The rapid digital acceleration of the NHS, here to stay?
Allowing patients to manage their own health records could improve NHS efficiency, says Digital White Paper Editor Sarah Cartledge.
Healthcare has undergone a rapid digital progression in 2020. A pandemic may not be the textbook way to bring about much-needed change, but few would contest that Covid-19 has led to a digital evolution in healthcare. The NHS rose to the challenge of coronavirus and responded in a way that would have seemed impossible just 12 months ago, proving that when the need is great the NHS can move swiftly and embrace change.
But the virus has also shone a light on the shortcomings of the NHS, from resource pressures and lack of funding to outdated processes. And once again the important debate has opened up: the most effective way to join the dots in a fragmented health service. The NHS may be magnificent in many ways, but efficient it is not.
However, there is a huge cultural change that needs to happen before a digital NHS can become a reality. Lack of digital awareness and reluctance to fund digital solutions lie at the heart of current stagnation. This is a result of the pressure on resources and time in each institution to find the optimum solutions that fit in with their outdated legacy systems – a failure of vision rather than anything else.
Now that Covid-19 has brought these digital deficiencies into sharp relief, barriers to interoperability have been highlighted, presenting the opportunity to redefine the vision and create a new reality fit for the 21st century.
Accelerating Digital Healthcare How the rapid uptake of digital services as a result of the pandemic can transform UK healthcare: a new White Paper from Public Policy Projects, sets out a vision for an effective roadmap for digital transformation and implementation in UK healthcare.
The patient first and centre
Most of us manage our lives with our phones these days, so it makes sense that any healthcare transformation starts with them. The NHS Covid-19 app, part of the Test and Trace service, recognises this and to date more than 10m people have downloaded it to enter their symptoms. If a majority of the population engages with it, there is a fighting chance that as a nation we can control coronavirus.
Following on from this, most people would understand the concept of having their healthcare records to hand whenever they need it. So digital transformation has to begin with the recognition that the patient or citizen is the data controller who chooses to share their health information with healthcare professionals who are then data controllers on their behalf.
By giving patients responsibility for maintaining their own health records, they can be supported with relevant, easily accessible apps approved by the NHS. In this way, everyone will become a digital citizen and will value the benefits that data sharing can bring to managing their health.
But there are hundreds of healthcare apps available on popular platforms, and not all are effective. Although the NHS has its own Apps Library, it is not widely promoted. Yet this is the ideal place for apps that are NHS approved and compatible to be made available. And once patients become accustomed to using apps for monitoring health, practitioners will be able to prescribe them in much the same way as a medicine, and the NHS Apps Library should be the place to find them.
Similarly, any solutions for a clinical setting should be designed with patients and users in mind. Clinicians are rarely consulted about digital solutions, and if these solutions do not benefit patients and healthcare users then uptake will be low to non-existent. So digital thinking has to come first, rather than fit in with an existing system.
But we must also bear in mind the digital divide, and ensure that digital inclusion tools and effective broadband are available to all so that health inequalities are not further exacerbated.
Improving digital awareness in healthcare settings
Healthcare professionals are hugely reliant on their mobile phones to connect them to colleagues and source information. But there appears to be a general lack of awareness among healthcare providers of how digital technologies can benefit the patient. While we’re all adept at using our mobile apps for social exchanges, there isn’t the same level of engagement for apps that could really make a difference to both patients and clinicians. If digital training were to become an intrinsic part of clinical and continuing professional development programmes, there would be much more understanding of how such tools could transform healthcare in the future.
With this in mind, healthcare providers should incorporate change-management programmes into new digital provision, especially from a funding viewpoint, so that staff understand fully how and why the new systems will benefit the patients and their own working practices.
In addition, it seems logical that there should be a basic digital record of the care that a patient has received. And equally logically, all treatment records should join together to create a comprehensive report of the health of any individual. So minimum digital functionality for any health and social care provider is imperative, and such organisations should not be able to exist without such systems in place. As there is no single standard for data sharing within the NHS, this minimum digital functionality should be overseen by NHSX for any healthcare provider.
But to maximise data for reinvestment and research there has to be a co-ordinated approach at local and national level to support trusts. Integrated Care Systems have a remit for digital so it would seem logical for them to drive integration for digital investment, while integration to drive interoperability between all the various systems should be the responsibility of the Department of Health and Social Care.
Covid-19 has helped everyone understand the basic concept that we should all be responsible for our own health, and that of others. It’s not a huge leap to manage our own health and healthcare records, and to expect the NHS to do the same via digital transformation – we’re only asking it to do exactly the same as we do ourselves.
Yes, the task is vast and complex, but if digital transformation starts with the patient and works outwards, then the right procurement solutions will be found that optimise healthcare provision for the patient, the clinicians and healthcare providers.
White Paper link here