simple.uk.net for patients, not profit “Design the best healthcare first and only then see if technology can improve it” Sir John Oldham I'm sure readers will recall the £m's of NHS money wasted on telehealth initiatives in recent years where NHS Commissioners were exposed to misleading sales practices, hype and overstated benefits of the latest shiny new apps, baubles, widgets & gadgets. There are of course, ethical technology companies out there with proud evidence based histories working with the NHS, so how can you tell the difference? We looked into a number of companies cited by members and we were surprised at some of the questionable practice used by these companies. Using the collective experience of our members, below we've complied a list of indicators. WebsitesPropensity for questionable practice can be glimpsed from a company's website. This would typically be evidenced by the website being opaque and designed to convince you to buy their technology without independent evidence of clinical outcomes;
One more surprising but common item we noted was the lack of evidence about the safety of the 'apps' or services they are trying to sell, which simply would not be tolerated for anything else a patient would use. Mandatory IG RequirementsDespite it being a mandatory requirement for commissioners to ensure via contract that organisations who process NHS Patient Data ( i.e. NHS digital/telehealth space) are compliant with IG requirements , many of these companies do not possess the correct level of accreditation. To process NHS patient data for digital/telehealth services, companies must have a data processing agreement with the commissioner and accreditation under the category of 'NHS Business Partner' on the HSCIC IG Toolkit, which provides mandatory assurance that they are appropriately compliant with;
Some companies register under the base category of the IG Toolkit as a 'Commercial Third Party'. This is inappropriate for majority of digital/telehealth services because the company's software processes NHS patient data.
Furthermore, Section 9 of the IG Assurance Mandate states;
Although we'd expected companies to volunteer details of their IG Toolkit compliance, many don't. To find out how a digital/telehealth provider rates; Visit www.igt.hscic.gov.uk, click on 'report' and enter the company name. ( For Florence, enter 'Mediaburst' ) Companies with a pedigree in healthcare such as Philips, take a responsible approach to their activities and are in the market for the medium to long term to make a difference to patients outcomes. However tech companies entering the healthcare market can be under pressure to make 'sales' in the same way as they do in the commercial sector. We found that in some of these companies, even the small ones, driving a pressured culture of 'sales', Executives can be rewarded with eye wateringly high salaries, and up to 40% of the workforce can be 'Sales People'. 'the failure was due to the supplier’s sales people overstating the efficacy of their product' Financial due diligence Adding to the pressure to achieve 'sales' can be the company's finances. We were again somewhat surprised to find that some companies are making substantial year on year losses. The level of risk posed by this must be taken into consideration by commissioners. For a private company it's not sustainable and given that most of these companies are created as independent entities to isolate their shareholders from risk, the risk and consequences are entirely the NHS commissioners. We looked into two companies and both were losing substantial sums of money, one lost £1.5m last year and substantial amounts in the previous years. Shareholders must be applying pressure to recoup their losses to date, to not to make a loss this year and to return a profit. The second company has been making losses for a number of years, but has been temporarily 'bailed-out' by a pharma company for a share in their business ( this is not declared on the company's website). Financial data on companies is freely available and more detailed information as contained in the annual returns can be easily obtained from Companies House too. SummaryIt's always good to pass a critical eye over a company's website, and to check out how they're structured, where the public money will flow once its paid to the company and what sales and financial pressure is exerted on the company to inform the likely propensity of the company to 'overstate' to make sales. And of course an eye needs to be cast over the level of risk being entered into if consistent financial losses are being reported by the company and the final red line is the mandatory requirement for the correct level of IG compliance. #TotallyUnique |