David Walliker explains how NHS tech is saving lives in Merseyside

David Walliker’sdigital initiatives are not only saving money; they’re saving lives.

Walliker is CIO of two major hospitals, the Royal Liverpool and Broadgreen University Hospital and Liverpool Women’s Hospital. He also recently added executive accountability for the Life Science Accelerator to his long list of responsibilities, giving him the opportunity to focus his IT strategy on an area he’s extremely passionate about: health inequalities.

“There are some poor outcomes in Liverpool, and fundamentally, our strategy is about how we improve the outcomes for our population,” he says. “That’s number one.”

Walliker is helping the city build a digital infrastructure for healthcare that can address its health inequalities in Liverpool, which are among the worst in the UK.

These include the only 5G testbed dedicated to health and social care in the country and the Livernerds Lab, a high-tech facility for testing supported living tools that could help patients transition from the hospital to their home.

It consists of a smart hospital room that replicates those that will be found in the 646-bed Royal Liverpool Hospital, which is due to open by the end of 2020, and a smart house that simulates a patient’s home. Each has been fitted with sensors, telemedicine, virtual reality headsets and other digital tools that can help clinicians monitor changes to a patient’s health.

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The NHS hopes that trials of these tools in a realistic environment will help refine existing treatments and identify new ones.

“We need to put technologies into that room to identify if you’ve fallen, if your machine has started beeping, and to take your vital signs,” says Walliker. “We’ll still do nurse observation but that technology is necessary.”

Patient groups will play a fundamental role in the design of the solutions, which will then be developed and deployed by a mixture of larger companies, SMEs and startups. Walliker is keen to use the lab to allow smaller companies the opportunity to compete with their larger competitors, by giving them an affordable testbed to demonstrate the value of their technology.

He believes this approach will challenge the typical procurement model, which favours IT giants with big budgets and established relationships with the NHS at the expense of smaller companies that may have more inventive ideas.

“It stifles innovation in the NHS, essentially, because we make it too hard for the startups, and therefore the bias goes into the more established players in the market because they can afford to invest millions in their R&D to prove if something works or not. That was the purpose of the life sciences in the first place.

Detecting danger

While the Livernerds Lab looks to the future, other digital initiatives led by Walliker are already having a major impact on present-day healthcare.

In 2018, his team rolled out e-Sepsis, a clinical decision support tool developed in-house to increase screening and subsequent antibiotic administration for sepsis, a potentially life-threatening condition triggered by an infection.

The tool analyses clinical parameters including patient observations and laboratory results to automatically detect whether a patient has sepsis and instantly alert clinicians without the need for manual intervention.

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Its ability to quickly identify sepsis has already saved more than 200 lives, been highlighted as a best practice case study in the NHS Long Term Plan, and won an award at the NHS 70th birthday awards last year. None of that would have been possible had the Trust not realised a more rudimentary achievement: going paperless.

It completed the transition from 100% paper to 100% electronic records in 2017, using a strategy that future-proofed the shift by developing the ironically named PENS (patient electronic notes system), a suite of electronic forms that replace the paper.

After his team removed paper records from and digitised nurse observations, they realised they could create a new system for identifying sepsis.

“E-sepsis is now a case study in the NHS platform, and that was a product that we developed because we got rid of paper records,” says Walliker.

Connected future

Fragmentation remains a challenge across the NHS, and Walliker’s surroundings are no exception. There are eight hospitals in the North Mersey area, all of which have their own systems and standards that don’t easily connect.

Walliker has helped drive interoperability by securely sharing clinical information across the area through the e-exchange systems, developing a system that can pull together data from the Trust’s various healthcare systems and selecting suppliers whose products can work on various operating environments.

His team has also been sharing best practices across the NHS, most notably in the case of the e-sepsis tool, which was selected in the first wave of NHS England’s Global Digital Exemplar (GDE) Blueprints, detailed information packages on digital initiatives offer other organisations a model to follow.

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Walliker now plans to enhance the system developing push messaging from clinical applications to a secure messaging platform that can send the alerts straight to the phones of clinicians.

The CIO 100 high flyer is also exploring a range of emerging technologies. He’s particularly excited about the potential of blockchain, which he believes will eventually enable the secure sharing of medical and AI, which he predicts will transform clinical treatment.

“I have no doubt at all that there will come a point in time where the machine will do the routine check-in and flag to the doctor which ones need to be looked at,” he says. “I don’t think there’ll ever be a scenario where the machine will replace the doctor, and fundamentally, somebody has to programme the AI. I don’t think it will replace that, and I hope it never does because I think medicine is about human interaction. You wouldn’t want to replace that completely with technology.”