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Instant messaging for healthcare professionals

with Dr Barney Gilbert, Co-founder & Co-CEO at Forward

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More and more healthcare professionals in the UK are turning to Whatsapp and Facebook Messenger to communicate at work.

Since the 1960s and even till today, doctors, nurses and other healthcare staff in the UK are still expected to communicate at work via radio pagers, which is why most of them have switched to mobile instant messaging apps.

But the problem with these apps is that the patient data that’s being put on these platforms isn’t being handled in a way that’s legal and safe, putting sensitive patient information at risk. They’re also not built with the kind of features to help doctors and nurses to be more productive at their jobs.

Built by a team of tech-savvy junior doctors in the UK, Forward is an app designed for healthcare professionals to communicate with their teams as well as other healthcare professionals while sharing patient information securely and managing tasks more efficiently. Joining us on this episode of HealthRedesigned, Dr Barney Gilbert, Co-founder and Co-CEO of Forward.

Fixing an outdated system

What is Forward trying to improve?

Our mission is to connect healthcare teams around the world to empower health professionals to be able to spend more time with patients and doing the things that matter.

We know there’s a problem with this connectivity or communication between different healthcare professionals in any system in the world. We want to give them a tool that allows them to use all of their own expertise which is clinical, acumen and skill, to actually serve the patients that they want to come to work to serve.

“At the moment, people are wasting so much time using inefficient outdated systems. We're going to give them their time back.”

What did your team start with when you began building the app?

From the very early stages, our founding team sat down together to wireframe an app that really brings value from the moment it’s downloaded by any healthcare professional. It’s done in a couple of ways, but messaging is the core of it all. The messaging reliability and interface has to be on par with WhatsApp which is really difficult to do but we think we’ve gotten there. We call it messaging plus because we need to be 10 times more useful than WhatsApp for people to switch over from that kind of a tool to Forward.

What’s been really valuable is creating a directory of users, so any user who comes on board can find the name and contact details of the person they’re trying to get hold of in their own hospital network and in other hospital networks. It’s really simple, but it’s a massive advantage over WhatsApp where in the system of a million health professionals, you actually have to ask for the mobile number of the person you’re trying to contact.

We’ve also created patient cards in the app. For the first time, this allows teams of health professionals to look after their patients on a mobile device. They can list all the patients under their care and any relevant diagnostic and demographic information, create tasks that need to be done for those patients and share them quickly in real time with the whole team—it’s a massive advantage over the way they’ve been working before.

Dynamically improving communication

Are there any examples of how Forward has improved the efficiency of hospital service?

At the high level, the data that we’re collecting shows that versus the current communication systems, Forward saves each staff member more than 40 minutes per shift. That’s a large proportion of say, an eight-hour shift, so we’re making big high-level improvements. But you start to see what that means for individual workers in the system. One of our users works as a clinical scientist in a hospital where we’ve launched in Kent and she basically sits there during the day, receiving blood requests from all of the doctors working in that hospital.

Forward has allowed her to put it on her own device and whenever other doctors need to add a blood test or a particular kind of niche test or requirement, they can just message her and she’ll get it done. The process is instant and takes a few seconds rather than the really slow convoluted process of having to try and phone her.

How do you ensure patient data is secure especially since it’s being passed through a personal mobile device?

Firstly, we make sure we host it on the cloud in the country of origin and at the moment, that’s in the UK. We don’t want to be sending the data like WhatsApp does to a Facebook server in the US. There’s a two-factor authentication for anyone coming in and they need to have an NHS verified email account to join. As soon as they’re on the app, it’s PIN protected at all times so that no one can hack in on the front end easily.

We’ve also recently changed the messaging technology that’s underpinning the app to allow us to really scale fast because our target this year is to have 100,000 UK health professionals on Forward by the end of 2018. We’ve switched to a messaging system called MongooseIM which is the technology underpinning Facebook Messenger. But, we’ve hooked it up at the backend to be a legal and secure pathway for hosting secure data.

Do you have plans to integrate more features into the app in the future?

Absolutely. There are there are two phases in my mind to this project. The first which we’ve already touched upon is building a big network, so we want to have 100,000 users by the end of this year and we want Forward to be the place where healthcare professionals are going for their communication and task management when at work. But the second part of the vision is bigger than that. We want Forward to become the place where all clinical work is done.

“In our view, the future of healthcare technology is on a personal mobile device—we want to be the integrated nexus where all of that information flows.”

At the moment, the whole NHS system in terms of its management is fragmented, so is the technology used within the NHS. There’s a disparate system of electronic health records, but we are working towards a pathway for pulling relevant structured information from health software providers onto a Forward patient card, so that doctors can turn up in any hospital in the UK or elsewhere and get the critical information they need right at their fingertips when they need it.

There was a really brilliant article published last week by Forbes which described us as the future Slack for healthcare. Obviously, Slack is a tool in the corporate sector that combines all of the integrations that someone working in an office needs to get their work done really efficiently—we’re looking to become that place in the health space.

Mobile-first communication

What has been your biggest learning throughout this journey of building Forward?

I think the biggest learning is how much energy and commitment is required to actually shove a project forward. People talk about the healthcare industry being really primed for disruption because in every Western system, there are trends of rising costs, constantly rising demand and ageing populations on a background of inadequate poorly performing technology. Now you’d think that was the perfect landscape to innovate in, but actually, because the system is extremely bureaucratic, not just in the UK but elsewhere, there are constant barriers to create scale.

It’s really about trying to find smart ways to get around those barriers which might be human factors or technical challenges. In both cases to date, we’ve done well, but we need to continue building a great relational network with the key players in our system and predict the technology shifts that are taking place because we’re at the cutting edge of hosting this kind of information on personal smartphones. It’s really transformative and we don’t want to be the first emerger that then slacks behind a competitor that comes up behind us. We want to stay ahead and claim the whole market.

What are you and your team most proud of?

At a macro level, we’re proud of the progress we’ve made to date, but we’re also really proud of the passion that we all have for this project. In our team of 15 people, there are actually eight doctors working for us who are really fast learners and people who understand the problem intricately well. They’re now turning their hand at some of the marketing, sales and operational challenges of scaling a startup.

You sit back and understand the passion of these people who are leaving their jobs as doctors who have trained for many years to be where they are but are so passionate about solving this problem that they are working full time on it.

If you’re in the UK, you can download the Forward app on the App Store or on Google Play. The team would like to hear from healthcare professionals who think they could really benefit from using the app. They’re also currently expanding their team and are looking for an Android or iOS mobile engineer. Get it touch via their website or social media for more information.

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