NHS Blood and Transplant is using digital technology to transform the life chances of patients


Three people on average still die in the UK every day waiting for a transplant. Technology can play a key role in reducing this number.

Aaron Powell, chief digital officer at NHS Blood and Transplant, is using a complex mixture of advanced technologies to boost organisational efficiencies, simplify the organ allocation process and save patient lives.

His organisation is responsible for the reliable transfer of blood across a complicated geographical network. NHS Blood and Transplant is also responsible for the organ allocation system across the UK. It is, says Powell, a time-critical process that relies on a range of complex decisions.

While his organisation makes constant life-saving interventions, Powell says it should be emphasised that three people on average still die in the UK every day waiting for a transplant. Technology can play a key role in producing new efficiencies for his organisation and its patients. To this end, Powell – who was appointed CDO in July 2015 – says he is using a combination of the cloud, analytics and automation to change processes at NHS Blood and Transplant for the better:

We’ve badged our digital transformation as being at the heart of what we do. Our chief executive made digital a watchtower for the organisation and that heralded my appointment as CDO. The problem with digital is that it means something different to everyone – at NHS Blood and Transplant, we say it’s about providing a personal service to both patients and staff, and it’s also about connectedness, in terms of joining up the data and services across our organisation and the wider NHS. We do that through technologies that support automation, intelligence and integration.

Balancing equity, utility and fairness

Powell says the cloud plays an enabling role in this digital transformation. On-demand IT, he says, allows NHS Blood and Transplant to integrate data more effectively across services. Powell says the aim is to apply some of the intelligence capability and, also some of the predictive elements, of those tools to the challenges his organisation faces. This insight, developed through technology partnerships with firms such as IBM, informs organ allocation schemes and helps employees make-life changing decisions:

We must balance three key areas: equity, so everyone has an equal chance, utility, so we make the most of the organs we have, and fairness, so if you’ve waited longer, you have an element of priority on the waiting list. It can be a complex process. We have many factors to consider like blood groups, tissue mapping and the potential risk involved in undertaking a transplant. We must manage those areas effectively.

Technology is providing a vital tool in helping Powell and his colleagues to balance the requirements of patients. Yet the introduction of systems and services is by no means straightforward. Powell says the implementation of technology has involved in a two-year process. Employees at NHS Blood and Transplant have a number of critical decisions to take during the organ allocation process. Powell says the workflow involves as many as 96 business rules to consider. Prior to automation, staff relied heavily on paper and white boards to wind their way through this decision-making process. Powell says the past two years have seen the introduction of a smarter, technology-enabled workflow:

We started using automation and workflow from IBM to help manage our organ allocation processes more effectively. So far, we’ve removed about 40 per cent of the manual steps in the process. The technology has been deployed on the cloud and information is available when staff need it to make decisions. The key data gets to where it needs to quickly and that reduces donation times, helping to ensure the process is safer. What we’ve seen is a substantial improvement in terms of helping our staff make crucial decisions on a day-to-day basis. It’s an example of how using the technology, and leveraging the power of cloud and automation, can have a significant impact.

The automation and workflow technology was first applied in the area of heart allocation last November. Powell aims to extend the approach to lung and liver donations in early 2018. He recognises many IT leaders face cultural challenges when they attempt to roll-out automation and big data technologies. While staff can be reticent about the introduction of machines into a previously human-dominated process, the significant business benefits – in terms of improving efficiencies and saving lives – help Powell overcome cultural barriers to technological change:

We’ve had a range of different responses. Some people are concerned by the rise of digital, while others adopt willingly. When you show staff that technology will improve their working lives, then we get buy-in much more quickly. As an example, some staff say they don’t have a computer at home, and aren’t sure how to use the technology, However, they all have a phone. So, if we give them an application that works on a phone, they’ll quickly see the benefits and find it useful. Cultural change happens when you get more and more buy-in from more and more people in the organisation. As a CIO, you have to create a snowball effect as the impact of technology extends out across the organisation.

More to come

Powell is keen to investigate the use of further advanced technologies at NHS Blood and Transplant. Any new technologies are subject to an extensive assessment period. The organisation also seeks data security clarity from all partners, including IBM. Powell refers to the potential power of edge computing, where an increased amount of information is processed at the source of the data. He also says a number of interesting trials are currently taking place, including around the use of predictive analytics and the likely waiting time for an organ:

Our current predictions are based on averages, but the reality is that availability can vary considerably depending on individual context. We’re trying to provide people with a more personalised prediction based on the power of technology. In blood donation, we’re trying to find out whether we can work out the predictability of people turning up – some people are no-shows or are deferred for illness. We want to know whether we can take broader data feeds, like weather and sports, to see whether that impacts the likelihood of people turning up. Our clinics currently over-book by 20 per cent in case of no-shows. If we know that attendance rates can be predicted, we can ensure people aren’t waiting, staff aren’t over-worked and enough blood is collected.

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