Systems integration: communications

Linking the islands

April 2007

Cisco UK’s Terry Espiner offers his opinion on the potential of unified communications.

Since unified communications arrived on the scene a few years ago, the private sector has been quick to take advantage of the technologies to increase the agility and efficiency of staff. More and more businesses have realised that by migrating to a single, converged network supporting internet protocol (IP) telephony, videoconferencing, video-on-demand and contact centres (see jargon buster below), productivity gains that would have seemed unimaginable a few years ago can be achieved.

Linking the ‘islands’

As the NHS continues to evolve and to implement new technologies, the adoption of this private-sector unified communications model will enable healthcare trusts to ensure that voice, video and data communications are integrated into a unified service, rather than functioning in isolation.

In many NHS organisations today IT staff run the data network and telecoms or facilities staff run the voice networks. This separation has in some situations led to problems such as video networks being implemented in isolation, which has often limited their availability and, consequently, their effectiveness and value to the business. A unified approach can help overcome this by linking together these ‘islands’, ensuring that video networks are used to their maximum effect.

Effective patient care A unified communications approach can also enable staff working remotely to deliver more effective patient care. It makes it possible to contact an on-call consultant, for example, who could offer immediate advice. A consultant living an hour away could look at the patient’s medical records and/or current condition from home, and provide an informed decision on treatment which could be started in the hour it will take a consultant to get to the hospital. Technology has moved on to the stage where such a flexible approach to healthcare is now possible.

Out with the old, in with the new?

When considering upgrading or replacing a telephony system, many NHS organisations look at simple dial-tone-type replacements. While there may be an element of comfort in straightforward implementations like this, unified communications systems and the associated added value IP-enabled applications provide incremental benefits like collaboration and ‘presence’.

Collaboration applications enable clinical teams or speciality groups to meet virtually to discuss and share information and can also be integrated with high-grade video systems. ‘Presence’ provides an instantaneous view of whether desk phone, mobile or instant messaging are best to contact a colleague. Both of these integrated applications can realise real benefits in a healthcare environment.

The service providers of the world are a good barometer of technological advancement and the benefits it can bring. Service providers are conflating various networks and platforms onto a single IP network, for example, BT with its plans for the 21st century network to replace existing networks with a single IP platform. The introduction of technology to support effective communications, combined with changing working practices, will make the NHS a more productive, collaborative and joined-up organisation.

The NHS is often justifiably cautious about new technologies, and information governance — rightly at the top of the NHS agenda, given the legal and ethical aspects surrounding confidentiality of patient data — is often a major challenge. Technology that supports many of today’s common processes — online banking and online retailing for instance — is also now available to the NHS. And if the majority of FTSE financial institutions trust the integrity of IP communications to support their organisations, it is a good indication that this technology is now able to provide secure and confidential communications. Furthermore, organisations such as Miercom, a leading voice over internet protocol (VoIP) security consultancy, regularly test VoIP equipment to ensure it adheres to industry-recognised security standards.

For the NHS to maximise its potential, ICT should have a higher place on the NHS agenda at trust level. The Wanless Report’s recommendation for a 4% increase in trust ICT spending emphasises the vital role that ICT has to play. Only by ensuring that ICT is given support within trusts at board level, and by it being seen as a crucial component of everyday NHS healthcare delivery, can facilities such as unified communications — which the private sector largely takes for granted — demonstrate their true value to the NHS. It will be interesting to see how wider EU initiatives like Transforming Public Services and localised Department of Health schemes such as that driving strategic health authorities (SHAs) to produce development and funding plans for ICT services, will ultimately drive the NHS to install unified communications.

Shining lights

Some trusts are already making optimal and effective use of unified communications. The York and Selby NHS Trust is a good example of an organisation using technology in an innovative way to benefit the provision of healthcare. All NHS facilities in the area are connected to a Community of Interest Network (CoIN) (see jargon buster below), which shares information between a number of interactive mediums, including video telephony, at minimal cost. Within the York and Selby CoIN, GPs have faster access to clinical and patient information. Clinical applications such as PACSs are now available to all clinicians in the SHA, enabling xrays taken at York Hospital to be available within minutes — and sometimes seconds — to other clinicians on the network.

What the future holds The adoption of new technology within the NHS will continue to evolve in the long term. We shall see clinicians and consultants who have lived with such technology from a pre-school age, and accept it as if part of their DNA, seeking the ability to use it to deliver effective patient care. It may be some time before this generation takes the decisions on what forms of technology are adopted. We are, however, already seeing the first of these implementations taking place today in islands of excellence throughout the NHS. We must recognise that the NHS is a vast organisation that employs 1.3 million people and that adoption of new technology in such an environment is often a major undertaking. In the short term, the full acceptance of collaborative ICT implementations within healthcare will remain a challenge, but those trusts that do adopt a unified communications approach will see improvements in overall performance and, ultimately, better serve their patients’ needs.

Terry Espiner, Healthcare Sector Manager, Cisco UK.