“It always struck me as crazy that I could book a flight using my phone yet when I was at work I used scraps of paper and a pencil" - Matt Prime, surgeon and co-founder of e-health company Open Medical, on working with the NHS to introduce innovation
Founded by orthopaedic surgeons Matt Prime and Harry Lykostratis with ICT and e-health entrepreneur Kostas Lykostratis, Open Medical designs software products that manage the care of trauma patients within hospitals as they pass between different teams. The products aim to improve on the traditional paper-based systems of managing patients, which are prone to inaccuracy, duplication and loss of information.
The systems have won commendation from clinicians for their usability and, three months after implementing their first system eTrauma in one hospital department, the team was able to demonstrate a 50% reduction in complaints.
The products also act as a secure central repository for historical data, which can be used to improve services. A service analysis for one client revealed a 25% increase in emergency admissions which led to an increased waiting time for theatre from an average of two to five days and an increase in patients’ average length of stay in hospital from 10 to 15 days. The detailed information enabled the trust to make changes to its service provision which managed the continued increase in admissions to maintain a waiting time for surgery of two days and an average stay of seven days.
Orthopaedic surgeon and company co-founder Matt Prime says:
“It always struck me as crazy that I could book a flight using my phone yet when I was at work I used scraps of paper and a pencil. On one particularly day, I had 25 plus patients who I had diligently recorded in my notebook, before scribing them onto the whiteboard and then further completing a handwritten theatre list. I came in early the next day to prepare for the morning trauma handover and was greeted by the cleaner diligently cleaning my ‘messy whiteboard’. Profanity and panic were the result.”
The team developed the new software product in response to this experience with the support of the hospital, which allowed them to trial it for a month alongside the paper system. Following the success of the pilot, the department gave up whiteboards and paper for good.
However, despite demonstrating the benefits of the products, the company has faced challenges in engaging other NHS trusts, including:
- Clinical leads and service managers are enthusiastic but the company found it very difficult to translate that into a formal contract.
- Feedback from one trust was that the company is too small to be considered as a supplier.
- Lack of clarity about who the decision-makers in a trust are, and difficulty in getting feedback on why a proposal isn’t successful.
- Challenges in engaging IT departments; at least two trusts rejected the proposal because the IT department promised to build their own system – one trust has just invited the company back 18 months later due to failure to deliver.
- Success with one trust does not translate to success in others – each one has to be treated separately
“Forming a business was an afterthought; we felt we had created something really useful and wanted other people to experience the same benefits. The biggest challenge has been trying to increase the uptake of products in NHS hospitals. As a doctor I have been able to speak to and present at lots of orthopaedic departmental meetings. Senior clinicians are broadly supportive of implementation but there is generally a breakdown when it comes to ‘who pays’ and ‘who to speak to’. It seems to me hospital managers and IT managers are scared to try a new idea for fear of being blamed if it fails.
“The thing that would improve our business journey is knowing who to approach in a hospital and what they need us to do. I feel frustrated that the NHS is missing out on so many innovative ideas because it doesn’t want to do business with small enterprises.”
The team has achieved some success by switching to a ‘freemium’ model, in which the company will install software for free for six months, perform a free-service analysis and thereafter move to an annual or monthly payment plan. This enables them to prove the worth of the system at no risk to the Trust.
They are now working with two NHS trusts and are about to begin trial periods with two more, which they hope will become paying clients.