GUY’S AND ST THOMAS’ TRUST

DIGITAL STRATEGY
September 2017
FOREWORD

To ensure that we get the most from this documentation I thought that I would take this opportunity
to position what digital means in the wider context. So what is digital…

Digital is a combination of pervasive data, continuous connectivity and intuitive analytics. When the
power of digital is harnessed alongside business change it has the potential to truly change the way we
work.

Digital will radically change our everyday working lives; from the way we deliver care, interact with our
patients and work with each other. That caring moment, the clinical interaction between patient and
healthcare professional, is at the heart what GSTT is all about; becoming digital will strengthen and
enhance that. But beyond that, digital will impact every aspect of the Trust, from our ways of working
with each other, to how we buy supplies and services, to where and how we work. Digital will be the
vehicle for our business transformation that continues to put patients and staff first and drives
continuous improvements and innovation.

This document sets out our first ever Digital Strategy and is an important first step towards taking
advantage of digital. For this to work well there has to be alignment between this strategy and other
Trust strategies, such as clinical, workforce, research, education and training, estates, finance and IT
strategies. The transformation delivered by becoming digital will have a direct impact on Trust
strategies, as well as being shaped in turn by these strategic priorities and directions. We will have to
work hard to ensure digital is meeting the needs of our business areas, by regularly reviewing and
updating this strategy to ensure it is supporting the clinical and corporate directorates and linking us
into the wider health economy. The Digital Strategy is not the IT Strategy, but they are vital to each
other’s success. The IT Strategy will consider how to deliver the technology that underpins the vision
and outcomes defined in this document; the Digital Strategy outlines how to apply that data and
technology to improve our organisation.

The Digital Strategy shapes our approach to taking advantage of digital information and services to
support sustainable care delivery ambitions and align with changing patient and staff expectations. It
describes the vision and the strategic outcomes that will be our focus over the next five years and
beyond. These represent a fundamental step change in the way we approach and deliver services. This
document sets out the guiding principles which outline how to deliver and embed digital services into
everyday care delivery and into our ways of working. It is vital that the transformational opportunities
identified are fully understood and are committed to. It is this combination of business change and
digital technology that will setup the Trust for success.

The rapidly changing digital environment will require us to continually evaluate and adapt. The
recommended strategic roadmap and initiatives represent a ‘point in time’ view. The strategic
roadmap is not bounded by a specific timeframe but instead will be used to guide future investment.
The initiatives are not static but instead must be continually renewed to align and support changing
organisational priorities and the evolving digital landscape. Becoming digital will leave no part of what
we do untouched; we must become digital to ensure we retain what makes GSTT special.

Steve Townsend
Chief Digital Information Officer
IT/Digital Directorate

GSTT – Digital Strategy – v1.0 2

 EXECUTIVE SUMMARY

GSTT – Digital Strategy – v1.0 3

EXECUTIVE SUMMARY

STRATEGIC CONTEXT

Guy’s and St Thomas’ Trust (GSTT or the Trust) is one of the UK's busiest and most successful
foundation trusts, with a long history of clinical excellence and high quality care. The Trust is an
integrated community and acute provider comprising of two of London's best known teaching
hospitals, St Thomas' and Guy's Hospital, the Evelina London Children’s Hospital at St Thomas’ and the
community health services for adults and children in the London Boroughs of Lambeth and Southwark.

Rapid innovation in digital continues to fundamentally change the way patients, clinicians and
providers interact and transform healthcare. Patients and front-line staff expect more from digital
technologies; to communicate, share information about care, and manage health needs. Finding new
ways to sustainably deliver care is always going to be about different ways of supporting our staff and
patients and working with our partners to deliver seamless care.

As the focus moves towards population health outcomes, providing a new model of care that is
digitally enabled extending care beyond the hospital walls will need to be taken into account. The
implications of this care model will inform our digital solutions and the alignment between our
partners.

OUR DIGITAL VISION AND OUTCOMES

“At GSTT we will use digital technology to deliver effective, engaging experiences for
our patients, carers, and staff to continually improve healthcare, research and
education outcomes.”

To deliver on this digital vision and bring real improvements for patients, clinical and non-clinical staff,
we will focus on delivering six key outcomes:

GSTT – Digital Strategy – v1.0 4

Figure 1 - Strategic Outcomes

DIGITAL FOR OUR STAKEHOLDERS

Digital impacts everything we do. It refers to more than just the devices and channels for consumer
interaction. It touches upon the key components of our Trust, including how we provide our services,
to whom we provide services, where we provide our services and how we are organised to provide
services.

Digital is about utilising technology to reinvent the way we deliver our services whilst driving improved
patient and staff experience and operational efficiency. Digital is the combination of modern
technology components that deliver mobile, data rich, and secure services; these have changed the
way we work, shop, communicate and travel. It is the combined power of these technologies that will
bring real improvements for patients, clinical and non-clinical staff.

In order to truly realise the benefits of these technologies we will need to change the way we provide
services. Capturing data in a timely manner will require us to observe and record the required data in
our everyday activities. Technology will reduce the time required to analyse the data captured,
enabling us to use the insights generated into everyday care delivery. Similarly, we will need to rethink
where we work from and how we work with each other, enabled by mobility solutions. Finally, our
everyday tasks will be supported by automation, enabling us to focus on activities to deliver better
outcomes for our patients.

Figure 2 - What does 'digital' mean for our stakeholders?

GSTT – Digital Strategy – v1.0 5

BECOMING DIGITAL

In order to deliver the outcomes and benefits identified, we will link the directorate objectives to this
strategy. This will identify opportunities for how digital can have the greatest impact on our
directorates and identify plans to take advantage of these opportunities.

GSTT – Digital Strategy – v1.0 6

We recognise that we are currently delivering digital solutions across the Trust. We will build on this
further, seek collaboration and coordinated effort from multiple stakeholder groups across the Trust to
continue delivering the initiatives. The following principles will guide this approach to digital and
delivery of initiatives.

Figure 3 - Digital guiding principles

The digital delivery will be guided by an overall strategic roadmap, delivered over a number of steps.
We will establish the foundations for becoming more digital, implement incremental change whilst
driving the Trust towards digital as ‘business as usual’ in a way that is achievable for the Trust.

Figure 4 - Strategic roadmap

GSTT – Digital Strategy – v1.0 7

The digital solutions being delivered through existing or planned programs must be aligned with the
strategic roadmap. Specifically, this must consider opportunities to collaborate and pool effort towards
achieving commons goals for the Trust.

Delivering the digital outcomes will require the right blend of people and skills, supported by clear
governance and accountability. In order to be successful, we will implement the required tools,
methodologies and frameworks.

Although the primary purpose of this Digital Strategy is to inform direction and vision, it is important to
recognise the investment that will need to be made to achieve the vision. Healthcare providers
currently only invest 0.5% to 0.9% of total operating expenditure on digital initiatives.1 This is reported
to be doubled in 20182 to 1% to 2% of the total operating expenditure. We must identity and source
further investment to boost our digital capability.

NEXT STEPS

We have already seen the major benefits technology can bring to our patients and our organisation but
it is vital that we have the right strategy to ensure that we manage future technological developments
efficiently and effectively. The Digital Strategy sets out a very clear plan for the work we need to
undertake and ensures we have the right priorities to deliver world class digital healthcare across the
Trust. In order to execute on this plan, we will

1. Establish a digital function within GSTT, bringing together existing digital skills and resources,
and addressing capability gaps. The digital function will have the responsibility to define the
tools, frameworks and methodologies to enable digital across the Trust.
2. Introduce ‘digital champions’ across the Trust to lead and coordinate digital across the Trust
and within each directorate.
3. Establish digital governance to coordinate and drive speedy decision making on digital
investments across the Trust.

1 Gartner IT Key Metrics Data (December 2016)

2
Gartner CIO Agenda: A Healthcare Perspective (February 2017)

GSTT – Digital Strategy – v1.0 8

TABLE OF CONTENTS

Executive Summary .................................................................................................................................... 4

Table of Contents ....................................................................................................................................... 9

1. Strategic Context ............................................................................................................................. 11

2. What is GSTT’s Digital Strategy? ...................................................................................................... 17

3. What does ‘digital’ mean for our stakeholders? ............................................................................. 22

4. Becoming digital: How will we realise the vision? ........................................................................... 28

Appendix A. Digital initiative description ........................................................................................... 36

GSTT – Digital Strategy – v1.0 9

 WHY IS DIGITAL IMPORTANT?

GSTT – Digital Strategy – v1.0 10

1. STRATEGIC CONTEXT

WHO ARE WE?

Guy’s and St Thomas’ Trust (GSTT or the Trust) is one of the UK's busiest and most successful
foundation trusts, with a long history of clinical excellence and high quality care. The Trust is an
integrated community and acute provider comprising of two of London's best known teaching
hospitals, St Thomas' and Guy's Hospital, the Evelina London Children’s Hospital at St Thomas’ and the
community health services for adults and children in the London Boroughs of Lambeth and Southwark.

We offer community based child and family services such as Health Visiting and school nursing as part
of the full range of universal children’s services as well as specialist services. For adults we offer a full
range of services to support people in their homes, intervening early to avoid hospital admission and
supporting early discharge. GSTT have a wide range of rehabilitation and therapy services and in all
services work closely with primary and social care. We have recently taken on some reablement
services locally from social care.

The Trust provide a full range of diagnostic, emergency and elective hospital services, including
women’s services, orthopaedics, ophthalmology, general medicine, diabetes care, and rheumatology
for local people in South East London, visitors and the London commuter population. For our wide
range of specialist services we are variously the provider for south east London, Kent, Surrey and
Sussex, southern England and in some instance we have national services. These specialist services
include children's services, cancer, cardiology, cardiac surgery, vascular, kidney care, plastics, specialist
surgery and dermatology. As part of delivering these services we work with a wide range of local
hospitals through clinical networks. We have one of the largest critical care units in the UK and one of
the busiest Accident and Emergency departments in London.

The Trust is also a founder member of King’s Health Partners (KHP) Academic Health Science Centre,
one of only eight AHSCs in the UK. KHP brings together a range and depth of clinical and research
expertise spanning mental and physical health and aims to drive improvements in care for patients
allowing them to benefit from breakthroughs in medical science and receive leading edge treatment at
the earliest opportunity. KHP is seeking to further develop and grow strong relationships with industry
partners, spanning pharma, med-Tech and digital sectors specifically to focus on focus on translational
and clinical research, leverage new technologies that empower people to better manage their care,
and transforming outcomes through an integrated informatics strategy, and establishing a dedicated
med-Tech hub for the next generation of technologies, and leveraging big data in improving models of
care.

We are also a teaching Trust meaning that a range of professional and technical staff groups receive
undergraduate and post graduate training in our facilities- doctors, dentists, nurses, therapists,
midwives etc.

Digital will be a key enabler for future changes in the way we work, the way we are organised,
including our partnerships, future organisational structures and group ambitions.

UNDERSTANDING THE FU TURE DIGITAL NEEDS O F THE TRUST

The Trust’s Strategic Plan 2014–2019 describes the plans to be a clinically, operationally and financially
sustainable organisation over the next five years so that we continue to provide high quality clinical
services for our NHS patients. The Strategic Plan recognises information and technology as strategic
enablers to achieve the corporate vision.

GSTT – Digital Strategy – v1.0 11

The Trust’s clinical strategy builds on the Strategic Plan and defines the future direction of its clinical
business. The clinical strategy recognises the role of technology in enabling the clinical strategy
outcomes, specifically through

 Becoming paper-light and improving access to technology at patient bedsides in wards,

 Supporting access to a wide range of data everywhere and at any time,
 Delivering health care across very wide geographies, through the use of technology,
 Embracing technology to facilitate new ways of working including providing our services in off-
site locations,
 Empowering both service users and support professionals through the use of apps and social
media, and
 Enabling remote monitoring systems and home based technologies to support patients with
long term conditions at home.

THE INFLUENCE OF NATIONAL AND REGIONAL PRIORITIES

Healthcare organisations throughout England are facing financial pressures resulting from a reduction
in public sector spending and rising healthcare demands. In addition, there is building service pressure
as a result of changing patient needs, new treatment options and increased consumer expectations.
The NHS cannot continue delivering its current services free at the point of delivery without radical
change.

The NHS Five Year Forward View was published in October 2014 and sets out a new shared vision for
the future of the NHS based around the new models of care. The ‘Forward View’ sets out a clear
direction for the NHS and outlines a series of actions to achieve the vision, one of which is harnessing
technology and innovation to enable a sustainable NHS. Subsequently, the National Information Board
published their Personalised Health and Care 2020, which provides a framework for action to take
better advantage of the digital opportunity. The framework outlines a series of priorities for use of
digital and technology to achieve the ‘Forward View’. Specifically, this includes

 Providing citizens full access to their care records and access to an expanding set of NHS
accredited health and care apps and digital information services,
 Gathering real-time digital information on a person’s health and care by 2020 for all NHS-
funded services, and comprehensive data on the outcomes and value of services to support
improvement and sustainability i.e. give care professionals and carers access to all the data,
information and knowledge they need,
 Publishing comparative information on all publicly funded health and care services, including
the results of treatment and what patients and carers say,
 Ensuring citizens are confident about sharing their data to improve care and health outcomes,
 Making England a leading digital health economy in the world and develop new resources to
support research and maximise the benefits of new medicines and treatments,
 Supporting care professionals to make the best use of data and technology, and
 Ensuring that current and future investments in technology reduce the cost and improve the
value of health services and support delivery of better health and care regardless of setting

Guy’s and St Thomas’ is a key partner in the development of a five-year plan for health services in
South East London (SEL), known as the Our Healthier SEL Sustainability and Transformation Partnership
(OHSEL STP). Our STP footprint comprises of 6 clinical commissioning groups (CCGs), 6 local authorities,
6 acute providers, and the primary care providers within the SEL region. Our OHSEL STP echoes the
need to adopt new models of care and to align ourselves towards delivering an agreed set of
population outcomes. The OHSEL STP recognises that developments in IT and digital technologies
present a huge opportunity for us to advance the way we care for patients. An ambitious vision for

GSTT – Digital Strategy – v1.0 12

South East London has been set out in the Local Digital Roadmap (LDR), which examines the
opportunities to exploit new technology over the next five years and beyond. Specifically, this outlines
a digital vision focusing on:

 Being paper-free at the point of care by 2020,

 Using digital technology to empower patients to have more control over their day-to-day care,
 Making real-time data analytics possible at the point of care, and
 Compiling and analysing health and social care data to support population health planning,
effective commissioning and research.

THE DIGITAL CHALLENGE

Over the last decade technology has transformed many industries and the connectedness of
individuals within communities and across the globe. New digital technology continues to change the
way we connect, work, think and play. Healthcare is being rapidly pulled into the digital world. While
health is one of the more information intensive industries, in general it has lagged other sectors in the
speed of its adoption and exploitation digital technologies.

Rapid innovation in digital continues to fundamentally change the way customers, clinicians and
providers interact and transform healthcare. The opportunities that were promising only just a few
years ago are now demonstrating the power of their ability to transform how we manage our own
health, access health and social care. Already, robotic surgery, 3D printing, implantable devices, and
other digital and technology-enabled innovations that target prevention, monitoring, and treatment
are showing potential to improve outcomes and reduce costs. In addition, new R&D approaches, and
big data and analytics are creating opportunities for innovation.

The following innovations are most likely to transform healthcare over the next 10 years. 3
Incorporating these key innovations into healthcare delivery will require changing how the Trust
currently interacts with consumers, clinicians and staff to prevent, diagnose, monitor and treat disease.
In addition, the Trust will need to break current constraints and adopt new ways of working to take
advantage of these innovations.

Figure 5 - Top technologies impacting healthcare

3
Deloitte Global Health Care Outlook 2017

GSTT – Digital Strategy – v1.0 13

DIGITAL AT GSTT

GSTT recognises the potential of digital to significantly transform the way we work and how and where
we provide services. In NHS England’s 2015 Digital Maturity Index (DMI), we assessed ourselves as
highly mature. Our overall score across a range of dimensions was 86%, driven by the fact that we have
a wide-range of individual systems to support functions such as appointment booking, recording
clinical notes, prescribing, and ordering lab tests. The self-assessment did not explicitly require us to
consider the lack of integration in place between our systems, whether the systems enabled seamless
processes across the continuum of care, or whether we had the ability to utilise advanced analytics -
key requirements of NHS digital strategy and our future vision. There remain key pieces of the
functionality required to support our future vision that are not currently available within the Trust and
will need to be provided in order to support digital-enabled services and be future ready.

Directorates are currently undertaking some digitally enabled activities to address business challenges.
Alongside these there are Trust-wide initiatives, such as Digital Patient Journey and Transforming Our
Ways of Working that are already contributing to our digital future, changing the way that we work and
how our patients engage with us.

Digital Hub

The GSTT Digital Hub (the Hub) is a new function within IT focusing on digital innovation and
transformation initiatives. The Hub is focused on using private sector and tech start-up methods, such
as Agile, iterative, Minimum Viable Product (MVP), pilots, to bring about fast, high financial value, and
digital transformation delivery. The Hub currently undertakes projects focused on improving user
experience for clinician, patient, researcher, coder etc. and those that can be delivered as a MVP, pilot,
proof of concept usually in less than 3 months.

The Hub’s vision is to improve healthcare outcomes across the Trust by making better use of
technology, data and information. The Hub’s value proposition4 is based around:

 Fast, deliver results: the ability to quickly mobilise resource in technology and transformation
disciplines to support early adoption and embed digital solutions and behaviours within the
service
 Co-creation: working together with clinicians and service managers to identify, test and
deliver solutions
 Specialist capabilities: skills and capabilities to identify and trial innovation, platforms or
methodologies in small scale and test them. Abort if fails or if successful -adopt widely.
 Ideally positioned to drive innovation: we are external as well as internal facing, identifying
what works elsewhere and investigating if/ how it can be adapted and adopted at GSTT

Whilst the above initiatives have contributed to and will continue to deliver digital services, we need to
establish a controlled environment of scalable innovation. This will enhance our potential to deliver a
return on investment, rather than to continue with our current approach of working in silos of
unconnected innovation.

DIGITAL PRIORITIES

4
GSTT Digital Hub Strategy July 2017

GSTT – Digital Strategy – v1.0 14

The implications from the current health climate, the Trust’s ambition, the influence of national and
regional priorities have been distilled into the following digital priorities for the Trust:

 Deliver integrated patient information at point of care to support coordinated care.

 Improve patient empowerment by providing easier access to the information and tools to
make appropriate choices for their care.
 Support a seamless experience for patients and staff across and beyond GSTT.
 Support integrated and networked models of care and service delivery with community care
partners and the broader network of healthcare providers.
 Support a rapid and continuous cycle of learning, discovery and improvement to enable care,
research, education and health service management.
 Use data-driven insights to inform clinical quality improvement, service and organisational
planning, and organisational performance management.
 Provide staff with an effective working environment that increases their productivity and
supports them in providing better services for patients, staff and the Trust.

Case Study: Precision Health focuses on improving an individual's health by

diagnosing, preventing and treating a future illness

Precision Health combines advances in genomics medicine, wearables and the

Internet of Things (IoT) with enhanced data collection in electronic health record
systems (EHR), wearables and mobile apps. Diagnosis is based on an analysis of
data generated by an individual's life style, real-world environment, biometric data
and genomics. It is enabled through machine learning, deep neural nets and
Natural Language Processing (NLP).

Ginger.io, offers a mobile app in which patients with select conditions agree, in
conjunction with their providers, to be tracked through their mobile phones and
assisted with behavioural-health therapies. By monitoring the mobile sensors
present in smartphones, the app records data about calls, texts, geographic
location, and even physical movements. Patients also respond to surveys delivered
over their smartphones. The Ginger.io app integrates patient data with public
research on behavioural health from the National Institutes of Health and other
sources. The insights obtained can be revealing—for instance, a lack of movement
or other activity could signal that a patient feels physically unwell, and irregular
sleep patterns (revealed through late-night calls or texts) may signal that an
anxiety attack is imminent.

GSTT – Digital Strategy – v1.0 15

 WHAT IS OUR DIGITAL STRATEGY?

GSTT – Digital Strategy – v1.0 16

2. WHAT IS GSTT’S DIGITAL STRATEGY?

DIGITAL VISION

The digital vision responds directly to the implications and priorities identified within the strategic
context and will position GSTT as a leading digital health service provider.

“At GSTT we will use digital technology to deliver effective, engaging experiences for
our patients, carers, and staff to continually improve healthcare, research and
education outcomes.”

STRATEGIC OUTCOMES

Delivering the digital vision will bring real improvements for patients, clinical and non-clinical staff. To
deliver these improvements we will focus on delivering six key outcomes.

Figure 6 - Strategic outcomes

USER EXPERIENCE: DELIVER A HIGHER QUALITY, SEAMLESS EXPERIENCE FOR OUR

PATIENTS AND STAFF WITHIN AND BEYOND GST T
GSTT will deliver a consistent set of services and unified experience for patients in their interactions
with the Trust, across all areas of GSTT facilities and beyond the hospital walls. Staff will be supported
in working efficiently and seamlessly across the different parts of the Trust, maximising as far as
possible the consistency of their experience. This will be achieved through

 Delivering digital solutions and services to support patient interaction with the Trust across
the end-to-end patient journey
 Enabling staff to focus on providing effective patient care, by simplifying and improving their
clinical, corporate and research systems

GSTT – Digital Strategy – v1.0 17

  Understanding the user needs and focusing on user experience when implementing new
digital solutions
 Structuring user interfaces and experiences to be non-intrusive and to blend seamlessly with
journeys, tasks and workflows so that they form a natural part of the user’s activities.

SKILLS AND CONFIDENCE: EQUIP OUR STAFF WITH THE SKILLS, TOOLS AND
TRAINING IN THE USE OF DIGITAL S OLUTIONS
Create the culture, tools and environment to allow front-line staff to adopt new and enhanced digital
technologies through

 Creating an environment within the Trust for staff to adopt digital technologies in their day to
day working as they evolve, using multi-channel learning tools such as webinars, that go
beyond standard IT training to support learning at the point of need
 Providing assistance and digital support as and when required, to allow seamless working
 Ensuring staff are adequately engaged and supported through the process of change.

LEVERAGE DATA: DRIVE EVIDENCE BASED CARE AND TIMELY DECISION MAKING
THROUGH THE BETTER CAPTURE AND USE OF DATA AND ANAL YTICS
Be a more data-led organisation with improved data accuracy, timeliness and availability to all staff and
patients at the right point of care to enable more effective clinical, performance, and research
decisions by

 Capturing holistic patient information, their conditions and their care, once to provide
clinicians with a single view to support the planning and delivery of the best care possible and
the reduction of clinical risk
 Providing staff with easy access to service delivery, performance, operational management
and demand data to support clinical service performance and operational management
 Enabling data and information availability for research analytics to reinforce KHP’s position as
a world leading research institution
 Making available to users, information that is personalised to their needs and presented
through simple, intuitive and engaging user interfaces appropriate to the user and their
context, from anywhere and on any device of choice.

EFFICIENCIES: DRIVE CLINICAL AND CORPORATE EFFICIENCIES IN CLINICAL AND

NON-CLINICAL PROCESSES
Increase clinical and corporate efficiencies and value for money in line with regional and national
priorities by

 Enabling the use of digital technologies to enable clinical pathways, in collaboration with our
clinical stakeholders
 Leveraging digital technologies to eliminate waste, automate processes and eliminate
bottlenecks across supply chain, patient throughput and capacity management
 Standardising products that have been tested and proved across the NHS or other healthcare
systems in order to identify opportunities to increase clinical and corporate efficiencies
 Consolidating a range of bespoke systems and coordinate the data to gain operational
efficiencies

GSTT – Digital Strategy – v1.0 18

  Providing access to information and tools that support the analysis of health service
management and operational performance information and assist in the identification of
areas of significant variation and opportunities for improvement.

DRIVE INNOVATION: IMPLEMENT PROCESSES & STRUCTURES TO SUPPORT

DIGITAL INNOVATION AT ALL LE VELS
Encourage staff, across all areas and levels, to be innovative in the use of digital technologies to
improve delivery of care to patients and ways of working. This will be supported by:

 Implementation of appropriate digital methodologies, processes and tools to enable staff to

collaborate and innovate
 Manage the lifecycle such that successful innovations can be deployed across the Trust in a
focused, cost effective and supportable way
 Partnering with innovative organisations to learn and adapt approaches to innovation and
identifying ideas that could be applied to GSTT.

SECURE ENVIRONMENT: CREATE A STRONG, SEC URE FOUNDATION FOR DIGITAL

TECHNOLOGIES THAT PA TIENTS AND STAFF HAVE CONFIDENCE IN
Whilst digital offers new opportunities, it also presents new threats. Adopting a digital mindset is also
about understanding and effectively managing the risks associated. This will require investments in
establishing a sound and secure technology infrastructure environment that supports:

 Fast, efficient and secure access to systems is provided within the GSTT facilities in a
‘frictionless’ manner
 Sufficient secure connectivity so support the efficient use of digital information and services
 Ability for staff and patients to access information and services via a variety of device types,
both within and beyond the hospital environment
 Technologies are based on open, common industry and healthcare technology standards to
enable interoperability and
 Reliable, adaptable and scalable core ICT infrastructure to support future digital information
and service needs of GSTT

GSTT – Digital Strategy – v1.0 19

 Case Study: Advanced analytics, combined with machine learning improve
forecasting and staffing

Assistance Publique-Hôpitaux de Paris (AP-HP) in Paris is trialling advanced

analytics and machine learning to forecast admission rates; leading to more
efficient deployment of staff and better patient outcomes. Internal hospital data
(including 10 years’ worth of hospital admissions records) combined with
external data sources (weather, public holidays and flu patterns) has been
crunched to come up with the number of patients expected through the doors.
The result is a self-service tool designed to be used by doctors, nurses and hospital
administration staff – untrained in data science – to forecast visit and admission
rates for the next 15 days, by the day and hour.

GSTT – Digital Strategy – v1.0 20

 HOW WILL DIGITAL IMPACT US?

GSTT – Digital Strategy – v1.0 21

3. WHAT DOES ‘DIGITAL’ MEAN FOR OUR STAKEHOLDERS?

WHAT IS ‘DIGITAL’?

In the broadest sense, digital is about utilising technology to reinvent the way we deliver our services
whilst driving improved patient and staff experience and operational efficiency.

Digital impacts everything we do. This refers to more than just the devices and channels for patient and
staff interaction. It touches upon the key components of our Trust, including how we provide our
services, to whom we provide services, where we provide our services and how we are organised to
provide services. Digital services are designed from the ground up for digital delivery - putting the
needs of patients and staff first, and taking advantage of the benefits that digital technology offers,
such as real-time data collection, process automation, mobility and data-driven decision support. A
“digital first” service can look very different to an online service that has been migrated from an
analogue channel to an online channel.

Alongside the technology, digital will reshape the way we work in order to take advantage of
technology. Capturing data in a timely manner will require us to observe and record the required data
in our everyday activities. Technology will reduce the time required to analyse the data captured,
requiring us to adapt to use the insights generated into everyday care delivery. Similarly, we will need
to rethink where we work from and how we work with each other, enabled by mobility solutions.
Finally, our everyday tasks will be augmented by automation, enabling us to focus on activities to
deliver better outcomes for our patients.

HOW WILL DIGITAL IMPACT OUR STAKEHOLDERS ?

Achieving the scope and ambition of the Digital Strategy will have a significant impact on multiple user
groups across the Trust.

PATIENTS

 I can manage my appointments online and get text and app alerts to my phone to remind me
 I can check-in to my clinic appointment on my phone and be notified with up to date waiting
information
 I don’t have to repeat the same information to different clinical and operational staff
 I can manage my recovery and health conditions by accessing my care plans at home, and
have access to online information
 My care team monitors me remotely. I can also have virtual appointments to avoid disrupting
my daily life and saving me time
 I can better navigate around the hospital with assistance from wayfinding services

CLINICIANS

GSTT – Digital Strategy – v1.0 22

  I can access information and services on my laptop, iPad and phone wherever I am without
having to log-on continually, enabling me to efficiently do my job
 I can see an integrated and complete view of a patient’s information at the point of care,
including inpatient, outpatient and community-based care episodes, as well as information
about care delivered by our external care partners
 I spend less time on clinical documentation. I can dictate patient notes. Vitals and medical
device data is automatically recorded into the patient’s electronic record
 I can have remote calls for multi-disciplinary care planning and coordination within and across
departments, care centres, hospital facilities and with external care partners
 I can better support coordination of care as visibility of patient schedules and flows has been
improved
 I can communicate more easily with patients and their carers both when in the hospital but
also when they have returned home, allowing me to better support their care and recovery
 I can better support clinical decision making as I am able to analyse and draw insights from
massive amounts of patient data from GSTT and from our partners.

COMMUNITY NURSES

 I can easily access relevant information about the care that my patients have received from
GSTT, including inpatient, outpatient and community or home-based services, as well as
information to support the delivery of shared, coordinated care
 I can more easily record and share patient information with the clinicians as part of the
ongoing care of my patient
 I can receive notifications when my patient presents unexpectedly to a Trust facility for care
 I can better collaborate with the Trust staff in multidisciplinary team care planning and
management
 I can efficiently refer patients to other parts of the Trust through a standardised approach to
electronic referrals.

WARD MANAGERS

GSTT – Digital Strategy – v1.0 23

  My clinic planning and staff scheduling has improved as I have a better understanding of what
patients are scheduled or require appointments for based upon their clinical history and care
plan
 I can manage clinical operations better through easy access to accurate, real-time
performance information and intuitive tools that enable insights to be drawn from this
information
 I can quickly locate patients, and mobile medical devices and equipment within the hospital
 I can rely on being able to communicate and collaborate with my colleagues, regardless of
their location (or the location of the staff they contacting) within the hospital environment.

RESEARCHERS

 I can collaborate efficiently with other clinicians, researchers, health informaticians and other
staff. This helps me develop new ideas, undertake research and translate learnings back into
clinical practice, regardless of their geographic location or the institution to which they belong
 I can better support clinical decision making as I am able to analyse and draw insights from
massive amounts of patient data from GSTT and from other collaborating institutions, for
example, the comparative effectiveness of different treatments on the outcomes of similar
patients
 I can rely on being able to communicate and collaborate with my research colleagues,
regardless of their location (or the location of the staff they contacting).

CLINICAL SUPERVISOR S

GSTT – Digital Strategy – v1.0 24

  I can train students in the effective use of information and systems in their roles including the
use of clinical information systems in care delivery and the use of research informatics tools
and data assets in undertaking integrated clinical care and research
 I can efficiently deliver ward rounds and other team-based learning activities such as patient
case reviews through electronic access to patient information by students when and where it
is needed for learning
 I can publish and communicate news, information and resources to students to support and
assist them in getting the most from learning journey at GSTT
 I can deliver virtual and online training and education activities for students to complete when
and where it is convenient for them to do so
 I can broadcast or make available recorded media of clinical care, lectures and other types of
education and training sessions for students to watch when and where it is convenient for
them to do so
 I can track completion of pre-requisite administration processes for future students, and their
completion of learning requirements throughout their learning journey at GSTT.

STUDENTS

 I can access information and tools required to support the role(s) I am performing at each part
of my training, including access to view and contribute to the patient’s electronic medical
record
 I can learn how to effectively use clinical information systems in care delivery in a safe and
controlled manner
 I can complete virtual and online training, as well as access live and recorded media of clinical
care, lectures and training sessions, when and where it is most convenient to me
 I can access personalised student news, information and resources to support and assist me in
getting the most from my time at GSTT
 I receive regular feedback on strengths and development needs through online evaluations
involving educators, staff and mentors through my learning journey
 I can complete my student administration processes online prior to arriving at GSTT, including
a virtual orientation for the hospital and training I will be receiving.

OPERATIONS MANAGERS

GSTT – Digital Strategy – v1.0 25

  I can better forecast future service demand to inform operational and strategic service
planning
 I can better manage business operations through easy access to accurate, real-time
performance information and intuitive tools that enable insights to be drawn from this
information
 I can better coordinate delivery of services and reduce access blockages through improved
visibility of historical, current and forecast bed utilisation across the hospital
 I can quickly identify and resolve current and future blockages through improved visibility of
patient schedules and access to accurate, real-time service coordination and patient flow
information
 I can rely on being able to communicate and collaborate with hospital staff, regardless of their
location (or the location of the staff they contacting) within the hospital environment.

Case Study: Innovation will require cross-functional collaboration and culture

change

Cardinal Health, a global, integrated health care services and products

company, enhanced its culture by establishing a new innovation center called
Fuse. Cross-functional teams, including Cardinal Health engineers, creative
designers, and scientists, work alongside consumers, health care providers, and
other ecosystem participants. Consumers and employees regularly propose
ideas that are screened and tested using agile one-week sprints. These
ecosystem partners work with Cardinal Health innovators to deeply understand
issues, craft solutions, and try them out. Continued support from Cardinal
Health’s leaders helps ensure that Fuse initiatives are integrated successfully
into the broader organisation.

GSTT – Digital Strategy – v1.0 26

 HOW WILL WE BECOME DIGITAL?

GSTT – Digital Strategy – v1.0 27

4. BECOMING DIGITAL: HOW WILL WE REALISE THE VISION?

LINKING DIGITAL STRATEGY TO THE TRUST’S STRATEGIES

Digital technology continues to evolve and the challenges we face continue to increase. We need to
ensure the Trust is resilient and our use of digital is sustainable. This will require looking at our
organisation through a digital lens to identify how technology could really change how we work,
operate and deliver our services. Specifically, this strategy will have major implications for our
transformation capability, patient-public engagement, finance, estates, workforce, procurement,
research, education, training, as well as the Trust’s clinical strategy. The vision and outcomes outlined
in this strategy should be used as an input into the development of these supporting strategies.

Historically, our directorate objectives have been aligned to the Trust’s strategic plan. Going forward,
we also need to link our directorate objectives to this strategy to identify opportunities for how digital
can have the greatest impact on our directorates. Finally, this requires agility and flexibility so as to
adjust to a rapidly changing digital landscape.

GUIDING PRINCIPLES

Digital is everyone’s business. The digital vision and strategy represents a fundamental step change in
the way the Trust approaches and delivers services. However, this strategy is not a centralised
mechanism to deliver everything digital. Realising the vision and outcomes defined in this strategy will
require coordinated effort from multiple stakeholder groups across the Trust. In order to guide the
development of digital initiatives and influence our approach to digital, a series of guiding principles
have been developed. These guiding principles will enable everyone in the organisation to come up
with ideas to contribute to the digital vision.

Figure 7 - Digital guiding principles

STRATEGIC INITIATIVES

GSTT – Digital Strategy – v1.0 28

Delivering the scope and ambition of the Digital Strategy requires a clear focus on what actions will be
put in place and where the priority lies. The strategic outcomes will be delivered across three transition
horizons. This phasing will establish the foundations, implement incremental change whilst driving
GSTT towards digital as ‘business as usual’ in a way that is achievable for the Trust.

Figure 8 - Strategic roadmap

Case Study: Augmenting in-person care with virtual health assistants

Virtual health assistants (VHAs) use augmented reality, cognitive computing,

speech and body recognition to create a virtual encounter between a health
assistant and a patient. They are geared toward the helping the patient manage
their health, with often a lifelike interface that creates a personalised service to
help patients stay healthy and on track. VHAs can converse and empathise with
patients using real language, thereby developing relationships with them. VHAs
can help patient stay on their medication routines, and can offer first hand triage
for common medical ailments.

In the U.K., Sensely's mobile platform provides a virtual nurse (Molly) that guides
patients through the management of their chronic conditions. Using advanced
machine learning, speech and body recognition, it provides patients with
customised monitoring and follow-up care recommendations. It has a smiling,
amiable face coupled with a pleasant voice and its exclusive goal is to help people
with monitoring their condition and treatment. The interface uses machine
learning to support patients with chronic conditions in-between doctor’s visits.

GSTT – Digital Strategy – v1.0 29

A number of initiatives, linked to the outcomes, have been identified that form the strategic roadmap. Refer to Appendix A for the initiative descriptions.

Figure 9 - Digital initiatives

GSTT – Digital Strategy – v1.0 30

ALIGNMENT WITH KEY PROGRAMS

Delivering the strategic initiatives is dependent on a number of strategic programs of work across the
Trust. It is assumed that a number of digital solutions will be delivered through existing or planned
initiatives or program across the Trust (e.g. clinical information and services is expected to be defined
and delivered through the EHR program of work). As such, consideration must be given to
understanding the dependencies and alignment with current and planned initiatives within the Trust.
Specifically, this should consider opportunities to collaborate and pool effort towards achieving
commons goals.

EHR PROGRAMME
The EHR programme will establish a single, integrated patient record and help us reach a paperless
environment. Our staff will be able to access clinical and operational information, when and where
they need it, both at the patient bedside and working remotely. We will harness the clinical and
operational information available to help us make better decisions and to progress our research and
education agendas.

The objective of the EHR programme is aligned to the digital priorities set out in this document.
Specifically, it is envisaged that the EHR programme will deliver the clinical information and services,
upon which supporting digital services, such as mobility, data, amongst others will need to be
implemented. It is recognised that as the EHR programme progresses further, consideration must be
given to how it could deliver on the aspirations and vision described within this document.

DIGITAL PATIENT JOURNEY

The DPJ programme will deliver digital solution across the end-to-end patient journey. This is aligned to
delivering a seamless experience for patients in their interactions with the Trust, which is identified as
a key outcome of this strategy. There are significant opportunities for collaboration between the DPJ
and Digital Strategy, which must be explored further as both the programmes evolve and mature.

CARE REDESIGN PROGRA M

The Care Redesign program will embed a process of clinically led pathway design - and continuous
redesign – that is evidence-based, reproducible, minimises unnecessary variation and makes the best
use of available data. The aim is to develop care pathways and processes that are maximally efficient
and deliver demonstrably better outcomes for patients consistently. The programme aims to capture
what is best about the care at Guy’s and St Thomas’ and creates an important vehicle through which
we drive clinical change moving forwards.

The objective of the Care Redesign program is aligned with the strategic outcome outlined in this
document. Specifically, it is envisaged that digital solutions and data-driven insights will be key
enablers of delivering on the clinical change.

TRANSFORMING WAYS OF WORKING PROGRAM (TOWOW)

The TOWOW program aims to enable out staff to work from anywhere, anytime, and any place,
empowered by technology. The aim is to create virtual offices by using technology to allow people to

GSTT – Digital Strategy – v1.0 31

work productively in different locations and reducing the size of our estate. This will mean exiting
existing offices through remote working and utilising existing spaces more efficiently. We will create
more flexible working environments, with hot-desking and break-out areas to encourage greater
collaboration and creativity. Rather than attending for clinic appointments, some of our patients will be
assessed and managed in virtual clinics, with the clinician located in a more economical hospital setting
or even at home.

Mobility within and outside the hospital walls is a key aspect of the Digital Strategy and outlined as a
strategic outcome. The principles outlined within this document will need to be used as an input into
the TOWOW program to successfully align the Digital Strategy and the TOWOW program.

IT STRATEGY
The Trust is currently refreshing its IT Strategy seeking to rationalise its application portfolio, identify
infrastructure investments and future proof IT environment. As the IT Strategy is currently in
development, the initiatives identified within this document should be used as an input to inform the
future IT investment needs. IT should provide the foundational capabilities upon which digital
capabilities will be built.

CAPABILITIES

The capabilities required to achieve our digital vision are different to those required to run traditional
IT. The digital capability framework, in Figure 10, provides an overview of the capabilities required to
deliver on the digital vision.

Figure 10 - Digital capability model description

A high level assessment of existing capabilities, shown in Figure 11, identified capability areas for
future investment to deliver more agile, digitally-enabled services to our patients and staff.

GSTT – Digital Strategy – v1.0 32

 Figure 11 - Digital capability gaps

In addition to the right blend of people and skills, delivering on the digital vision and the strategy will
require the underpinning frameworks, processes and tools, overseen by clear governance and
accountability. When we address the above capability gaps, we will implement the required digital
tools, methodologies and frameworks in order to be successful.

INVESTMENT

Although the primary purpose of this Digital Strategy is to inform direction and vision, it is important to
recognise the investment that will need to be made to achieve the vision. This investment will be made
through multiple initiatives and programmes across the Trust, most of which will not be identified as
IT\Digital, and not through a centralised single programme of work.

What makes up digital differs across various organisations which presents a challenge in providing
‘apples with apples’ comparison. In addition, organisations are at varying stages of digital maturity
which increases the complexity of this comparison. We conducted a high level review of digital
investment, as % of total operating expenditure, by healthcare providers to provide a directional
understanding of the typical investment associated with becoming a digital organisation. Data
reviewed indicate that healthcare providers currently spend about 0.5% to 0.9% of total operating
expenditure on digital initiatives.5 This is projected to be doubled in 20186 to 1% to 2% of total
operating expenditure. Based on GSTT’s historical operating expenditure 7, this is estimated to be
approximately £13m-£26m. Further detailed work will be undertaken to define the initiatives described
in this document and identify the investment required.

NEXT STEPS

GSTT will need to address the capability gaps and setup a digital function to drive digital initiatives.

5
Gartner IT Key Metrics Data (December 2016)
6
Gartner CIO Agenda: A Healthcare Perspective (February 2017)
7
GSTT Annual Report and Accounts 2016-2017

GSTT – Digital Strategy – v1.0 33

 1. Establish a digital function within GSTT – This initiative will bring together digital resources
from across the Trust into a digital function working alongside the CDIO. This will also address
the capability gaps identified above. The digital function will have the responsibility to define
the tools, frameworks and methodologies to enable digital across the Trust.
2. Introduce ‘digital champions’ across the Trust - This initiative will involve the introduction of
roles to lead and coordinate digital across the Trust and within each directorate.
3. Establish digital governance - This initiative will involve the establishment of a governance
body to identify opportunities for digital investment, make decisions on investments and
prioritisation leading to increased coordination of digital investments across the Trust.

Case Study: Artificial Intelligence speeds up radiology

AI-enabled diagnostic imaging interpretation uses deep learning techniques

and categorisation technology on very large sets of medical images in order to
create algorithms that allow for faster and more-accurate reading of x-ray
studies, MRI exams and computerised tomography (CT) scans. IBM launched
an exploratory project called Medical Sieve to build the next generation
“cognitive assistant” with analytical, reasoning capabilities and a wide range
of clinical knowledge. Medical Sieve is qualified to assist in clinical decision
making in radiology and cardiology. The “cognitive health assistant” is able to
analyse radiology images to spot and detect problems faster and more reliably,
with radiologists only looking at the most complicated cases where human
supervision is useful.

GSTT – Digital Strategy – v1.0 34

 APPENDIX A: DIGITAL INITIATIVES

GSTT – Digital Strategy – v1.0 35

APPENDIX A. DIGITAL INITIATIVE DESCRIPTION

USER EXPERIENCE - DELIVER A HIGH QUALI TY, SEAMLESS EXPERIE NCE FOR OUR PATIENTS AND STAFF WITHIN AND BEYOND GSTT

Objective

To deliver an improved patient & staff experience by:

 Gaining insights into patient and staff journey to be able to design services based on patient needs and expectations
 Developing GSTT’s digital presence to improve patient interactions with the Trust and its care partners
 Making appropriate technology available to staff to enable to undertake their work both within and beyond the hospital walls

Key initiatives

Initiative Description

1.1 Develop patient experience Identify and map the end-to-end patient journey, including identifying and analysing the way patients interact with the Trust over the course of their care
strategy journey, their use of various channels, the touchpoints with the Trust staff (clinicians and non-clinicians) and how digital solutions can reduce their pain
points and build on the delight points. The Trust should engage patients to co-design and co-develop these digital solutions. Identify and define a roadmap
to address patient needs.

1.2 Develop staff (clinical and non- Identify and map the end-to-end journey of the Trust’s clinical and non-clinical to identify and analyse the way they interact with the Trust and each other
clinical) experience strategy over the course of clinical and non-clinical service delivery and how digital solutions can reduce their pain points and build on the delight points. Identify
and define a roadmap to address staff needs.

1.3 Implement digital solutions for Implement digital solutions to meet patient needs, based on the priorities identified in the patient experience strategy. Examples includes solutions that
patients enable patients to perform a range of self-service capabilities, provide access to their care information, and provide options for proactive, personalised
communications, amongst others.

1.4 Implement digital solutions for Implement digital solutions to meet staff needs, based on the priorities identified in the staff experience strategy. Examples includes solutions that provide
staff (clinical and non-clinical) GSTT clinicians and care partners with information to support integrated and coordinated care, enable them to undertake administrative tasks anywhere,
amongst others.

1.5 Identify use cases for and Identify use cases for Virtual Healthcare Assistants (VHAs) and implement solutions. VHAs support patients manage their health using a personalised service
implement Virtual Healthcare to help patients stay healthy and on track. VHAs can converse and empathise with patients using real language, thereby developing relationships with
Assistants them.

GSTT – Digital Strategy – v1.0 36

Expected benefits & outcomes

 Increased understanding of patient journey and their interactions with the Trust and their care partners
 Better understanding of staff touchpoints along the patient journey
 Enable the delivery of integrated and coordinated healthcare services to patients across the variety of care settings
 Support staff with consistent access to the information and tools they require to deliver care, regardless of the care setting
 Improved collaboration between staff through the ability to easily share knowledge, collaborate and communicate with one another
 Enable staff mobility and flexible work practices including ability to access information via a variety of device types

Key dependencies  Patient and Public Engagement Strategy

 Digital Patient Journey Programme
 EHR Programme

GSTT – Digital Strategy – v1.0 37

SKILLS AND CONFIDENCE - EQUIP OUR STAFF WITH THE SKILLS, TOOLS AND TRAINING IN THE USE OF DIGITAL SOLUTIONS

Objective

To create a culture that doesn’t just tolerate digital, but embraces it as a key enabler to deliver service excellence.

Key initiatives

Initiative Description

2.1 Identify digital leadership across Identify digital champions across the Trust’s directorates to champion the digital vision and drive towards becoming a more digital, innovative and
the Trust customer centric organisation. This will also involve the design and implementation of a program to train GSTT’s leadership, across the Trust, in digital
practices. The Trust’s digital agenda will be led by the CDIO.

2.2 Establish change agent network This initiative will involve recruiting and training change agents/ champions from across business units and teams to drive digital throughout GSTT. This will
consider the cultural shift required and outline actions to drive this cultural change. It will also involve the development and rollout of a communications
strategy and plan.

2.3 Establish upskill program This initiative will involve the design and implementation of a set of training plans to upskill employees on digital. The training plans will be specifically
developed per role, to ensure appropriate training is delivered.

2.4 Implement virtual learning Implement virtual learning tools and platforms to support Trust clinical and non-clinical staff to complete their learning and training using digital solutions.
solutions

Expected benefits & outcomes

 Increased awareness of digital at all levels of GSTT

 A digital workforce that is trained in the appropriate digital methodologies, processes and tools
 Staff feel empowered and encouraged to improve processes and care delivery and service using digital.
 Increased knowledge of digital through training programs.
 Increased ability for staff to complete their learning and training from a number of devices, from anywhere and at anytime.

Key dependencies None identified

GSTT – Digital Strategy – v1.0 38

LEVERAGE DATA - DRIVE EVIDENCE BASED CARE AND TIMELY DECISION MAKING THROUGH THE BETTER USE OF DATA AND ANALYTIC S

Objective

Be a more data-led organisation with improved data accuracy, timeliness and availability to all staff and patients at the right point of care to make effective clinical, performance, and research
decisions.

Key initiatives

Initiative Description

3.1 Establish accountability for Trust- Align enterprise data and information function under the CDIO, which has the accountability for making Trust-wide decisions regarding the use of data. This
wide information management function should take the lead in establishing a Trust-wide enterprise strategy for addressing the governance issues associated with EIM. CDIO leadership is
needed to bring the necessary expertise to the strategy discussion and to consider the implications for IT relevance going forward.

3.2 Develop Trust-wide information Develop an information management strategy that describes a vision and pragmatic roadmap for developing GSTT analytics and reporting capabilities to
management strategy support organisational and clinical planning, management and decision support.
The strategy identifies how the vision will be executed; what priorities, risks, and needs exist around data, information and analytics; and what the plan
should be for how the program will ensure that enterprise data is positioned to support the vision and define the groups and organisational structures to
support EIM.

3.3 Identify and execute analytics Identify and implement business intelligence and analytics capability (technology, people, processes, etc.) that will deliver on the priorities identified in the
priorities information management strategy.

3.4 Identify use cases for and Define use cases for leveraging machine learning capabilities to support clinical activities, such as revenue optimisation by increasing coding efficiencies,
implement machine learning for extracting relevant information from unstructured notes, amongst others.
clinical activities Examples for further exploration include computer-assisted coding and real-time physician documentation improvement.

Expected benefits & outcomes

 Improved use of data across the Trust

 Coordinated initiatives to enable the use of data to drive decision making, including collaboration with the business areas

Key dependencies None identified

GSTT – Digital Strategy – v1.0 39

EFFICIENCIES - DRIVE CLINICAL AND CORPORATE EFFICIENCIES THROUGH REDUCED VARIATION IN CLINICAL AND NON -CLINICAL PROCESSES

Objective

Increase clinical and corporate efficiencies and value for money in line with regional and national priorities.

Key initiatives

Initiative Description

4.1 Align care redesign and HER Ensure alignment between the care redesign and EHR programs, to ensure that the care redesign program is leveraging the EHR platform to support the
programs redesign of the clinical pathways. This should also identify opportunities for improvement through reduction in clinical variances by leveraging data and
digital technologies.

4.2 Review operational and back office Review corporate and operational processes to identify opportunities for improvement and use data-driven insights to redesign processes to ensure
processes effective resource usage

4.3 Identify use cases for and Define uses cases for leveraging healthcare bots to improve the efficiencies of running a hospital and eliminating bottlenecks. Examples of this include using
implement healthcare bots to support bots to provide customer support and service for staff, for knowledge sharing, bill paying, appointment scheduling, medication refills or other simple
operational and back office processes administrative needs. The bots provide a personalised interface and available 24/7.

4.4 Identify use cases for and Define uses cases for leveraging Robotic Process Automation (RPA) to automate operational and back office processes. Examples of this include utilisation
implement RPA management, care coordination, case management, and remote monitoring of patients.

Expected benefits & outcomes

 Enhanced patient safety and experience,

 Efficient use of resources,
 Sustainable model of care through reduced cost variation

Key dependencies  EHR Programme

 Clinical care redesign programme

GSTT – Digital Strategy – v1.0 40

DRIVE INNOVATION - IMPLEMENT PROCESSES AND STRUCTURES TO SUPPORT DIGITAL INNOVA TION AT ALL LEVELS

Objective

Encourage staff, across all areas and levels, to be innovative in the use of digital technologies to improve delivery of care to patients and ways of working

Key initiatives

Initiative Description

5.1 Implement innovation program Define and implement a Trust-wide innovation drive to encourage staff to identify opportunities for innovation in their day-to-day activities. The purpose of
this initiative is to encourage staff to identify solution that can improve clinical and operational activities. This will establish an innovation fund that will
enable the top rated innovation ideas to be developed, tested and implemented.

5.2 Innovation upskill Deliver the upskill plan to ensure that GSTT employees are appropriately trained on new methodologies, process and tools. The training will be targeted at
specific roles to ensure relevant training is delivered.

5.3 Establish digital partner network Establish an ecosystem of partners to augment the Trust’s existing capabilities to identify innovation opportunities for healthcare. The Trust will work with
the partners in the ecosystem to monitor the impact of technology trends on healthcare delivery, identify potential solutions for use within the Trust and
work with them to implement and scale the solution. Types of partners could include start-ups, other healthcare organisations, and digital implementation
partners and so on.

5.4 Identify use cases for emerging Implement mechanisms to continually review the emerging technology landscape and timing to identify technologies that will have a direct and indirect
technologies impact on healthcare delivery and the business model. These should become the focus of strategic planning at the executive level. This should be used to
identify uses cases for implementation. Potential targets for exploration include IoT enabled monitoring, AI-enabled diagnostic imaging interpretation,
precision health, and clinical diagnostics, risk and disease prediction.

5.5 Develop a mechanism to trial Implement mechanisms, frameworks, tools and processes to trial emerging technologies to support clinical and non-clinical activities. This should provide
emerging technologies the platform for developing proof of concepts to validate the technology and provide the mechanism to scale the proof of concepts to be implemented
across the Trust.

Expected benefits & outcomes

 Employees are encouraged to be innovative and are recognised and rewarded based on their contributions
 Improved awareness of innovation in other organisations to facilitate idea generation
 Promotion of internal digital innovation

Key dependencies None identified

GSTT – Digital Strategy – v1.0 41

SECURE ENVIRONMENT - CREATE A STRONG, SECURE FOUNDATION FOR DIGITAL TECHNOLOGIES THAT PATIENTS AND STAFF HAVE CONFIDENCE IN

Objective

To provide a strong foundation for digital technologies, and to integrate online channels with other systems

Key initiatives

Initiative Description

6.1 Stabilise IT to support digital Identify and address implications for IT arising from the Digital Strategy. This could include application rationalisation, infrastructure modernisation,
initiatives mitigating IT/data complexity amongst others. These should be addressed the upcoming refresh of the Trust’s IT strategy.

6.2 Review the Trust’s cyber security Undertake a review of the Trust’s cyber security capabilities to identify the implications arising from the Digital Strategy, including the use of digital
capabilities solutions and emerging technologies. A comprehensive cyber security should be developed to address the implications including defining, data exchange,
privacy and security standard, reducing IT and data risks amongst others.

6.3 Develop unified communication Implement a unified communications platform that will allow for the simultaneous communication and sharing of content, schedules, messages and ideas
strategy between staff. This initiative will also enable integration with document collaboration and co-development tools.

6.4 Develop mobility strategy Develop a mobility strategy for the implementation of a mobile enabled environment for GSTT to enable staff and patients to interact with GSTT in a mobile
way within and beyond the hospital walls

Expected benefits & outcomes

 Reduced ongoing costs due to a simplified, rationalised IT landscape

 Improved digital procurement processes to better match digital project delivery needs
 Easier access to systems for employees
 Shorter timeframes for the development and delivery of mobile applications through new partnerships

Key dependencies IT Strategy Refresh (planned)

GSTT – Digital Strategy – v1.0 42