“They need to put the work in with the humans”

What Steven asked Lisa Riley, nurse and Executive Vice President of a health tech company VitalHub UK

Steven and Lisa Riley first met in GCSE science at the Hundred of Hoo School. They met at the Ivy in Canterbury as an opportunity to catch up, where they talked about how Lisa came to work for the NHS, her own experiences of the window of opportunity, the time she won a house, and the great medical app you haven’t heard of…

Lisa Riley

What is your official occupation?
I always call myself a nurse. I'm not registered anymore. But that is at the core of everything I do. I trained as a nurse when I was 18. Officially, I've been a nurse for 27 years, but my official occupation right now is Executive Vice President of Strategy and Growth for a health tech company.

Do you have any additional roles, paid or unpaid?
Not anymore. I was a Prince's Trust talent match mentor, and I was a board trustee for MVA (Medway Voluntary Action).

When did you join MVA and why did you leave?
I joined MVA when I was a clinical services manager at Medway Community Healthcare. I had just designed a Home First pathway, which is getting people out into the community from the hospital, and I realised there's so much more the voluntary sector could do to support health. I started talking to the MVA team, celebrating what they do and signposting them to funding and services. They had a vacancy on their board, so I applied. I think I was there for about ten years, quite some time. They had no input into health at all. They were completely funded by the local council and would do things like housing, education, but nothing in health. I helped introduce them into health and social care, and they are at the heart of everything to do with the health and care social partnership now.

Why did you leave?
Time. I couldn't give them enough time.

What is VitalHub? What does that do?
VitalHub is a health software company. The headquarters are in Canada. It's a Canadian corporation, and they have been buying smaller health tech companies and putting them under the umbrella of VitalHub. They bought two companies in the UK, and then they bought the one I was in, which is a company called Transforming Systems. I'd come across this piece of software called SHREWD, that's my baby, when I was in the NHS. I've worked for NHS England at this point, and I was part of a national team doing improvement management and all the trusts that were really struggling with urgent care. I kept hearing this word SHREWD. I asked to see the system, and I loved it. I'm quite a bit of a data geek at work, and within NHS England, I get these lovely reports that would tell me the relationships and coincidences with different pieces of data. ‘When the ambulances turn up at this point, this means this is going to happen in A&E.’ SHREWD was very easy for me to understand. I didn't have to try and work stuff out. It was in my face, and I got it. I left the NHS, and I went to join this health tech company, and VitalHub bought us. We decided we would set up VitalHub UK. Our plan is to bring all acquisitions together in the product portfolio, so now we are one enormous company in the UK. We've got 16 health tech businesses in the UK now.

Whenever you hear the words health and tech, it's never normally a good story. Why is IT and the health industry so bad?
Because they forget the human element, and I think that's what I'm proud of that my team do. My nursing background means I look at it different. I look at the human side. How is someone going to use it, how are they going to make their own lives better, but be more efficient, so that patient care at the end of the day is consistent, they're not missing anything, there's no human errors in there, and they can get through the waiting list quicker and things like that. I think a lot of tech companies forget that bit. They forget the change management. They think they can buy the kit, stick it in, everything's going to suddenly change, and it's going to be great overnight. They need to put the work in with the humans. They need to help change the processes, teach them, and get super users on there so that they're also the people on the ground who are owning this and making the change happen.

Do you have confidence that things will improve, or is it just people making the same mistakes?
You do see them making the same mistakes, and I'd like to think my team and I are a bit different because we do challenge, and I personally do hold them to account. I hate people thinking I'm selling a we're actually trying to make their lives easier, because selfishly, at the end of the day, I want people to stay alive. I do see it happening. Silly mistakes, like not doing a piece of paper, are causing unknown issues and impacting lives constantly. My team are very good at bringing the human element to it. It's because I think we're credible, because we're not trying to sell them a bit of kit, we're trying to help them. I call my team ‘Partnership Managers,’ because they're in there holding the hands of the clinicians and giving them advice. They come and ask us for advice all the time because I think they trust us.

You mentioned the human element. What part does AI play in what you're doing?
AI is a bit of a swear word for me right now. It has a part to play, but it is a buzzword right now. Every customer wants to hear you've got AI, but unless it's going to do something intrinsically different, don't just plug it in for the sake of it. I help design the innovation at work, and I help decide what the products do and what their strategies and roadmap are, and I am often the one saying, ‘You don't need to do that, they're never going to use it; they're never going to trust it.’ Even simple things like prediction, how many patients we think are going to come in ED (Emergency Department), they don't trust it. If it’s out by even a small amount just once, and then you’ve completely lost your credibility.

Is your company invisible? If our readers’ care has been improved by your service, would they be aware of that?
We've got 16 companies in the UK now and about 60 products. We are in every part of the NHS in England in one way or another. We're also the national coordination centre for England for urgent care. My team and I helped design that. I'm very proud of that. SHREWD, the baby one of mine, they were struggling with oversight of urgent care pathways, and obviously, coming up to winter, we know there's going to be a problem, and hospitals are going to be overrun. We get the data anyway, so I said to an old colleague of mine in NHS England, “Do you want me to build something so you can see it?” and we gave them visibility of what was going on around the country in ambulances, and in every ED department. We've now built their national coordination centre, and it's gone out into the community and mental health. We're the first in the world to ever have live, real-time data of what's going on across the whole country. I forgot what your question was.
Will patients know? Will patients be aware of this?
Yes, so there is something in Kent and Medway called Waitless. That's ours. You've not heard of it, have you?
No.
It's a patient-facing app that obviously needs publicising more if you haven’t heard of it!
It takes all of the live data in every urgent care centre, every ED in the county, and it combines that with the travel time to get to these facilities and tells you where the quickest place is to go, to be seen and travel. If it's an emergency, obviously you don't want to muck about on this. Call an ambulance or 111 if you're not sure.
I've just typed my postcode up there. All these icons are the facilities I might be able to go to. Actually, it's telling me it's quicker for me to travel all the way down here and be seen. It took me 49 minutes to get there and be seen because there's only one person waiting. If I click on it, I can find out what they've got. Some facilities don't see paediatrics, they don't do x-rays. More importantly for the patients is about experience, but it balances the pressure across the county, rather than everyone making Medway (Maritime Hospital) busy and the patients at risk, as an example.
I've got an analytics team, because I love my data. I said ‘Can you show me what impact we've had across the different facilities?’ You saw A&E attendances went down, urgent treatment centres all went up, because you're moving the activity to where there's capacity, and it was completely different to the rest of the country. Data is a really great tool, but I think in healthcare, a lot of people do not have the headroom to sit down and work it out. There's different data in different places, that's the other thing.
If I'm running services, which I did when I was at Medway, I've got an Excel spreadsheet there, I've got an email, I've got a WhatsApp, I've got a phone call from my team, and I've got meetings left, right and centre. As a human being, I'm trying to piece that together, join the dots and come up with an answer. I remember we went to a local hospital and did a PowerPoint presentation. We put a scenario on the screen and said, ‘You've just walked into work, you've got five ambulances outside, you've got people in the corridor and some other bits.’ We said, ‘You've got an option one to four, tell me where you think we are.’ They had the same data presented to them, and they all came up with different answers. Human error, interpretation, and God forbid, you might have missed something. That's what happens in NHS. A lot of what we do stops ambiguity.