The better EPR Solution

Delivering Better Mental Health Services through IT Innovation – A Five Year View

The better EPR Solution

CareDirector the Better Mental Health Solution

Delivering Better Mental Health Services through IT Innovation – A Five Year View

It’s clear that there are major challenges for Mental Health leadership teams over the next 5 years where they will be asked to deliver more services but not necessarily with bigger budgets. The good news is that there is help in the form of Information Technology (IT) innovations.  These innovations can help deliver better mental health services.  We carried out this research to find the innovations which we feel will help meet the challenges most effectively.

A good starting point is to understand some of the key challenges for Health leadership teams coming down the line:

NHS Goals & Challenges over the next 5 years:

Tougher targets – The future policy direction is for services to achieve ‘parity of esteem’ with physical health – more demand but the same budgets?

Increasing demand – It is anticipated that service demands will continue to increase, leadership teams will be asked to do more with less.

Reduced capacity – Average target waiting times are expected to increase combined with a decline in the number of NHS mental health nurses working in the system since 2010.

National technology directives – NHS England (2017) has set specific technology goals for trusts to achieve.

As leadership teams think about their goals and plans, they have to consider how the current trends and innovations in IT can help them achieve those goals.   Effective technology is about being able ‘to do more with less’.

What is the Current Situation?

Based on publicly available evidence the current electronic health/patient record (EHR/EPR) systems widely used at local services are relatively immature.

The Care Quality Commission (2018) identified ‘poor IT systems’ as one of its main themes. It saw the main issues as clinicians using ‘combinations of systems’, the ‘time taken to enter information’ and ‘inability to retrieve information others had recorded’. CQC also identified widespread experience of ‘incomplete and out of date electronic care plans for patients.

What innovations can help meet the challenges?

We considered ICT developments with the potential to contribute to the NHS goals and challenges previously outlined while recognising the likely budgetary and resourcing challenges it will face. The main ones are:

  • ‘personalised services’
  • ‘paper free at the point of care’

Information Technology can help

IT can provide smarter, patient-centred, cost effective treatments within and outside the walls of your hospitals and clinics through areas including:

  • Electronic Patient Records
  • mHealth
  • Social Networks
  • Patient self-care apps,
  • Big Data and Cloud computing.

We looked at all these areas and how they are being used elsewhere or could be used in the UK to meet the challenges in the next five years.

For instance, apps and social media networks can be successfully used to monitor medical conditions and facilitate patient involvement in the treatment process.  This smart use of technology goes a long way towards achieving personalisation targets.  Looking at how these developments are being used makes for some very interesting reading.

If you would like us to hear more about these solutions then send us a quick message by clicking here

A bad user interface is a cranky receptionist

Being greeted by a cranky receptionist is the real world equivalent to a bad user interface in the digital world. Both are off-putting, both are uninviting, and both are thoroughly unexpected.

Consumers have come to expect slick, intuitive digital products, making design-related first impressions extremely important today. The first opening click of a new product – that fateful first impression, should be inviting. A clean, clear interface should surface, easing the user into the tech fluidly and with confidence. It is the digital equivalent of walking into a building and seeing a smiling receptionist. A friendly user interface, (UI) welcomes the user through the door of an app and settles them in right away. A bad user interface is like getting a grunt instead of a greeting. When presented with the unpleasant surprise of an out-dated or hectic UI, the user stumbles and starts feeling both distaste and distrust.

User Interface and Brand Credibility

We know that for our end users, our interface is our brand. It is how you interact with CareWorks; your chief touch point with us. Research shows that 75% of users make judgments about a company’s credibility based on design. We believe that the user interface is a visual indicator of commitment to clarity. It tells you how much we have invested in your experience. Our new CareDirector Mental Health solution has been designed with a renewed focus on user interface; we have invested a lot of time and thought into making your CareDirector experience better.


We understand that CareDirector’s user interface determines the solution’s usability. Not only can poor usability foster mistrust about a brand, it can also effect product uptake. While the functionality of a piece of software is critical, this functionality ultimately becomes redundant if users fail to grasp the interface they are dependent on for access. At CareWorks, we foster close relationships with our customers built on trust, and we want them to have an enjoyable experience using our solutions from the very start, resulting in an emphasis on creating a simple user interface with the new CareDirector Mental Health solution.


A cranky, unwelcoming receptionist will make offline customers disinclined to engage with a company. A bad user interface does the same. Because of this, user interface and user experience is at the heart of the new CareDirector Mental Health solution. We have created a solution that can be used with ease and effortlessness, enabling you to view data clearly and concisely, make informed decisions faster and improve care all round. Find out more about CareDirector at [email protected].

Read the full article here.

Using virtual reality to improve mental health

Dr Jamil El-Imad, inventor and virtual reality expert, shares his views on how virtual reality can treat mental health conditions and how it can democratise wellbeing.

Imagine you are sitting in your home, wearing headsets. You close your eyes and when you open them after few moments, you can see a beautiful beach on Easter Islands along the Pacific Coast.  Or perhaps hear the fluttering of prayer flags in a monastery nestled somewhere in the Himalayas.

Created by Dr Jamil El-Imad, an inventor, entrepreneur and research fellow at London’s Imperial College, the Dream Machine produces an immersive experience for mindfulness training to help treat mental health conditions such as anxiety, stress-related disorders and phobias.

The Dream Machine provides virtual meditation by using a VR headset combined with a mobile EEG headset to monitor brain activity, along with other wearable sensors to monitor ECG signals, breathing patterns and any trace of physical activity. The EEG front signals are processed using advanced algorithms to gauge the level of user concentration and relaxation in real time. At the end of the session, the patient is given a recording of how long they were able to concentrate along with a score, which can be improved, essentially training people to concentrate and focus on therapeutic mindfulness.

The idea of using therapeutic mindfulness as an alternative to treat mental health conditions has gained credence in the past few years. New evidence suggests that it can be useful in treating anxiety, depression and Post Traumatic Stress Disorder (PTSD).

Dr El-Imad points out that VR technology can help in democratising these experiences as well.

“You don’t have to be rich and go to these exotic places to meditate and relax. You can be living in a in a one-bedroom flat in a polluted and congested city but still have access to these experiences and learn to control your mind and feel positive,” he says.

In fact, it can be used to cure the attention deficit disorder especially among children. “It is a big problem among children and this can be a fun way to teach them how to concentrate.”

With mobile phones, tablets, wearables and other digital devices overtaking modern life, even adults are susceptible, he adds.

Challenges ahead

Dr El-Imad thinks we are still quite far off from using such technologies within acute mental health settings as it is still not fully digitised, which should be a prerequisite, before moving on to these sophisticated technologies. Another reason, he states, is that the status quo of using pills to treat mental health conditions remains prevalent, and people haven’t thought of doing things differently until recently.

Read the full article here.

Blended care: eHealth and mental health provision

NHS Providers found that 80% of bosses of NHS trusts fear they cannot provide timely, high-quality care to the growing numbers of people seeking mental health support. Resulting in the NHS increasingly looking to eHealth as an alternative solution. The NHS has been presenting webcam and instant messaging, (IM), appointments to patients to ease pressure and waiting times, as a combination of rising demand and cuts to the workforce provides a real challenge for NHS mental health services.

The limitations of eHealth

However, since clinicians often have a minimal or no role in stand-alone eHealth initiatives, they stay in doubt about their usability and clinical effectiveness. Currently, the number of evidence-based eHealth interventions is limited. As such, care providers remain sceptical that eHealth can significantly reduce waiting time pressures and improve the quality of life for their patients and their relatives. In addition, most eHealth interventions are highly standardised and can’t be easily adapted to meet the personal needs of each service user.

The success factors of blended care

These shortcomings can be met with a blended care format that embraces eHealth while keeping clinicians firmly in control. For this to be an effective and acceptable treatment method, it needs to meet three key requirements.

Firstly, face-to-face and digital solutions should complement each other qualitatively in a way standalone webcam or IM-based initiatives are unlikely to achieve. Clinicians are able to maximise face-to-face sessions as necessary for high-quality therapy, and consider digital alternatives for vital but lower-level treatment.

Secondly, blended care should reflect the specific needs of the service user and the flexible input of clinical expertise. For example, one therapist realised that internet based therapy enabled some patients to make a positive connection with her because they were physically in different locations. It fostered a sense of security that was needed before they were able to participate in deeper face-to-face sessions.

Thirdly, blended care should be time and cost-saving. Considering that there are shortages of specialist nurses and psychiatrists, clinicians simply lack the time to carry out all therapy sessions face-to-face. Blended care allows them to carry out some part of the treatment programme at a time and location that is convenient to both parties, saving travelling time and money.

The benefits to clinicians and patients

Waiting times can be reduced by starting treatment before the first face-to-face session. Patients can complete preparation work online, for example a diary for tracking behaviours, emotions or cognitions. It can give the service user a sense of control from the outset and accelerate the diagnosis and treatment planning process. Equally, clinicians can make other digital support tools available once face-to-face sessions have ended, allowing service users to continue building on their progress.

Traditional therapy focuses almost solely on the individual, though a mental health patient rarely exists in isolation: there will be close friends and family who wish to support but lack the knowledge and tools, or the facilities to join the patient in face-to-face sessions. A blended care approach gives the person’s support network more opportunities to provide effective help.

Adding eHealth components that target secondary health-related problems can optimise treatment services. Mental health conditions can cause financially reckless behaviour, whereas financial problems can in turn exacerbate mental health problems. eHealth modules can include advice on how to address and solve money problems. More importantly from a clinical perspective, eHealth modules can also be applied to help the patient understand the psychodynamics behind their pattern of dysfunctional behaviours, teach them how to recognise emotions that can trigger these behaviours and how to prevent them in future.


Blended care is a highly dynamic and flexible care format. It is not just about adding eHealth components to support face-to-face sessions in order to ease pressure on clinicians and waiting times. When done right, blended care can accelerate and deepen face-to-face therapy improving overall health outcomes for patients and the NHS.

Read the full article here.

See your data in new ways

The psychology behind CareDirector dashboards

Data-driven decisions are extremely important within healthcare, giving the dashboard a very important role. With its interactive and intuitive interface and its ability to visualise data in a single screen, it’s becoming a critical tool in the hands of healthcare professionals. That is why the new CareDirector Mental Health Solution has been designed with a renewed focus on data visualisation via dashboards. But what is it that makes dashboards so appealing to the human mind? What is it that the human brain seeks that is so nicely provided by dashboards?

Desire to Control

From an evolutionary standpoint, if we are in control of our environment we have a better chance of survival. Our subconscious mind prepares us for all kinds of danger based on our perceived level of control. Dashboards give you that control by heightening your awareness of a situation.

CareDirector dashboards use a three-pronged strategy to establish a sense of control:

  1. Giving you a clear understanding of things to help establish a feeling of clarity
  2. Giving you the resources to predict outcomes and plan care pathways
  3. Helping you complete critical tasks in time to avoid last-minute panic

Limited Short-Term Memory

The human brain can’t store much information in the short-term memory and that this is especially true when bombarded with multiple pieces of data in rapid succession. By displaying all relevant information on a single screen within a user’s eye span, CareDirector dashboards reduce the dependence on the short-term memory. Dashboards work around the limits of short-term memory in three ways:

  1. Using chart and graphs to reduce the dependence on short-term memory
  2. Providing a summary screen with drill-down options
  3. Splitting data across tabs and placing all related data under one tab

Ease of Use

A good dashboard is a simple dashboard. Dashboards within CareDirector appear familiar, are intuitive and can be accessed on any modern device. Paper based patient records leave room for human error, run the risk of data being lost can take up a lot of time. CareDirector’s digital dashboards eliminate all of these problems by placing data in one, easily accessed place.

The product designers at CareWorks kept the needs of its end users in mind when creating this new product. People like being in control, they have a limited short-term memory, and they love things that are simple. These are three essential factors that form the foundation of CareDirector dashboards to help you do your job more efficiently. Find out more about the CareDirector Mental Health Solution today, email [email protected]

Read the full article here.

The digital revolution is coming and the NHS needs to be ready

Stephen Barclay, Minister of State for Health and Social Care, believes that it is important the NHS is “future-fit” to embrace the digital revolution.

Aided by the rapid advance of new technologies, the science of human health is starting to be digitised. Sophisticated smartphone apps are being used to continuously monitor a patient’s vital signs, opening up new ways of managing long term conditions such as diabetes. Artificial intelligence is revolutionising diagnostics, with machine learning technologies set to improve the accuracy and speed of diagnosis. Developments in medical imaging technologies are helping to bring the diagnostic arsenal of a hospital out into the community, while robotics and augmented reality technology is similarly delivering profound changes in surgical practice. Perhaps most significantly of all, the development of genomic science, supported by our world-leading 100,000 Genomes Project, is poised to transform our understanding and treatment of rare or hereditary diseases.

Digital transformation

There’s not a single professional group or specialism within the NHS that will be untouched by the way digital technologies shape their work over the next decade or two.

From understanding the algorithms and analytical tools necessary to process big data sets, to the management challenges of information governance and data protection, as well as the highly specialised training to use new forms of equipment, these will mean equipping teams with a new set of skills and knowledge, as well as potentially creating new professional roles.

It will also, in some cases, shift the way the NHS provides care – most obviously in the increasing use of online consultations and remote monitoring of long term conditions – meaning that clinicians will need to have confidence to maintain patient relationships through different media and support patients’ abilities to self-manage care.

Some technologies may also open up potentially difficult ethical questions that the skilled professional will need to manage in discussion with their patients.

New skills needed

All of this points to a capability challenge. NHS staff need to be equipped with the skills and knowledge they need to unleash the full, transformative potential of these new technologies, many of which simply were not in existence when many parts of the current workforce were in training.

That is why the renowned American academic and technologist Dr Eric Topol has been asked to deliver a landmark review into the workforce implications of new technology. Dr Topol’s study will cover the full span of technological change, drawing in support from established experts to forecast the potential skills that will be needed and how best to build capability across the NHS workforce. His findings will inform the workforce strategy that Health Education England are developing.

While much of the current debate about workforce focuses on the recruitment and retention issues facing the NHS, which is being tackled by increasing medical training places, it is just as important is producing doctors and nurses with the right skills set to practice modern medicine.

Read the full article here.

Mental health services: How to fill data gaps to improve outcomes and drive efficiencies

The cost of mental illnesses to the economy is estimated at £105 billion a year. When you consider that patients with mental illness are almost twice as likely to die from coronary heart disease, four times more likely to die from respiratory disease and are at a higher risk of being overweight or obese, that estimate is likely to be conservative. Efficiencies need to be found if mental health services are to be improved and made available to those in need.

Efficiencies such as an intuitive case management system could be the best place to start.

Reducing clinical risk with data

Risk management is a key component of effective mental health treatment. A huge part of a clinician’s job is risk assessment of a patient and being able to clearly justify why a certain treatment plan was chosen. In order to do this, a clinician must be able to review a patient’s entire background and history.

This is often a complicated task as data may be required from multiple sources and interactions over extensive periods of time. Without access to the full patient history, this can lead to management decisions being taken with a limited understanding of the associated risks, and result in poorer outcomes.

A key component of this is data management and visualisation. CareDirector Mental Health solution has a renewed focus on data visualisation. All of a patient’s data can be viewed easily in one place, the system is updated in real time and can integrate with other third party systems, meaning clinicians can view a patient’s entire history in one place and make an informed decision faster about a treatment plan.

Efficiency benefits in the real world

The demanding nature of mental health clinics often results in little time available to review a patient’s history prior to an appointment, meaning a lot of the appointment time can be spent reviewing a patient’s history, collecting data from disparate systems. Although the relevant patient data may be on a system, it might not be accessible. It might be spread out across siloed systems, be out of chronological order, inappropriately titled, or be buried amongst multiple sets of unstructured data, where it is poorly sorted.

This leaves little time to collect and corroborate new assessment findings. These gaps in finding data also often mean that multiple parties will have to be contacted, not only potentially increasing and duplicating data storage, but also leading to further delays in treatment.

CareDirector Mental Health solution eliminates this issue. All of a patient’s data will be in one easily accessible place. Data is stored and organised to be readily available to clinicians. A clinician can search for certain information points, or scroll through the patient’s entire history with ease in a social media style user interface, reducing time spent searching for data and eliminating the issue of data duplication, and ultimately reducing the delay in patient treatment.

CareWorks know that clinical risk needs to be reduced and quality of patient care needs to be improved. CareDirector can help achieve this by streamlining access to a full patient history, leading to time and cost efficiencies. Our solution is highly customisable meaning that a trust can ensure that CareDirector aligns with their workflows and needs, ensuring that clinicians have the right tools to make quick, accurate diagnosis and treatment at the point of care.

Read the full article here.

Robots and artificial intelligence could save NHS £12.5bn a year

The NHS could shave off a tenth of its budget by assigning nearly a third to robots and artificial intelligence systems, a new report by surgeon and former health minister Lord Darzi, has claimed. The report suggests the NHS could achieve cost savings of £12.5bn a year, by fully automating repetitive and administrative tasks, such as communicating medical notes, booking appointments and processing prescriptions.

It suggests that “home help care robots” designed to help people move around the home, help with household maintenance and even wash, dress and feed themselves, could reduce the human workload by 30%.

The report claims that artificial intelligence and automation will serve to complement human workers and free up more time for direct patient care, rather than resulting in mass unemployment. It also points out that technology will also help to fill a void left by a shortage of frontline staff in health and social care.

The report claims that robots and artificial intelligence systems could take on approximately:

  • 31% of the workload currently faced by GPs,
  • 23% of that of hospital doctors,
  • 29% of that of nurses.

Meanwhile, tapping the full potential of machine learning and artificial intelligence systems in diagnostics could enhance the speed and accuracy of diagnoses, particularly for conditions such as pneumonia, eye diseases, heart conditions and different types of cancer, the report claims. Biosensors will also allow the remote monitoring and alerting responses to clinical observations, such as sepsis.

While the report makes no reference to the potential cost or timeline for achieving such a high level of sophistication, it acknowledges many barriers facing to this innovation including “a lack of investment in the technological infrastructure; a need to redesign care pathways around automated solutions; and to retrain impacted staff to perform new roles.”

However, the report stresses that “the opportunity is too great to ignore”, and new funding for health and social care should include a sizable budget for this innovation pathway.

The report concludes: “Automation has the potential to transform the social care sector by connecting support at home, in residential care, and in hospitals, thereby smoothing the transitions between these settings.

“The future is full of possibilities where robots empower people in old age, enabling better, longer, and more fulfilling lives. Wider application of social digital technology at all ages will enable more people to remain supported and connected to friends and family.”

Read the full article here.

NHS Digital programme director: Innovation needs more work

Speaking at the NHS Confederation 2018 Conference in Manchester, Cleveland Henry, the programme director of innovations, digital futures and digital collaboration service at NHS Digital, talked about the digital successes and challenges that NHS Digital has encountered.

The session looked into how the advancement of technology in the health and care system has helped transform patient care. While successes were listed as e-referrals, NHSmail and the Spine, Henry concedes that technology is being introduced to patients and clinicians across the NHS, however, he admitted more work was needed to actually get people to use it.

“We have 95% of GPs offering online services but only 20% of people are using it…Yes we are doing innovation but there’s work we need to do. We can’t just chuck an iPad at it.”

Henry added that it is important to deliver solutions “that are easier to use than not to”, adding clinicians must be “comfortable” employing the technology on a daily basis.

“We need to make sure that we do our job so that front-line staff can do theirs…The more digital we make services, the easier it becomes for the staff to treat patients.”

Henry stated that the overall aim is to make the NHS “future fit” and innovation should not be stifled by previous IT projects.

Read the full article here.

Is the NHS reinforcing mental health stigma through excessive data secrecy?

Dr James Reed, chief clinical information officer at Birmingham and Solihull Mental Health NHS Foundation Trust, posed a thought provoking question recently; is the NHS reinforcing mental health stigma through excessive data secrecy?

Often clinicians talk about mental health data in hushed tones, as if there is something secret and extra sensitive about it when compared to other health information. This can result in clinicians not being as informed as they should be when treating people with mental illnesses.

Dr Reed argues that, “Treating mental health data as if it needs to be locked away in isolation is a complete contradiction to delivering equality for mental health.” Information about one’s schizophrenia or depression should in no way be seen as different, or any more sensitive or difficult as information about cancer or diabetes.

Patient privacy is central to effective care, and any sensitive patient information must only be accessed when appropriate. But when mental health is singled out with excessive secrecy, or even hidden away entirely, much worse outcomes for the patient can ensue, particularly when their problems are not understood.

Patient treatment cannot be effective if professionals don’t have access to information they need, and that inevitably leads to poorer standards of care. Parity of esteem, or valuing mental and physical health equally, and reducing mental health stigma, is now a national priority. CareDirector Mental Health solution can help to eliminate this data related issue. All of a patient’s data is stored and organised to be readily available to clinicians in one place. A clinician can search for certain information points, or scroll through the patient’s entire history with ease in a social media style user interface, offering a clear and complete picture of a patient’s history and ultimately reducing the delay in patient treatment.

But to really reduce mental health stigma, Dr Reed argues that we need a societal shift to ensure availability of information needed to treat patients with mental illness becomes acceptable. We are not there yet, but the conversation continues to evolve, especially with high-profile individuals like Princes William and Harry talking openly about mental health and mental illness.

As with any sensitive data, it is important to ensure that it is accessed appropriately, with safeguards in place. However, Dr Reed passionately proclaims that we must stop seeing mental health as a special case – there should be no shame attached.

Read the full article here.