

Just a few years ago, some NHS hospitals had to turn people away due to ransomware attacks on outdated systems . Have things improved ready for the digital future yet?

I think there's a long way to go. The malware stuff was a massive wake-up call. You had lots of people in the IT community being ignored, saying we don't have the money, or the effort, or the time to do this.

Clearly that was a kick up the backside to show that you've got to do something about it. I think things are improved. But, is it possible to have a completely safe, secure system 100% of the time? No. The only safe, secure system is not to connect to the internet. But you know, you've got to have a risk-benefit analysis, and manage the risks sensibly to maximise the benefits.

In your technology role at the Royal Brompton and Harefield, do colleagues view you as a 'nerd'?

I was one of the computer club nerdy people in the 80s, you know slightly weird people who like computers. But then I went into medicine, and I kept it in the background.

I like computers but I'm not nerdy in that sense. But I am an enthusiast.

When I was appointed as a consultant, I wanted to run an audit on a particular procedure, AF ablation. I realised it was laborious, hand collected, going through every single set of notes. There's got to be a better way. So, I went to IT and said can you help me because I want a database so I can improve care.

It took forever to get this done. So I became a very vocal critic of our IT department. They said to me, why don't you become part of the solution?

So I got involved with the IT team. They are desperate for clinicians who are positive and want to help make them deliver things.

I got involved, and suddenly I became the person that they would turn to when they want to run a pilot, or they wanted someone to explain to other clinicians how it works.

I always see myself as a clinician. But over the last 4 or 5 years, I've become the IT person.

So if someone has a problem, they come to me. Now, that's not my formal role.

But I became like a facilitator between clinicians and IT. It was a two-way approach. I became like this bridge person between IT and clinicians.

I'm currently leading a project to use Microsoft Teams within the Trust to see how we can change how we communicate between each other.

What about those who might be left behind in the digital revolution?

I think there are two different groups of people we're talking about, one is patients, and the other one is staff.

In terms of patients, we mustn't lose sight of these people. Most of the patients that we see in the NHS are elderly, and may or may not have the physical, socioeconomic, or mental capacity to deal with IT. If you deal with a lot of patients with dementia, there's no point delivering a digital service for those patients. So we have to be acutely aware of those patients.

The Royal College is very keen to make sure there's no digitally excluded patients.

And how we do that, and how we allow people to have the option to have both physical, traditional, and digital approaches, is we have to remember patients' different needs.

The other thing is, in the NHS, we have a huge range of staff. We've got people who are digital natives. They're always on their phone, always on an app. For those people, it's relatively straightforward. You say to them, here's a new way of working using digital. And even if they don't quite know exactly how it works, they don't have the fear of using that system.

You have to make sure the system is correctly designed and you have users engaged in it.

There's also a huge number of people who feel very scared about digital approaches, and they're concerned how this will interact and will affect their jobs, and the way they care.

One of my senior colleagues was not very keen on the electronic patient record. He was much happier with patient notes. But once it was implemented, and we showed him how it worked, and how it helped facilitate the best care, then suddenly he became a major user of it.

So I think it's about training, it's about user involvement and participation to make sure that everybody can do it.

You don't need a degree in computer engineering or software to make things work.

We've got to include everybody. I'm not just talking about consultants, but nurses, allied health professionals.

You can create the best system in the world, which is amazing, but if no one uses it, you're not going to get anywhere.

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