As much of the developed world faces the burden of escalating healthcare costs, ageing populations, and increased incidence of chronic diseases, countries and localities are experimenting with innovative approaches to address these challenges.
In a recent visit to Greater Manchester, England, I learned of an innovative initiative recently launched that aims to use technology to create a civic partnership between NHS and social care providers. The principal goals of the initiative are to 1) improve health outcomes, 2) reduce healthcare disparities, and 3) reduce income inequality. While many nations and municipalities are working to achieve these goals, Greater Manchester’s approach to achieving these goals is multi-pronged and systematic, and will use technology in a way that will integrate social services into healthcare delivery.
Using Technology for Data Storage, Analysis, and Interoperability
Greater Manchester’s plan calls for the creation of “Connected Health Cities” (CHCs), which will be powered by health innovation centers. These centers will assemble the data from multiple sources. What is especially novel about these CHCs is that the collection, management, and analysis of both health and social care data will happen at a scale that until now has been impossible. Shared protocols for data analysis across the CHCs will allow for timelier and more powerful research studies, and ultimately better informed decision-making.
Interoperability and integration of myriad data sources will be a vital component for realizing these goals. Clinical, community, and patient-generated data will be used to inform decision-making not just among clinical providers, but also among public health policy makers, planners, social care providers, and researchers. Finally, technology will also support continuous evaluation of the program, and use of actionable measures to drive decision-making.
Decision Making at the Local Level
Another unique feature of this plan is that the UK will provide the locality with 6 billion pounds for Greater Manchester to use at its own discretion. Granting control of the budget to local municipalities will allow for decision making to happen at the lowest possible level.
The Greater Manchester Board will set strategies and priorities, but local boards will devise plans that will be tailored depending on the needs of the local environment. The budget will be used not just for healthcare, but also for social programs and public health activities. The technology and data will help to bridge health and social programs at this local level.
Tackling Priority Care Pathways
Greater Manchester will focus initially on optimizing four “care pathways.” One pathway will use support tools for self-care to reduce hospital admissions for patients with chronic conditions. Another will support schizophrenia patients by linking self-reported symptoms to responses from community psychiatric nurse visits. Studying the effects of the program on specific pathways will allow for evaluation and iteration to help ensure the program’s success.
Public and Patient Engagement
Involvement from the public and from patients is a central pillar of this devolution plan. A panel of 10 patient and public representatives will have a say in how the data is used. The program leaders believe such involvement will ensure sustainability and transparency of these CHCs, and ensure that citizens’ needs are met in this civic partnership.
Insights for other Countries and Cities
I am eager to observe the implementation and early results that come from this Greater Manchester initiative, as it is a test bed for the devolution of health and social care. The potential for this initiative to accelerate and scale innovation to reduce disparities and improve population health is exciting. Data will be used from multiple streams in ways that haven’t before been possible, and will be used in a way that is tailored to the local environment. With a growing body of research that highlights the impact that social determinants (e.g., housing, social services and support, access to care) have on healthcare, using technology and data to tackle these issues could help other nations and cities in their efforts to improve population health.