skip to content

Centre for Digital Built Britain

 

Plans are afoot to relocate the century-old Moorfields Eye Hospital from its current home in London’s Old Street to a two-acre site at St Pancras Hospital, in the King’s Cross area. The move brings opportunity to use digital technologies (AI, analytics, digital twins) to innovate service provision to NHS patients and redesign hospitals and the wider health (eco)system. Cambridge researchers are working with Moorfields clinicians and management on a project to help Moorfields plan services fit for a digital future which will lead to better health outcomes, improve productivity at lower cost and with superior patient/user satisfaction.

Moorfields is the leading provider of eye health services in the UK and a world class centre of excellence for ophthalmic research and education. The new hospital will create an integrated eye-care, research and education facility with the aim of facilitating improvements in people’s sight.

A Cambridge-based research team is currently working with multiple stakeholders – asset owners, management, service providers, and medics – to better understand how the digital transformation of the built environment will create new opportunities to enhance and improve the services provided to patients in the new smart hospital. Digitalisation is emerging in the application and use of AI and machine learning, cloud technologies, virtual platforms, telemedicine and other digital technologies. This project explores potential drivers in relation to the design, construction, and planned operation of the new smart eye hospital – known as ‘Oriel’ – a joint venture between Moorfields Eye Hospital, UCL and Moorfields Eye Charity.

The rapid response to delivering services during COVID-19 has also become an important part of the study and researchers are exploring how the digital transformation during/post COVID might inform the reconfiguring of care provision around the planned physical hospital hub at Moorfields. This multi-disciplinary research project draws on service innovation, ecosystem dynamics, and digital transformation in putting visually impaired patient wellbeing at the heart of service delivery across the new hospital building and wider ecosystem.

Big picture

Sight loss is an increasing problem. By 2050 it’s estimated that four million people will be living with sight loss in the UK. AI and digital technologies are pushing the boundaries of how eyecare is currently provided and are offering new possibilities for treatments and cures in the future. To leverage these oncoming opportunities, Moorfields is designing and constructing a smart hospital of the future. This hospital will host state of the art technologies (e.g. telemedicine) and provide more efficient and advanced eyecare. However, the process of transitioning the current service into the future service is a significant challenge that Moorfields is looking to overcome. First, the physical relocation of any hospital is an enormous task and moving an eye hospital where the visually impaired patient community have a more complex relationship to the digitally transformed built environment presents additional challenges. Second, the current services provided to patients by Moorfields will also need to be reconfigured into the future service model.  This service model is enabled by digital technologies and across different stakeholder ecosystems (clinicians, technicians, and caregivers) who may be expected to work in new ways and take on different roles.

Working in a cross-disciplinary and collaborative environment, the Cambridge research team is working with colleagues at Moorfields to explore the above challenges and issues that are being faced in transitioning  service to the Smart Hospital of the Future.

The project

The project consists of multiple components.

The first component focuses on how new technology, in particular, telemedicine and AI which is transforming how Moorfields’ services are being provided to visually-impaired patients at the organisational frontline. In particular, the researchers are investigating the rapid and unprecedented adoption of video consultations in innovating ophthalmic services during the COVID-19 pandemic, and how emerging risks during a crisis shape service innovation at organisational frontlines. The implications of such rapid adaptations for Moorfields’ future service provision and business models post-COVID are also being considered.

Beyond this, the team is also working with Moorfields’ digital service hub to explore how other technologies – especially surrounding telemedicine – will shape the design and built environment of the future smart hospital. Digital technologies will be able to help clinicians provide better, more accurate, efficient and cost-effective care for patients, and inform the purpose-built hospital space with a new approach to service delivery. This will include developing new ways to support the satellites of different centres that work with Moorfields.

Finally, the project also explores how these transformations will necessitate a service transition effort impacting the user journey of the future. The research team is working with stakeholders at the Moorfields building-in-the-making to determine how best to deploy digital technologies to support staff and patients, and how the shift to the uptake of digital technologies around telemedicine and AI will impact Moorfields’ service provision. Such changes will also impact the ecosystem of care providers and lead to new responsibilities and roles being formed. Additionally, researchers aim to increase collaboration between younger, smaller start-ups and larger, more established companies up the value chain. Specifically, in focussing on the transitioning service journey for the visually impaired, researchers will build upon engagement between NHS Moorfields Eye Hospital and smaller, innovative companies with expertise in mobile-based AI and indoor/visual tracking – such as WayMap and Navvis – to aid patients’ navigation to and within the future hospital building. This aspect of the research may also offer a route to connect with Digital Twins.

Insights and new digital processes

Navigation tools can provide a gateway to inclusivity for a sight-impaired community and will be crucial to Moorfields patients who will need to travel to and navigate a new site served by a range of transport hubs. This research project is exploring a range of technologies and apps to support patients to access services and appointments at Moorfields. Digital tools and technologies that provide information that enables access to spaces are of interest to other groups of people beyond the sight impaired community and provide good practice that supports inclusive universal design. 

As a world class centre of excellence for ophthalmic research and education, the UCL Institute of Ophthalmology shapes clinical applications and trials treatments at Moorfields bringing progressive research from ‘bench to bedside’. During the COVID-19 pandemic Moorfield developed virtual clinics to safeguard the health and wellbeing of patients and staff. While telemedicine is not a new technology, the rapid use of virtual clinics for sight impaired patients, where historically face-to-face examination has been key, is radical. Data from this recent development is currently being assessed in relation to patient prioritisation systems, potential permanent future service provision and built environment design to meet the needs of patients and clinicians.

Timeline

Phase 1 (2020): The researchers built on an established formal collaboration with the Moorfields Innovation Hub. Data collection took place in Phase 1, with multiple rounds of interviews conducted with numerous groups of stakeholders. Preliminary data collection on the service transition and digital transformation of Moorfields’ built environment began but this observational ethnography was postponed due to the COVID-19 pandemic.  Instead, the researchers took the opportunity to conduct Zoom interviews to study how technology was being used by Moorfields to respond to the pandemic and transform the organisational frontline of service provision.

Phase 2 (2021):  The research team has been analysing the data collected from Phase 1 and translating the findings into conceptual insights via journal articles. In Phase 2, the research team will write a white paper on “Telemedicine and Service Transition: Building hospitals in the post-COVID era”, as well as develop other papers for upcoming conferences. Furthermore, data collection on the service transition and digital transformation of Moorfields’ built environment will be resumed in the latter part of 2021.

Phase 3 (2022): Phase 3 will be focused on further developing the various outputs from the data and insights gained in Phases 1 and 2. This will include other academic journal articles, industry papers, as well as conference papers and specialised workshop presentations.

Impact and wider benefits

This project will provide insights for practitioners at Moorfields as to how they can deliver value in a new purpose-built smart eye hospital space. In particular, emerging digital technologies and AI that will become core to Moorfields’ future hospital and services are already beginning to impact how the ophthalmic ecosystem is structured. As such, this project looks at the service implications that will impact the future roles of the stakeholder ecosystem, the way of ophthalmic work, as well as for Moorfields’ state of the art service provision.

A current, ongoing investigation reviews recent innovative advances to ophthalmic video consultations made due to and during COVID-19, to safely accommodate the needs of patients and staff. The pandemic, and its urgency, has vastly accelerated Moorfields’ progress in telemedicine. Our research team is writing a paper with Moorfields practitioners that explores how this will impact and transform the future patient journey and service provision of ophthalmic care, as well as implications for the future smart hospital building. Additionally, partners at Moorfields are conducting a study of how the increase of telemedicine and the changes in the delivery of services at Moorfields during the COVID-19 pandemic is leading to changes in greenhouse emissions.

This research project aims to generate important and transferrable learnings from this project beyond the ophthalmic services setting. In particular, the project will provide guidance for other service-based organisations’ process of service transition and transformation, in shifting to the new digital built environment of the future. Together, this qualitative project aligns with the Construction Innovation Hub’s mission to improve the delivery, resilience, sustainability and performance of infrastructure and enhance quality of life for its users.

“Moorfields is in the process of digitally transforming its clinical services in readiness for a move to a new hospital in 2025. Working with Cambridge Digital Innovation and the CDBB has generated insight from stakeholders throughout the organisation, and especially those on the clinical frontline, to understand how this transformation will affect our future services, and to learn importantly from the rapid innovation of clinical services that the Covid-19 pandemic demanded.”

Peter Thomas, Director of Digital Medicine, Moorfields Eye Hospital

Collaborators

  • Moorfields Eye Hospital
  • Centre for Digital Built Britain, University of Cambridge
  • Cambridge Judge Business School, University of Cambridge
  • Cambridge Digital Innovation, Hughes Hall, Cambridge Judge Business School
  • Warwick Business School, University of Warwick
  • WayMap
  • NAvVIS

Meet the research team

“With the UK’s planned expansion of 40 new hospitals in 10 years, this research on the Smart Hospital of the Future could not be more timely in leveraging this once in a generation opportunity for step change improvement in healthcare.”      

Professor Michael Barrett

Professor Michael Barrett, Professor of Information Systems & Innovation Studies, Cambridge Judge Business School, University of Cambridge: m.barrett@jbs.cam.ac.uk

 

 

 

Dr Edwin Lee, Research Associate in Digital Innovation and Policy, Cambridge Judge Business School, University of Cambridge: e.lee@jbs.cam.ac.uk

 

 

Professor Eivor Oborn, Professor of Healthcare Management, Warwick Business School, Research Fellow at Cambridge Judge Business School:  Eivor.Oborn@wbs.ac.uk

 

 

 

Dr Karl J Prince, Director of Knowledge Innovation at Cambridge Digital Innovation, Hughes Hall, Cambridge Judge Business School: cdi@hughes.cam.ac.uk

 

Engage

Keep up to date with this project via the PROJECT PAGE. If you would like to get in touch, please contact us through CDBB, or you can reach Michael Barett at m.barrett@jbs.cam.ac.uk.

Need to know

  • Moorfields Eye Hospital has the largest ophthalmic patient population in the Western world
  • According to WHO, more than 2.2 billion people currently live with a form of sight impairment
  • In 2018, the FDA approved the first artificial-intelligence-based device to screen for and monitor diabetic retinopathy.