License to Heal: Transitioning to Secure Remote Healthcare Services Across Wales

By: Dr. Ian Cox, Head of Client Services at NHS Wales Informatics Service

In the medical field, we’ve all had to get creative in 2020. What if your living room became your waiting room, and the whole experience became virtual? What would be the impact on the quality of care?

NHS Wales found out firsthand, as much of the world was forced to transition to remote work during the COVID-19 pandemic. The challenge was a combination of balancing logistical needs with maintaining quality of care.

For my team within the NHS Wales Informatics Service, this was no small task.

Scaling to the Cloud with Urgency

The NHS Wales Informatics Service is responsible for providing national IT systems and services to the Welsh NHS. Along with providing over 80 clinical and business applications across NHS Wales, we provide direct IT service and desktop support to approximately 15,000 staff. About 12,000 of those staff members work in general practices in clinical or administrative staff roles, serving approximately three million citizens across Wales. As Head of Client Services, I’m an IT manager providing services and support to our user base. I’ve worked in the NHS for 17 years, and I’ve seen the direct impact we have on providing those frontline services.

Over the past five years, we’ve seen a shift in users leveraging cloud technologies on multiple devices. It’s become the norm, and my team’s roles have changed significantly in response. I manage a team of 110 staff, with 40 staff working on the IT Service Desk. Our engineering staff are transitioning from managing physical computer hardware and systems to managing cloud services. That’s caused a big shift in service provisioning and the roles and makeup of skills we need on our team.

Part of this change has been a move to a cloud-based remote support service. In the past we used in-house technology to remotely connect to end users’ devices and provide support. But its capabilities were very limited. It was based on devices being connected to our network, so it wasn’t very flexible. If we wanted to provide support to someone working at home on an iPad, for example, we couldn’t because the device wasn’t connected to our network.

Obviously, circumstances in 2020 accelerated the trend of gaining access to your entire work environment, no matter where you are. It’s a complete departure from our traditional office workspace setup, and the in-person nature of our industry. We wanted and needed a product which would allow us to support any device in any location, that also had recording capabilities for training and audit purposes. It also needed to integrate with our existing service management tools to manage support cases and track the user support journey. And we needed it fast.

The initial conversation happened on a Friday and, by Monday, our first practice was up and running. Four days later, we had 10 practices on the system. Within a fortnight, we connected 308 practices and registered 1,500 users.

IAN COX, HEAD OF CLIENT SERVICES

Transitioning an In-Person Service to a Remote Reality

We got introduced to BeyondTrust in 2017 after seeing it in use by another part of the NHS. We began with Bomgar, which is now known as BeyondTrust Remote Support, and a big selling feature was its flexibility to integrate with our existing systems.

We’d just experienced a period of massive growth—from 3,000 users in 2012 to around 15,000 in 2017. We knew how many licenses we needed from BeyondTrust in that initial contract three years ago, but the pandemic required us to adapt yet again. In Wales, our government strongly encouraged us to work from home, if possible, and our IT staff did so immediately.

There was also a huge demand for our user base—both general practitioners (GPs) and administrative staff—to work remotely, too. We had a lot of GP Practice Staff who were deemed “at risk” and hundreds of GPs and staff had to go into self-isolation. The question became less about working from home and more about continuing to provide care when the usual process of doctor visits was disrupted. To continue providing healthcare services, GPs needed access to the same systems that exist in their consultation rooms.

The traditional approach would have been to provide each user with a laptop and a VPN connection so they could connect from home. But global demand for laptops skyrocketed, so ordering and configuring 2,000 laptops was going to take at least eight weeks.

Under pressure to find a solution quickly, we approached BeyondTrust to see if they could help our GPs get remote access to the systems they needed.

A Two-Week Transformation

We had a conversation with our BeyondTrust account manager who was very supportive and quickly shared technical resources so we could begin to discuss our options. We agreed to do a pilot using BeyondTrust to provide remote access from a GP’s home to their practice.

Our technicians were already familiar with BeyondTrust’s remote technology, so we were able to move fast. The initial conversation happened on a Friday and, by Monday, our first practice was up and running.

Four days later, we had 10 practices on the system. The following week, we deployed that system to every single GP practice that wanted access. Within a fortnight, we connected 308 practices and registered 1,500 users. This setup included multi-factor authentication (MFA) to ensure system security, no matter which device they used to connect. It was as if they were sitting in their practice, accessing all the same systems that they would on a day-to-day basis, with the same level of security.

At the time, we didn’t know what the demand would be, so we needed something that could be quite flexible. For example, if we discovered there was more demand for the service in North Wales, but not in South Wales, we wanted to be able to move capacity between those environments. For that, we leaned on BeyondTrust’s Technical Account Management Services for additional support.

In addition to creating a stable service solution, our technical account manager helped us with management and reporting capabilities. Working with our engineers, BeyondTrust ensured we got the flexibility we needed.

BeyondTrust also prioritised our needs as a healthcare customer during the pandemic. Rather than be opportunistic, BeyondTrust was a genuine partner that came to the table with a sincere, fair, and proportionate response to our urgent challenge.

IAN COX, HEAD OF CLIENT SERVICES

The (Digital) Future of Patient Care

Had we not provided a solution, hundreds of GP Practice Staff would not have been able to resume work safely and securely. Without a doubt this has had a positive impact on patient care.

This wasn’t just a win for the NHS Wales Informatics Services team—it was a win for the health and wellbeing of Wales. The impact was not lost on our users and leaders. We have received a lot of positive feedback from our GP Practices.

We initially had a six month license with BeyondTrust, but have extended that by an additional 12 months, as we’re still in lockdown. With that service still firmly in place, I get a report every day that shows the number of active users. The data shows that it’s well utilised, and interestingly, what began as a temporary measure to deal with the pandemic and the local lockdowns sparked a desire to make it a permanent part of our normal healthcare offerings.

Now, we have a better understanding of which roles are most compatible with remote working. We can now role profile our user base to help better assess remote work needs going forward.

A Genuine Partner in Our Time of Need

While BeyondTrust’s Remote Support tool wasn’t meant for our unique use case, they stepped up to help us innovate and adapt to meet an urgent need. We approached them with a problem, and they helped us to create a custom solution.

The speed and quality of their support was excellent. BeyondTrust got the right people on the job right when we needed it, and helped us bring together people from different areas of the NHS so we could launch this project quickly. BeyondTrust also prioritised our needs as a healthcare customer during the pandemic. Rather than be opportunistic, BeyondTrust was a genuine partner that came to the table with a sincere, fair, and proportionate response to our urgent challenge.

IAN COX

Ian has worked in technology for over 20 years and has held a number of positions within the National Health Service and now leads a team of over 100 in delivering a range of services to approximately 15,000 NHS staff.

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