NHS Blood and Transplant Chief Digital Officer Aaron Powell discusses life-saving digital transformation operations

Chief Digital Officer Aaron Powell said he believes digital transformation is all about “personalisation and connectedness” for NHS Blood and Transplant, as he outlined how it has been using cloud-based data analytics capabilities to help save lives.

CIO 100 member Powell, who started at the NHS organisation responsible for the safe supply of blood to hospitals and for formulating the transplant system for the whole of the UK in October 2014, was discussing digital transformation and using IBM technologies for NHS Blood and Transplant’s organ allocation scheme.

“We’ve badged our digital transformation very much as being at the heart of what we do,” Powell said. “When our chief executive took over about three and a half years ago he made digital a watchword for the organisation and that heralded my appointed as Chief Digital Officer.”

A speaker at the 2016 CIO Summit where he discussed securing investment and executive-level buy-in for digital and change projects, Powell said that digital for NHS Blood and Transplant meant empowering all of it 5,000 employees as much as it did those who rely on the service.

“The problem with digital of course is that it can mean something different to everyone,” Powell said. “We’ve really badged it as being about personalisation and connectedness.

“Being a personal service for the donors, the people that we serve, and our staff – and we treat our staff as important constituents of our digital journey; we don’t give them second-class services. And connectedness in terms of joining up data, processes and the way that we work within our organisation but also across the wider NHS to make sure those services are as effective as they could possibly be.”

Life-saving technology

The Chief Digital Officer said that by using technology that utilised automation, intelligence and integration, NHS Blood and Transplant could improve its complex organ allocation scheme and ultimately save lives.

“Cloud services really come in in that integration and intelligence space because what we found is that the cloud enables us to integrate the data in a far more effective way,” Powell said.

“The cloud enables us to apply some of that intelligence and analytics tools, and also the predictive analytics – and we are starting our journey into predictive analytics.”

NHS Blood and Transplant’s organ allocation scheme balances three competing priorities, Powell explained. The need for equity and the idea that everyone should have an equal chance of a transplant. The principle of utility – the idea of getting maximum use from that transplant or the organs that are available, which can involve making decisions about what set of transplants will ultimately result in the most number of life years saved. And also fairness to support whoever has been waiting the longest.

Powell’s understatement was that “it’s quite complex”, but that two years ago the organisation started to use some of IBM’s workflow and automation tools for the scheme to streamline the 96 separate decisions NHS staff would have to make in order to offer organs from a single donor.

Powell’s team have managed to take out “about 40%” of the manual steps, while as a cloud-based deployment it offers greater flexibility in making the right information available to the right clinicians when and where it needs to be.

“Ultimately that has the effect of reducing the net time of donation, which benefits the family of the donors who have just been told their loved one has died,” Powell said. “As well as ensuring that overall the transplant is safer because the organ is where it needs to be and the clinician has access to all the right information – and ensuring we are applying the optimum allocation scheme for saving people’s lives.

“It’s been a substantial improvement; it’s really started to transform the way we allocate organs.”

Powell said that the scheme has been used for heart allocations since November 2016, and was subsequently extended to lungs and will be rolled out for a new liver allocation scheme at the beginning of 2018 “which we expect to save 51 lives a year”.

“So it’s an example of using the technology and leveraging the power of cloud – and some of that automation – to enable you to have a really significant impact,” he said.

Edge computing

Enhanced data analytics capabilities are an area Powell is excited about, particularly concerning ‘edge computing’ and the ability to make better decisions, faster.

“The interesting thing around edge computing is the emerging sense that we have often sought to take the data to the analytic capability,” he said. “I think increasingly we are finding that’s not the way that’s going to work anymore, you’ll find you need to take the analytic capability to where the data is.

“As both a way of reducing the cost of moving the data around which can be quite expensive in itself, but also enable us to apply the analytics even more quickly. Because if you can take that capability to where the data is you get quicker decisions.

“I think that capability of moving the analytics to where the data is is the emerging theme for us.”

Predictive analytics

Predictive analytics is also an area where Powell believes technology can have a hugely positive influence on NHS Blood and Transplant. The CDO said that a trial was currently underway which offered a more personalised prediction of the expected waiting time for an organ transplant.

Previously this was strictly an average of all the data available, but would not take into consideration personal circumstances depending on the illness, and also a person’s ethnicity which Powell said unfortunately had a significant impact on waiting times.

“There are far fewer donors from minority groups than there are from White British people and therefore you are likely to wait four times longer from certain ethnic groups than a white person from the UK,” Powell said, adding that the organisation could also benefit hugely from leveraging data and insight to target donors from groups the NHS requires most. “Can we provide a more personalised estimate of how long you might have to wait using some of the predictive capabilities and technologies?”

Powell was also interested in using predictive analytics to provide better insight for the blood donation process. Typically NHS Blood and Transplant overbooks donor sessions by 20% since there is a certain no-show rate, while others who do show up might be deferred due to certain reasons such as recent illness which mean they cannot give blood immediately. By including things such as weather data, Powell believes there is a better methodology which would result in NHS Blood and Transplant not disappointing those who do turn up, as well as meaning sessions run on time, staff get appropriate breaks, the NHS collects enough blood from the right blood groups – or prospective donors are turned away in advance since the session was supposedly full.

Cultural transformation

Powell said that running alongside NHS Blood and Transplant’s digital transformation is a cultural shift among the organisation’s staff. When Powell and his team have been able to demonstrate that using new technology has made their work easier and is accessible, buy-in has been much quicker than when it’s been harder to demonstrate real value.

This has increasingly meant offering tools on mobile devices, while Powell noted that the change management part of a transformation initiative was most successful when CIOs and technology leaders fully engaged will all parts of the organisations they work for rather than dictating from on high.

“My sense is that the cultural change part of digital transformation happens when you get more and more buy-in from more and more people within an organisation,” he said. “You cannot get it by just standing at the top saying we will do this and you will follow.”