Back when I studied economics at school, I was introduced to the concept of Ceteris Paribus – all other things being equal – and the term stuck with me, not least because phrases in Latin make you sound smart. It is used when examining, building and testing economic theories and models to explore their effects in isolation. The theory of Ceteris Paribus allows us to observe the changes made by a specific intervention in almost any given situation. There is, however, one fundamental flaw; theoretical hypothesising can be useful to a point, however, when deploying a theory to the real world, expecting the same results is foolish. Change cannot take place in a vacuum.
Deploying software solutions throughout the NHS has taught us that sustainable changes cannot take place with such expectations, and testing processes purely Ceteris Paribus yields no real insight. Lasting change happens best through strong collaboration between the provider and the client – in our case, between DrDoctor (a private company) and various NHS Trusts around the UK. There are many ways to define a partnership, but I see it as two or more parties – equal in their desire for the same results – sharing knowledge, resources and abilities to ensure that together, they are more than the sum of their parts.
Keeping track of key metrics and measuring results is critical to measuring the success or failure of implementing change. To know how well a new product or service is doing in the field gives room for iteration, improvement and dramatically increases the chances of a long-term successful project. Unfortunately, the setting of these key metrics all-too-often happens prior to deployment during project/product development, and as we previously established – nothing takes place in a vacuum. To paraphrase Andrew Lang, ‘Often, people use statistics as a drunk uses a lamppost, for support rather than illumination’. The ability to get deep, insightful feedback on a project relies on a nuanced understanding of both the project and the environment. For that reason, at DrDoctor the partnership with our clients starts from the very beginning – before we finalise the deployment plan – to understand the nuances of their needs and internal subtleties. We test our solutions, training methods, software, and terminologies in great depth throughout development, but never assume that the results we find in isolation will be the same when deployed in real life. Rather, we rely on the discerning feedback and detailed knowledge of the hospitals we work with.
As such, implementing small pilot style deployments and gleaning actionable insights for ‘next step’ wider rollouts are critical. When these insights are collected in conjunction with the entity where the pilot takes place, be it a company, government or (in our case) hospital, they are more valuable to all parties involved. It is then up to the provider to analyse, iterate and improve to ensure that future deployments are more effective, and learn from the initial pilot. An example of where a successful pilot influenced a full rollout can be found here, where DrDoctor ran a pilot with the Women’s Services Department of Guy’s and St. Thomas’ hospital, (one of the UK’s leading foundation trusts,) and went on to create a successful rollout across all outpatient departments.
Implementing meaningful change in healthcare systems requires the trust and collaborative work of many different stakeholders. Good partners listen, learn and grow together, and not entering a new area as ‘an external expert’ coming to preach ‘the way it should be done’ is key. A lack of ego and a state of humility is needed from both parties for a productive exchange of ideas to take place.