There is a general perception that the public sector lags behind its private counterpart when it comes to technology. But this is unfair. In my experience some of the most innovative technology applications have been within the public sector, and particularly in the UK. There is a wealth of inventive talent generating creative technology solutions for healthcare, education and government challenges; it just tends to be on a slightly smaller scale than the private sector.
When it comes to collaboration and ideas sharing, technology is the answer, and video in particular. The UK has the world’s best healthcare system. An independent panel of experts declared it top of the league tables, even above countries which spend far more on health. The National Health Service is an expert in doing more with less. A great example of this is Blackpool Teaching Hospitals NHS Foundation Trust’s use of video collaboration to deliver speech and language therapy. Not only are they able to treat more patients, they are able to offer them a better service. High definition video collaboration allows practitioners to make accurate assessments on a wide range of diagnostic variables from a remote location. The trust cares for a number of patients with dysphagia (swallowing difficulties) who are often elderly and living in nursing homes. Transporting them to hospital for assessment is stressful and risky. By training the nursing home staff to manage an iPad equipped with secure video instead the patient can be cared for in the comfort of their own home. It also frees up the therapists to treat more patients with swallowing problems as each appointment is far more efficient. It’s about removing distance from the equation.
Remote assessment isn’t about creating a production line for appointments though, it’s about matching the right specialist to the patient, especially when it’s critical. Some NHS trusts have geographical complications, with populations spread out over large, rural areas. Cumbria & Lancashire is one of these examples. That’s why Cumbria and Lancashire Cardiac and Stroke Network decided to use telemedicine to link eight hospitals. When a patient suffers a suspected stroke it’s important they are accurately assessed by a specialist to determine whether thrombolysis (the use of drugs to break up or dissolve blood clots) treatment is appropriate. These drugs must be administered within four hours of a stroke to be effective. Combining video carts in the hospitals with software on laptops for doctors means that the assessment can be made from wherever an available doctor may be, including at home. The patient gets the expert help they need in the shortest possible time and the trust estimates that the system saves £8 million a year which can be reinvested in services for the community.
It’s not just about bringing patients to the specialists, it’s also about enabling patient-driven healthcare. In February 2012, the NHS National Quality Board (NQB) published the NHS Patient Experience Framework, which makes respect of patient-centred preferences a key objective. Lancashire Teaching Hospitals NHS Foundation Trust has embodied this in an amazing way, by using video-enabled support for those who opt for home dialysis. Performing the process themselves at home means more independence and a better quality of life for patients. However, there is evidence to show that those on long-term dialysis can suffer from memory impairment, meaning remembering the complex process can sometimes be difficult. Having the nursing staff on screen means that should anything go wrong they can coach the patient through the corrections. Putting patients in control of their treatment is the future of effective healthcare.
All of these examples show that the NHS is making great strides with its use of technology, however there are plenty of areas where video could deliver even better value for trusts, not only in terms of live calls. There’s a lot of talk about the NHS going digital but we need to think beyond text-based records. Yes it’s important to move beyond handwritten notes but why stop there? If a picture is worth a thousand words, how much more valuable is a moving, talking picture? Instead of using one doctor’s notes on an assessment, a video record of that assessment would allow each specialist to make their own, objective assessment. The cost of storage is getting relatively cheaper, making expanded record-keeping in this way a more realistic and affordable solution. Beyond cost-saving, it would deliver a better, more joined up, quality of care for the patient.
Other verticals stand to gain from more efficient use of collaborative technologies. Teaching institutions traditionally make good use of these kinds of solutions at a higher education level, as they have historically been seen as a way to bring more students into one room for purposes such as distance learning degrees. However, the beauty of these systems is that they can be used to expand horizons for students, even at primary and secondary levels. Certain subjects such as foreign languages or music require specialist knowledge to teach, making it difficult for a small school to offer them all amongst a small body of staff. Purchasing these skills via external sessions can be prohibitively expensive. For many smaller educational institutions, video collaboration can offer a way to share the cost of outside expertise. Dumfries and Galloway Council in Scotland uses video to bring music education and tuition to pupils at 120 schools. Video units are installed in the schools and a specialist teacher delivers classes from a central location. In this way the participating schools benefit from a shared resource, and the more remote locations are still able to offer music education even when adverse weather could prevent a roaming teacher from visiting the more rural schools.
Technology needs to bring more than local expertise to the classroom. In an increasingly globalised economy, experience of other cultures is becoming more important for future job prospects. Beyond speaking a foreign-language, students need to understand how to work on an international scale. Global Nomads Group has used video collaboration to bring teenagers in the US together with their peers living in very different environments, including on the border of Chad and Sudan and in Rwanda. Through its Youth Talk program schools are paired for a year, working with teachers in many countries to help break down stereotypes and stigmas, ultimately increasing the likelihood of tolerance in the future by building awareness and understanding between different cultures today. Education is about more than just ‘the three Rs’ and that means getting out of the classroom to learn.
According to the Health and Safety Executive, “school trips have clear benefits for pupils”. Unfortunately the expense and organisation requirements of school trips means that most schools struggle to provide regular external-learning opportunities. Children from deprived areas are particularly affected as parental contributions to costs are often necessary to fund the trips, meaning schools in low-income areas are restricted. The Smithsonian Institution’s National Museum of African Art uses video to offer virtual school trips free of charge in the US. Arts learning in the States suffers from similar constraints to the UK; budget cuts and accountability programmes have nearly halved the hours spent in art classes since 2001, so this programme is a way of putting art back in the classroom. The UK might be on a slightly smaller scale, but it boasts an impressive array of museums, over two and half thousand in total and five are amongst the most-visited in the world. It’s not practical to drive children to every single one, but they can visit for an hour with video meaning that more regular educational visits can become a part of the curriculum for more children. There is significant evidence to show that these kinds of activities not only improve pupils’ personal, social and emotional development but also provide a hook for capturing the imagination of disengaged pupils, drawing them back in to their learning.
Improving access to public sector services is key to making them more efficient and cost effective. This is even more of a hot topic in the social sector. Digital exclusion seriously affects the 12 million people in the UK who have a limiting long-term illness, impairment or disability. Removing barriers to access has a positive impact on so many other areas of social services. In its simplest sense, it is about making it physically easier for people to meet with the correct representative. Putting social services access online is a great first step. Although 16% of UK households do not have access to connectivity in their homes, public libraries offer free internet access. This means that for those who are most needy and unable to afford transport could attend an appointment from a local library for free. The advent of open standards such as WebRTC means that secure, high grade video collaboration doesn’t require any software on your computer, it can be accessed via a web link. Therefore those who have mobility issues or health conditions which limit their ability to leave their house can join a meeting with all the relevant government representatives from their home.
Reducing risk for the vulnerable is incredibly important for social services, this can be as simple as avoiding unnecessary trips for the old or infirm, or it can be used in situations where being physically present can be stressful or detrimental to the individual. For example, victims providing evidence in trials can now do so via video from a location where they feel safe and secure.
In fact, video can be used to keep the general public safe from those who have committed crimes. The cost of bringing an offender to present in court can be extremely expensive when you take into account the number of agencies and officials included, as well as ensuring public safety when transporting them. Video arrangment allows the court to conduct appearances of offenders without transportation costs or security risks. Also, it’s more pleasant for the person presenting. We are innocent until proven guilty, even for those that can’t afford bail. Attending via video means that the individuals aren’t subjected to additional body searches, the use of handcuffs and long periods of uncomfortable waiting.
But video isn’t just something to be planned into processes, it can be the answer to unplanned events. Governments often need flexible and scalable solutions to deal with humanitarian crises, for example the current refugee situation in Europe. In this instance video collaboration could be the way to process large numbers of people in an efficient manner. Previously the hardware and networking provisions necessary to run video solutions made this impossible, but with modern flexible and scalable as-a-service options it’s perfectly possible to use video to draft in the necessary resources to help people quickly. Video could be used to conduct interviews with people in situ, whilst conferencing in translators to be as efficient as possible at processing people in their time of need. Translating over a video-call is much more accurate, as it is easier to correctly interpret context and meaning with the added information derived from facial expressions and gestures.
Video is a great work-around for when you can’t get staff ‘on the ground’ straight away. It’s also an important tool for protecting any organisation’s most valuable asset; it’s people. In September 2014 Polycom provided video conferencing equipment to the World Health Organisation to aid coordination of the agencies combatting the Ebola outbreak. When dealing with a highly infectious disease epidemic it’s important to limit unnecessary contact and travel in the affected region. However, it’s crucial that the right experts are able to see the situation clearly. Video is the perfect solution; it allows leader’s in the field to get a ‘first-hand’ view of the situation on the ground, accurately confirm suspected cases and securely share information including medical documents, all without placing them and their key-knowledge in harm’s way.
There’s no doubt that there are countless ways that the public sector can make use of video collaboration to improve services in a time of reduced budgets and stretched resources. According to the Institute of Fiscal Studies, government spending cuts will continue until 2020, which means that the public sector needs to learn how to use technology to fill the void. In the past the public sector has been put off by the cost of video conferencing. But now is the time to take advantage of more affordable solutions, and to calculate the benefits that modern solutions bring without fixating on the upfront investment. The public sector needs to harness the benefits of video communications and collaboration to deliver better services with less money and fewer resources.
The world is changing, in ten years the public will no longer expect to have to physically attend meetings to access services. They will also be perfectly comfortable with their public representative contacting them in this way, as long as it leads to better service, shorter waiting times and easier access. Younger generations are already au fait with video collaboration and its benefits, and they will expect to have this option for accessing the services to which they are entitled. The public sector has a chance to meet these expectations if it acts now. And it’s not just the public, local government employees want this change too; only 45% of such employees feel that they are provided with access to the technology services and applications they need to do their job. Let’s change that statistic and let our public sector agents perform to the best of their ability.
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