Conference report: discussing disruptive technology

In the run up to its annual conference in Manchester, the NHS Confederation produced a series of reports for discussion. One looked for the “disruptive technologies” that are likely to impact on the NHS over the next ten to 15 years.

Delegates had the chance to discuss the report and some of its implications at a fringe session, where they heard that change is not nearly that far away. 


The NHS is already seeing the first signs of a revolution that will give patients much greater control over their health and care, delegates to the NHS Confederation’s annual conference in Manchester were told.

Jerry Fishenden, Microsoft’s national technology officer for the UK, told a session called to discuss a report on “disruptive innovation” that it generally took 20 years for technologies to move from research and development to general use. “We need to accept there is wisdom in people’s opinions [and they are] a way to get quality across the NHS.”

As a result, he said, people who wanted to know what technologies would affect society in the future should look at what was coming out of laboratories ten years ago.

The economics of change

However, Mr Fishenden and his fellow speaker stressed that some technologies are starting to cause disruption now. Paul Hodgkin, a GP who is also chief executive of the Patient Opinion website, said this was a matter of economics.

What are sometimes called web 2.0 technologies had cut the cost of “voice” and “collaboration” to virtually nothing, he said. In other words, people no longer need expensive printing presses or even letter-writing materials to express a view or start a campaign - emails, blogs and collaborative sites allow them to do both cheaply and easily.

Dr Hodgkin argued these tools were bound to be used in connection with the NHS - indeed, he showed patients are already posting pictures on flikr to highlight failures in hospital cleaning and setting up blogs to complain about failures in care.

Therefore, he said, the NHS is already facing a “reputation governance” issue. And he argued it should adopt such tools to collect opinion and drive improvement itself.

Patient Opinion allows people to post comments about their care and trusts to respond. However, Dr Hodgkin suggested the health service should go much further, quickly. For example, he suggested that doctors could rate the letters and records kept by their colleagues, so patients and their advisors could assess their specialisms and competence. “The idea that you can keep the old model going if you beautify it a bit is wrong. We need a new model that puts the patient at the centre of thinking.”

“We do not need more government targets as long as people accept there is wisdom in people’s opinions; you can just let them run,” he said. “It is another way to get quality across the NHS.”

Cosmetic change won’t be enough

The government is taking some steps in this direction. It has already established the NHS Choices website to help people decide where to go for elective treatment, and it has promised that this will also allow patients to feedback on their care.

However, the “disruptive innovation” report that was published by the NHS Confederation with support from Microsoft, notes that more radical platforms are already being developed in the US.

Both Google and Microsoft have developed web-based services that allow people to conduct medical searches, store medical information, record data from monitoring devices and decide who this should be shared with.

Mr Fishenden argued they were in the vanguard of a new era of technological interaction with government. “We have gone from informational services – ie publishing – to transactional services to personalised services,” he said. “Things are becoming more social, and interactive, and relevant.” "...people no longer need expensive printing presses or even letter-writing materials to express a view or start a campaign - emails, blogs and collaborative sites allow them to do both cheaply and easily."


And he warned delegates that these changes were not going away. “The old model was that the centre decided and patients often felt at the bottom of the heap,” he said. “The idea that you can keep that going if you just beautify it a bit is wrong. We need a new model that puts the patient at the centre of thinking.”

Mr Fishenden admitted that these changes affected companies such as Microsoft as much as governments and public services. And he acknowledged there were challenges to overcome; not least how to guarantee people’s privacy in a much more joined up, interactive world.

But he said there was no going back, and change would only accelerate as more and more people adopted technology that is becoming cheaper and easier to interface with.

“For the past 40 years, technology has been a tool and using it has been a choice – people have been able to decide whether to use it or not,” he said. “Over the next ten years, it will no longer be a choice. It will be woven into the fabric of the way we work and think.”

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- Find out more about the NHS Confederation's Disruptive Innovation report