The Whole System Demonstrator (WSD) programme was set up by the Department of Health to:
- show what telehealth and telecare is capable of
- provide a clear evidence base to support important investment decisions
- show how the technology supports people to live independently, take control and be responsible for their own health and care.
Post WSD, the question was “How do we achieve scale and pace. What are the barriers to adoption and why is this just not flying?”
The conception of Delivering Assisted Living Lifestyles At Scale (dallas)
Having been both WSD Delivery and Programme Manager, I won’t be reminiscing about the programme but will say that what WSD did do was provide insight for the next generation programme in the assisted living space.
At the time, Innovate UK’s was drawing conclusions from its 5 years’ activity that had explored:
- the technology offer
- interoperability issues
- social and business models for the sector.
Using the insight from ALIP and WSD, the dallas (Delivering Assisted Living Lifestyles At Scale) programme was conceived.
The aims of dallas
Launched in 2012, dallas was all about:
- redesigning and delivering new approaches
- thinking beyond traditional health and social care
- seeing how new ideas and technologies can improve the ways people live and transform their choices as they age
dallas wasn’t prescribed, it isn’t a Randomised Control Trial, it isn’t just a technology programme – so what is it?
What did dallas deliver?
So what exactly did the four communities get up to? Well it’s not embedded in official secrets it’s just extremely complex and there’s lots of it. As dallas is disruptive, agile, diverse, different and a game changer and, because it could, it tackled some of the national blockers that don’t have a ‘national owner’.
To tell the story, warts and all, we have a resource site at DHACA (Digital Health And Care Alliance). We’ve been pulling together the resources but this is a mammoth task and we’ve still work to do.
Ideally join DHACA to receive automatic notifications (it’s free!) or keep looking, as new resources will continued to be added and in the meantime, to provide you with a window on dallas, we’ve produced a video featuring the DHACA project leads and others involved in the programme. Set some time aside, get yourself a cuppa and watch the video. There’s plenty for everyone whatever your lens and drivers.
Innovating at scale and pace
dallas has delivered and there are some fantastic insights into innovating at scale and pace whilst trying to deliver business as usual.
There were several themes that emerged and the communities, two being public sector led and two being private sector led, were diverse in their ambition, yet all had versions of those themes and the same national barriers.
Let’s consider one of the most discussed national barriers: Information Governance.
Information Governance (IG)
For the Year Zero project, who created a range of digital services, Information Governance was critical path for the e-Redbook – the Personal Child Health Record (PCHR).
The ambition was for a commercial e-Redbook, capturing all the critical milestones enriched with personal narrative, observations and images. Fantastic – the start of a Personal Health Record that has the potential for longevity. Just think of the opportunities!
Yet, the journey was complex, frustrating and repetitive. Year Zero worked in partnership with several NHS health providers, delivering service innovation and working through the same issues individually with each provider.
They also worked with the Royal College of Paediatricians to seek endorsement and approval for the use of this digital tool. The product was ready but a whole range of issues around ownership, dual system trialling and professional silos pressed a pause button for commercialisation.
However, resilience offers new opportunities and as a result Year Zero worked with Dame Fiona Caldecott the Independent Information Governance Oversight Panel, and the Information Governance Alliance and produced a White Paper on PHRs.
Year Zero went on to use this knowledge in supporting More Independent Liverpool (Mi) in the development of the Personal Health Record (PHR) Proof of Concept, which was based on the product ‘A Better Plan’ and the eDaybook with Kent County Council, Microsoft and a Domiciliary Care provider. All different, all with IG challenges and all delivered.
Coming back to the opening question, “How do we achieve scale and pace? What are the barriers to adoption and why is this just not flying?” one of the answers is that Information Governance still represents a barrier to the meaningful deployment of innovative digital healthcare services at scale. .
Yes, we all know that but here are two things to consider:
- The issue of information governance policies and legislation within the health and social care sectors, and how they are applied. Why is there so much diversity in interpretation and application and what policy leavers are needed to move us past the blockade?
- Having insight into how this translates into what you are trying to do and the right and wrong decisions taken by the dallas communities won’t necessarily give you all the answers, but it will provide some clear signage on a well-trodden path.
- Visit the dallas tabs on the DHACA website for more information: dhaca.org.uk
More diving coming soon – what will surface next time?
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