The NHS Wales Informatics Service (NWIS) has adopted the new definition for eHealth in Wales developed by the eHealth Industries Innovation (ehi2) Centre, which is: eHealth is better healthcare and a healthier life through digital technology. Examples include health information networks, electronic health records, telemedicine services, wearable and portable personal health systems and many other information and communication technology (ICT).
In a written Cabinet Statement on 23 April 2014, Mark Drakeford, Minister for Health and Social Services, announced a refresh on Welsh Government policy regarding eHealth and Care in Wales. He stated, “Our opportunity now is to focus on how eHealth and Care can help us to manage demand, empower us to take a more active role in decisions about our health and care, and deliver better quality services in the most effective and efficient way.”
A feasibility study performed in 2011 by ehi2 based out of Swansea University identified 70+ companies operating within Wales that were or had the intention to enter, the emerging market of eHealth. This multi-billion dollar global opportunity was seen by all as a major opportunity for Welsh businesses and also, if Wales were to leverage its major assets in the area – its university-based expertise, and its local NHS – Welsh companies could enter the UK and international markets with a significant competitive advantage.
Wales has competitive strengths in the eHealth sector which spans University, NHS and industrial sectors. Particular strengths lie in health informatics, big data, and associated Research Council-funded centres of excellence. Key eHealth companies in Wales specialise in healthcare data capture, management, and extraction; clinical decision support; and early warning tools. Wales has significant assets in a devolved NHS, areas of health research excellence in a number of universities and strengths in the life sciences sector. Wales’ success in the development of a single electronic patient record and the secure anonymised information linkage database makes it an attractive location for medical trials and epidemiological work. Wales also boasts a range of support institutions including, but not limited to, eHealth Industries Innovation Centre (ehi2), the Electronic and Software Technologies Network for Wales (ESTNet), and MediWales. These groups provide key guidance to and act as a voice for the eHealth sector in Wales.
In order to realise the potential of Wales as a leader in eHealth innovation, it is essential that the development of eHealth products and services is supported in a co-ordinated and consistent fashion at every stage of their development. Availability of funding, access to academic facilities and expertise and clear guidance on market requirements and technical standards are all important in supporting innovation. In particular, being able to secure input and collaboration from NHS Wales at appropriate points from initial concept, through design and up to and including adoption of new innovations for market testing within an NHS environment is essential.
Many of the issues discussed in the Focus Groups refer to the need to increase access to NHS Wales at both a pre and post procurement stage of product development. Whilst Wales represents a very small part of the global health market, products which have been developed in partnership with NHS clinicians and tested within NHS premises (either on a pre-procurement or post procurement basis) carry a great deal of credibility in the international health market and have a significantly improved potential for international commercialisation. The Welsh NHS as a market is small, but the benefits to companies in being able to develop products which are suitable for adoption within it are significant.
There are equivalent benefits to NHS Wales in encouraging collaboration too – addressing development of products and services to meet current needs, access to free or reduced cost products and services and potential IP shares from new innovations which go on to break into international markets.
1. ANNUAL LIFE SCIENCE RESEARCH PRIORITY STRATEGY
Life Science Exchange eHealth focus group members questioned whether research and development in health informatics (and Life Science as a whole) was sufficiently co-ordinated. Too often research and innovation activities are designed and developed within single organisations, based on their perceptions of priorities and requirements, without wider linking to the sector as a whole. This has a number
within Wales around achieving these. Projects which addressed priority areas should be given a co-ordinated development pathway from initial concept, through development to final trial in an NHS environment.
2. PROCUREMENT OF EHEALTH SOFTWARE
NHS Wales procurement processes are a significant issue for eHealth SMEs operating and innovating in Wales. NHS Wales is understandably keen to ensure that it works with companies which are reputable, stable and able to support NHS contracts into the future. However, current eligibility criteria effectively exclude small and medium sized companies from breaking into the market. The Life Science Exchange eHealth focus group members propose that NHS Wales (Shared Services Partnership) and NWIS should review the procurement models used in NHS Wales with the aim of creating a competitive environment for SMEs whilst still keeping risk within NHS procurements to an acceptable level.
3. NHS WALES STANDARDS DOCUMENT
Life Science Exchange stakeholders recognise that the technical and strategic direction of NHS Wales in relation to eHealth is driven by NWIS. Stakeholders suggested that NWIS should be involved in priority setting and identifying areas of unmet need (see above). The focus group welcomes the recent development of an NHS Standards toolkit, which provides a framework for companies to develop their software with existing data systems. The group feel that further work to promote this documentation and to embed it into research projects and development activities would be of great advantage to the sector.
4. SECTOR KNOWLEDGE AND COMMUNICATION
Stakeholders have shared concerns regarding a lack of sector knowledge throughout each of the Focus Groups. Generally, there is a need from all stakeholders for a global view of the resources, infrastructure, activities, events, products, and services that exist across the sector. In order to make the information about the Welsh Life Sciences sector clear to stakeholders, (all) information relevant to the sector should be available through one point of contact or organisation, which could also provide a comprehensive signposting service for accessing resources and support.
5. NHS ENGAGEMENT AND CLINICAL ACCESS
The size of Wales and its integrated NHS IT systems mean that it could be a fantastic place for clinical research, but more needs to be done to take advantage of this. Steps need to be taken to incentivise and promote clinical research, both at the institution and individual levels.