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21 July 2020

CliniSys and Pathology after the Pandemic

Clinisys

We reflect on some of the profound changes that the novel coronavirus has brought to CliniSys, to healthcare, and to pathology, and how they are likely to play out in a post-Covid future.

It is certainly been an eventful year. We moved into our new offices in Chertsey on 1 February, and as part of the move we refreshed our IT.

All our key systems jumped to the cloud, we became virtually paperless, and we deployed the latest Microsoft collaboration technology and Oracle business systems. So, when the novel coronavirus arrived in the UK, we were well-equipped to work remotely.

Which was fortunate, because on 23 March that is what we all did, as prime minister Boris Johnson instructed the country to ‘stay at home’.

Supporting the NHS through Covid-19

Remote working has worked exceptionally well for us. There is still a place for the office and, as long as we can do it safely, we will use our new headquarters to get our teams together to share purpose, hold creative meetings, and re-energise our colleagues.

We will also need to start to visit our customers again, combining on-site working with the best of our new delivery methods. Yet, in four months, we did not skip a beat. We did not record a single business or customer issue related to remote working. And yet we have been exceptionally busy.

We engaged with Public Health England as it put its communicable disease surveillance onto a new footing. Data liquidity was key, so we sorted out lab to lab connectivity. We delivered more than 60 connections to the National Pathology Exchange, NPEx, and have just a few left to do.

We delivered something like 80 analyser integrations, to help labs play their part in getting to the government’s target of 100,000 tests per day. We also developed Covid-19 specific order sets and dashboards to help labs handle Covid-specific requirements.

Virtual LIMS deployments and ICE innovation

We were involved with the first three Nightingale Hospitals in London, Birmingham and Bristol. In Bristol, that meant responding rapidly to a request from Severn Pathology for a piece of integration work to link the IT systems used by the labs at North Bristol NHS Trust with the IT systems deployed at the Nightingale, which are run by another city trust that uses a different instance of ICE.

We had a number of virtual go-lives. Two big projects were for Black Country Pathology Services and the labs at Luton and Dunstable University Hospital NHS Trust, which have deployed WinPath Enterprise as part of the development of the pathology network with Bedford Hospital NHS Trust.

And we worked with customers who wanted to innovate. A great example was a piece of work that we did with Hampshire Hospitals NHS Foundation Trust, which wanted to integrate ICE with its communications system, so staff could be given negative results by text.

New product developments, a genomics launch and a plan for cloud

CliniSys was also very busy in Europe. In Belgium, we delivered a LIMS to a new reference lab that was set up in just eight weeks to conduct testing for the whole of the country.

We did something very similar in the Netherlands. While in France, we worked on a new system to get results back to hospitals and GPs nationwide. All of this has made us faster and more agile about deploying our products, and that will continue. That will be an ongoing change for us.

At the same time, we have continued to develop our products. We have made enhancements to ICE and to WinPath Enterprise. Most significantly, WinPath Enterprise 7.24 was released and is in beta in Black Country Pathology Services and a couple of other networks.

We also launched our genomics product into the UK, which is very significant because it takes us from the wet lab into the genetics space, and we announced that the next generation of our products will be cloud native applications.

Healthcare reaches a digital tipping point

Many of the changes that we have seen at CliniSys have been mirrored in healthcare. At the start of the outbreak, the NHS also deployed Microsoft Teams. It rolled it out to 1.2 million staff in just four days to enable remote working, and trusts are reporting that thousands of staff are now doing their jobs from home.

The corollary for patients has been a rapid expansion of virtual clinics and consultations. In 2019, just 7% of GP consultants were carried out online. In July, a survey by the Royal College of General Practitioners found that just 11% of GP consultations were carried out face to face.

Those changes are here to stay, and they have pushed healthcare to a digital tipping point. The pandemic delivered the ‘radical shock’ that was needed to overcome professional concern and resistance to change. It also created a new backdrop of data enabled services as the backdrop to people’s lives, as they visited family on Zoom and sent shopping on Amazon.

Changes to pathology

There hasn’t been quite the same impact on pathology. Laboratories have been disrupted by the pandemic and will need to get back to conducting a different balance of tests as the NHS looks to ‘reset’ and get on top of the enormous backlog of elective work that has built up.

However, some of the changes that we have seen over the past few weeks are here to stay. For example, we think the focus on surveillance and testing for infectious diseases will continue, if only because we are already seeing how important that will be to control localised outbreaks of Covid-19; and to head off any second wave.

We also think the focus on data will continue and that it will benefit pathology. We will be able to work on ‘computational pathology’, on bringing data together for multi-disciplinary team meetings, to create more sophisticated diagnostic tools, and to stand-up digital and precision medicine supported by machine learning and AI.

The post-Covid world

We further think some of those bigger technology trends will impact pathology in the longer term. If we can work from home, we can work from anywhere, and that has the potential to make pathology a global business.

Some years ago, I worked in Holland, and I have a friend from that time who now lives off the coast of Venezuela, in Aruba, for six months of the year. In the US, it is common for pathologists to work from home for clusters of hospitals.

Work is going to come to people, instead of people going to work, and as part of that rules and regulations will need to change. At the same time, I think we can expect more changes for patients. During the coronavirus outbreak, we built a simple portal to support home testing.

The challenge that initiatives like home testing face at the moment is the ‘last mile’ – getting tests through the door and getting samples back again. I think the answer will be Amazonification. We will run our laboratories, and we will integrate with organisations that are experts in covering the last mile.

The CliniSys road map recognises this; particularly in its focus on cloud computing, which has developed to enable systems to be deployed easily, accessed through browser technology, and scaled as required. In the shorter term, it will enable us to deliver smaller, more rapid upgrades, which is something I know that customers want!

The MTV Moment

A colleague suggested that the rapid changes in the adoption of technology that we have seen over the past four months mean that healthcare has had its ‘MTV moment’. Once MTV launched, the way people produced and consumed music was never the same again.

The impact of Covid-19 on some patients and their families has been terrible, and I want to thank everyone who has worked so hard through this crazy time to lessen its impact. But the impact of Covid-19 on CliniSys and pathology has also driven change that will be positive, because it will enable us to use technology to shift our focus from organisations to the work at hand and to delivering for patients.