Lewisham and Greenwich NHS Trust

Justin Beardsmore

Healthcare organisations have used process automation tools for several years in various use cases. However, its adoption and profile have increased in the UK market over the past few years. It may not be the new kid on the block, but its facelift is paying dividends with cloud hosting and improved tools linked to the citizen development principle. 

From a provider perspective with aggressive targets for efficiencies, the failure of the single EPR certainly makes sense. Nimble SaaS providers have exploited the shortcomings of EPR and siloed national systems are here to stay. In this world of ever-increasing dispersed data and applications. It is easy to get consumed by a pitch that emphasises integrated flow across the silos delivered by turnkey technology. 

However, nine months in, with several processes ready to go live and lots of peer conversations, a few thoughts come to mind. Think of itasa report card that may improve or decline based upon further reflection.

The first rule of the RPA club is not to talk about the RPA club. The manufacturers are already changing the language to intelligent automation, combining technologies such as machine learning or natural language processing with optical character recognition skills to deal with unstructured data. This way, they can focus the customer's mind on the long journey.

In automating processes, you will leverage various existing in-place technologies to create the solution, so it's more about the ecosystems and not one tool. Therefore, focus on the transformation message that aligns with broader business change. 

“In a complex people-based service industry, change will be slow but can potentially be strong if aligned with broader business objectives over a sustained period.”

This brings us to outcomes and benefits. Don't open your mouth until you know what you aim to deliver to the business. In your mind, you also need to be clear about how you will measure success. Anyone who has pitched staff-saving times may have stood before a marketing director but not a CFO. Or at least the ones I've come across. You can play it in, but don't lead with it, as you are just defining the premise of the debate as cost reduction rather than broader organisational transformation. Focus more on the story. The UK has experienced low productivity for over 15 years; therefore, in a complex people-based service industry, change will be slow but potentially strong if aligned with broader business objectives over a sustained period. Your first process may deliver a time-reduction outcome, but the benefit may not be realised because of an issue in the complexity outside your control. This isn't a failure. It's a success as you have exposed what was once unknown. 

Suppose you have a deep automation strategy focusing on sophisticated long-running processes like clinical workflows. You will likely be reskilling or expanding existing in-place development and testing teams. If the focus is wide, the low complicated process landscape within a healthcare provider, there are opportunities to look into the organisation for hidden talent. Logical thinkers close to business problems can easily pick up the needed skills and get on with the less risky stuff. Agile governance frameworks can support this. Centres of excellence and citizen development are concepts widely used to explain this structure. 

National funding opportunities for digital productivity, cloud platforms, and low or consumption cost models have smoothed over the entry barriers; however, their impact on the price of success is less so. You are building a business workflow over an existing landscape, which you will have varying levels of control. Unkind commentators would say you are building on sand. I prefer the analogy of a flood plain where the ground and be hard or soft.The point here is to understand and mitigate the risks. Change control, monitoring, and downtime procedures are key here. The basics never go away. You will never build momentum if processes are constantly falling over. If you want to sustain the long-term momentum, look outside your organisation for like-minded organisations for mutual areas of interest. Don't try to standardise your process across organisations in the early stages, as you can quickly get into petty disputes on hows and whys. This can come later. Try and keep the engagement focused on areas of shared experience, like similar business applications and problems.