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Stakeholder Engagement — the Compass for Digital Advancement in Healthcare

Mar 21, 2023 - 7 minute read

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Andrew Smith Director of Healthcare Services at Objectivity

Andrew started his career on the Financial Management Training Scheme of the NHS, at the Royal Liverpool and Broadgreen University Hospitals. He later spent 10 years at the Department of Health, where he led several national programmes, working at the interface of the NHS and the commercial sector. 

For the last few years, Andrew has focused on Population Health projects and advised governments in the EU and Middle East, and supported health tech companies within the UK.  

Part of Population Health is about lifestyle and wellness, as such, Andrew enjoys running with his twin boys and, alongside his wife, supporting their daughter with her Rhythmic Gymnastics ambitions. 

See all Andrew's posts

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In my career, I’ve been fortunate to have worked with many organisations within the health and care sector. These have ranged in size and remit from a large NHS Teaching Hospital in Liverpool to the Department of Health in Whitehall, to supporting the digital transformation of health systems in the Middle East. Now, as the Director of Healthcare services at Objectivity, I continue to work with many organisations in Health and Social Care, both public and private sectors, in the UK and abroad. 

Each experience brings its own challenges and insights representing different parts of the ‘whole system’, however, there are common factors that determine the success of programme delivery. Whilst the people and their perspectives are as diverse as the projects themselves, one of the most consistent drivers in achieving velocity and efficacy in our work is the depth and quality of stakeholder engagement. 

Regardless of the challenge or ‘problem to solve’, multi-level, stakeholder engagement is a common driver for implementation, acceptance, and adoption (all vital in the deployment of new technologies). Overlooking, or trying to ‘short-circuit’, engagement at any point in the process means risking or limiting the success and sustainability of the outcome.  

I’m proud of the portfolio of projects we have at Objectivity, and as I review the programmes of work we’ve successfully delivered and continue to support, I can say with confidence that stakeholder engagement is genuinely ‘baked into’ our way of working. In every project, we invite contextual input from our clients as well as our teams. I often hear amazing stories — some happy, some sad, but all important — about why the project has meaning for each individual, or team and what value it will bring to their lives, or the lives of those for which they care. This kind of engagement is genuinely humbling, often inspiring and is what steers us towards delivering award-winning solutions that are inclusive and useful for all involved. 

Widening the Scope of Engagement  

At Objectivity, before we reach into the toolbox to build a solution, we make a concerted effort to sit with clients and partners to really get to grips with and understand the requirement. In fact, whilst we usually have a strong understanding of where and how to start, our projects are never just ‘out of the box’ or ‘off the shelf’, they start life from a deep understanding of what the challenge and solution really means for every stakeholder. This may be the commissioner of a service, the patient, the care team, or the family. It could also be the wider community, and, often, it's actually all of them i.e. the ‘whole system’. We work both on discrete projects and whole-system programmes, so we need to be agile in terms of who and how we engage. 

As a data-driven solutions provider, Objectivity naturally builds in the right metrics to ensure delivery within budget, on-time, and with maximum impact. But looking beyond these standard metrics, our most meaningful, human definition of success is being able to see the positive, day-to-day impact on staff and their patients and families. In Objectivity’s Healthcare Division, our teams tell us candidly that their motivation to deliver projects is not just driven by systems performance, but by the desire to witness the real-world benefits and human reaction to what they work hard to build — whether that’s technology that allows vulnerable babies to go home earlier after heart surgery, or that supports equitable access to support for adults struggling with smoking cessation.  

Of course, not all of our work is patient- or client-facing. Often, it supports clinical and non-clinical care teams to deliver a better service, where the ‘human reaction’ presents itself through that reduction of stress experienced when care teams see the system which they use on a daily basis just works. It can give on-the-ground staff access to more accurate, real-time patient data and confidence in clinical efficacy, and therefore, the safety and wellbeing of their patients.  

What most recently validated my view on the power of multi-level stakeholder engagement was the Little Hearts at Home project we developed with Alder Hey Innovation under the leadership of Dr Phuoc. Watching our UX and analytical experts engage with families and carers to ask them what they hoped to see from a remote monitoring system filled me with pride as you can see the responsiveness and engagement with the families as they feel listened to. Their early participation in the project was critical to achieving confidence and support. This, on a personal level, took me back 30 or more years to when my own family would travel many times with my brother between our home in Manchester and the heart clinic in Liverpool. I know first-hand how important it is for families to feel clinically ‘looked after’, but also to feel that they can carry on with their lives as normally as possible, experiencing the extension of that care and safety at home. 

So, we know that early and regular engagement ensures that we are on the right path towards building a system or technology solution that is collaborative and user-centric. However, our engagement activity doesn’t stop here — it’s a continuous process throughout delivery, implementation, adoption, and technical support. This allows us to support the client in framing what the solution needs to look like over time (or evolve into) as the project progresses and new requirements organically occur.  

Don’t Settle for a Generic Stakeholder Engagement Process 

Of course, sometimes a project has time pressure and may simply need a ‘quick fix’, a replication of a technology solution, or another type of ‘digital intervention’ which we know works universally, based on tried-and-tested use cases. Even then, however, engagement on the contextual application of that technology means more informed deployment and ROI for the individual customer and the individuals they serve. Checking back months later to check whether things are still going as they should is something we promote at Objectivity; we see our clients as partners and the first of our values is “win-win”, so we want to know the client is still happy and the solution still delivers its objectives.  

I was at a conference last year in autumn where a group of Chief Technology Officers were reflecting that a ‘one-size-fits all’ approach to technology provision is really a misnomer, and that this term is actually closer in meaning to ‘one size fits some, but even then, not properly’. 

This is really where effective stakeholder engagement (and the user-led solution development approach Objectivity employs) comes into its own — in the identification of specific requirements against commonly identified problems. There may be, for example, 80% consistency across operational practice and structure in a typical organisation, but we avoid the ‘one-size-fits-all’ trap by applying critical thinking to that 20%” of difference, and understanding how the nuanced needs of each organisation and its stakeholders can be met.  

Stakeholder Engagement Isn’t Always Easy 

Effective cross-sectional engagement depends on striking a balance between the shared objectives of the collective, the external directive (guidelines, regulatory, governance), and the personal drivers of each individual involved. 

When working with our clients, we’re tasked with engineering varying and sometimes conflicting motivations into the end solution. This means that whilst making sure our clients’ internal needs are met, effective external engagement is equally vital to, for example, making patient-facing delivery equitable and accessible to the entire affected population.  

The technology must be easy-to-use and adopted as an augmentative (not distractive) everyday practice for all end users, including patients, families, clinical and non-clinical care teams, integrated care systems (interoperability and data exchange), and other non-clinical support agencies. A good example of this can be seen in our smokefree pregnancy project engagement from across the socio-economic spectrum

We know that improving health equity is one of the top priorities both for the NHS and health systems globally, and that digital health and technology can, and will, play a critical role. However, new technology which has failed to address stakeholder engagement (representative of an entire patient population) can create further equity divide, particularly when digital inclusion factors have not been considered. Fortunately, I have experienced many more positive impacts on inclusion and equity than negative, particularly whilst working in the Middle East where women in rural areas, who would normally struggle to attend physical clinics, were given vital access to remote, digital support during higher-risk pregnancies.  

Finance Directors Are Stakeholders Too 

To ensure a project (which is already demonstrating early outcome improvements) can continue to deliver with longevity, scale, and sustainability, we must engage those who are measuring the value, efficiency, and ROI of the development. These are crucial metrics for a financially overburdened health system. Our Quadruple Aim approach includes providing care at a lower cost or through achieving more with the same money, or, indeed, the same efficacy at lower cost. Ultimately those responsible for ensuring the sustainability of our health and social care systems need hard and fast evidence that we are delivering value and delivering it early. Therefore, engaging with financial teams to agree what outcomes they are seeking around specific cost pressures and reducing inefficiencies is vital. 

Conclusion  

In conclusion, stakeholder engagement is one of the most imperative, integral activities when developing healthcare technology solutions. From building in the opportunity for the right evaluation of data to sustaining new services and digital pathways, to enabling clear outcome improvements, access, and inclusion for entire patient populations, to enhancing operational efficiencies and experience for the teams working tirelessly to deliver the best care possible. All these elements are crucial to delivering real value through technology innovation.  

We know that each client has their own unique perspectives, needs, hopes, and fears, but by engaging early and continuously throughout our processes, what we deliver is architected at its core to optimise experience and reward for the organisations and individuals we support. 

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Andrew Smith Director of Healthcare Services at Objectivity

Andrew started his career on the Financial Management Training Scheme of the NHS, at the Royal Liverpool and Broadgreen University Hospitals. He later spent 10 years at the Department of Health, where he led several national programmes, working at the interface of the NHS and the commercial sector. 

For the last few years, Andrew has focused on Population Health projects and advised governments in the EU and Middle East, and supported health tech companies within the UK.  

Part of Population Health is about lifestyle and wellness, as such, Andrew enjoys running with his twin boys and, alongside his wife, supporting their daughter with her Rhythmic Gymnastics ambitions. 

See all Andrew's posts

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