Shane Tickell has been working in the health tech industry since the late 1990s. He is probably best known for his long career at IMS MAXIMS, where he worked for 13-years, predominantly as group chief executive officer. However, he left IMS MAXIMS four-years ago "to pursue a wider agenda."
"I wanted to work on data," he says. "I want to be able to bring data together from conception to end-of-life, in real-time, with good governance, safely, so people can use it to provide great care and then, anonymised, use it for population health management and research."
A thrilling future for data
To this end, Shane is now chief executive of three companies including Temple Black, "a strategic company that is bringing together data to take advantage of quantum computing," and Voror Health Technologies, which is developing an open healthcare data platform on the AWS cloud and Endeavour Predict that provides risk scores for major diseases such as Cardio Vascular, Cancer, Diabetes."When I started in the industry, we knew about 80% of healthcare decisions involved pathology testing of some kind and that about 73% involved radiology," he says. "We also knew that about 90% of those results would be safe and in-line, so the majority of patients were seeing their consultants and GPs for reassurance.
"We started introducing algorithms to let clinicians focus on the other 10%. And we've had some significant success with that. But now we’ve codified a lot more information. We've started work on uncoded information, and we have large language models coming along to help us make sense of it.
"So, I think the next ten-years will be thrilling. If we get this right, we can tackle the backlog, by taking the people out of the waiting list that don't need to be on it, and we can start to tackle demand at source, by addressing the social determinants of health, meaning we can start to predict, prevent and personalise care.
"We need to do it, because we all know there is a global shortage of funding and workforce. The only way through is to use technology. That's why I came into the industry."
Speaking up for the health tech industry
As if that wasn't enough to be going along with, Shane has also been putting back into the industry itself. For the past two-years, he has been chair of the Frontline Digitisation Forum; a joint NHS England and techUK hosted body for electronic patient record vendors involved in the latest bid to complete the digitisation of acute trusts.And for the past four-years, he has been vice chair of the techUK health and social care council; becoming its chair in January. His background plus these experiences have convinced him that the NHS needs to think about how it does business; and it needs to give more priority to small and medium enterprises.
"For the first six-months, frontline digitisation was great," he said, "and then we lost our way. We had volatile funding and inconsistent leadership messages. Then we saw some major contracts in other areas awarded to a few big companies, when we know that SMEs are the largest employer of people in the UK, and a major driver of innovation.
"There are ways for the NHS to encourage SMEs, but one of the challenges is funding. Big IT projects tend to require capital funding, and that inevitably gets clawed back when finances get tight. Yet, every year, trusts roll-over IT contracts with an RPI uplift, so they pay more and more for technology that is aging, not necessarily keeping up to pace with the revenue increases associated each year. You could say this is money that could be better spent with emerging technology that is frankly better value. But change is hard!
"So, we need to get into the commercials. We need to find new revenue models to enable us, as a country, to buy technology that is more innovative. With the move to cloud, we should be able to do it. AWS, Microsoft Azure, Google and the rest of them are moving to a pay-as-you-go model, and we need to talk about the NHS following suit.
"Among other things, that would take decision making away from the whim of health secretaries and their appointees. At the moment, you get a new health secretary, and they have an idea, and it can lead to a programme with implications that last for ten-years."
Standing up for SMEs
Shane feels frontline digitisation is back on track; but there is still a lot of work to be done to encourage SMEs, both at the NHS and the industry level. On the NHS side, he argues the health service needs to understand the mechanics of doing business as a small company."SMEs need to win business, to maintain the confidence of their investors, and build the confidence of their customers," he says, adding that from personal experience, when this doesn't happen "they get dragged into a horrible cycle, where they can't invest in their products because they have no customers, and they can’t get customers, because there's no guarantee of development."
Hence his call for a hard conversation "on the commercials." On the industry side, he argues companies need to face up to what he calls "the elephant in the room" - the dominance of large, often US companies in the UK health tech industry, and their tendency to crowd-out or buy-up their smaller counterparts.
"As chair of techUK, I want to have some really robust conversations with people and point to the elephant in the room," he says. "I want to bring together the big and the small suppliers, so the big companies can't stifle innovation by starving the small ones of resources and making them vulnerable. We all need to work together and I have made my chairmanship of 2024 all about inclusivity"
Tough times, thrilling future
That's particularly the case at the moment, when the health tech market is tough. Outside frontline digitisation, and one or two other large programmes, like the roll-out of summary care records and the deployment of 'next generation' technology at radiology and pathology networks, little seems to be happening.And with the NHS bogged down with waiting lists and facing a significant financial crisis, that is unlikely to change ahead of the general election. But Shane insists the future is bright, as long as the health tech industry is confident - and business like.
"I can see a way through this," he says. "When I started at techUK, we would talk about what the NHS wanted, and suppliers would try and deliver it; only for the finances and the requirements to change.
What we need is a dialogue, where we say to the NHS: 'this is what we can do for you' and we learn 'this is how we need it to be deployed to be effective.'
"And that will only work if the industry is inclusive. Then, we need organisations like techUK to work on things that will support the whole industry, like standards, and we need to get the commercials sorted." It won't be easy, he admits; but it should be possible - and if it happens, it will lay the foundations for that "thrilling" data-driven future.