Why tomorrow’s patient needs a digital NHS: takeaway messages and key learnings
On 22 February, DigitalHealth.London hosted our first Anniversary Summit – why tomorrow’s patient needs a digital NHS – attended by a mix of over 120 NHS leaders, clinicians, healthcare professionals and innovators. Here we round-up the takeaway messages and key learning points.
By Richard Vize
What patients want from technology
Patients want technology which supports independent living by empowering them to manage their condition.
They want an integrated suite of options which allows them to build their own strategies to fit their unique lives, and they need clear and timely information they can act on, not lots of information.
At present it takes years of experience, trial, error and learning to develop effective self-management of a
long-term condition. Clinicians need to be digital champions, helping patients identify technology with which they can develop strategies for their condition in much less time.
What patients want from entrepreneurs
Patients want entrepreneurs to involve them in every stage of design and development. They should not throw tech at patients and expect them to find it useful, but explore the importance to patients of their idea before developing it. Filling in the gaps in their care and lives is more valuable than duplicating existing services.
Entrepreneurs need to understand how their technology relates to patient behaviour change, and to design it from evidence rather than anecdotes and assumptions. Measurement is crucial at every stage, such as using the Patient Activation Measure to assess effectiveness.
Health apps which do not join up are of limited use. Technology needs to be bundled together to meet the needs of the whole person, and address well-being rather than just clinical objectives.
How young and old, male and female patients use technology
There are 12.6 million UK citizens with no digital skills; the health prize for connecting them would be immense
Men are more likely to have digital skills but women are more likely to interact about health.
Don’t make easy assumptions about age and use of health-related tech. There is compelling evidence that all age groups – including 85+ – will engage with tech over long periods if they are given encouragement and support.
Tech savvy young people are often poor at engaging with health apps and information, which is one reason they are a major contributor to inappropriate use of A&E.
The potential role of virtual reality in patient-centred care
The power of virtual reality is that it is an immersive experience. It is already making treatment more comfortable and effective, such as by calming a child before an operation or distracting a patient during a painful procedure.
VR is demonstrating potential as a diagnostic tool, such as detecting cognitive impairment as an early sign of dementia. Novel therapies are being developed. For example, there is a trial to determine whether it could cut the incidence of post-operative delirium in intensive care by allowing patients to explore the unit virtually before their operation; this can reduce their disorientation when they come round from an operation.
It is revolutionising education and training, such as by allowing surgeons all over the world to be immersed in an operation. This could accelerate the spread of new surgical procedures.
Virtual reality will help clinicians to experience healthcare from the patient’s perspective, which could transform care quality.
The relationship between artificial intelligence, clinicians and patients
Artificial intelligence will redefine the role of clinicians and strip them of their monopoly of knowledge.
Combining mobile technology with automated diagnosis offers the prospect of universally accessible and affordable healthcare, by reducing dependence on scarce and expensive clinicians.
Clinicians risk losing the ability to work independently of machines. Bu it will be a long time, if ever, before machines can match the intuition of humans in understanding the context of a patient’s life. The clinician’s skill will be to unite the diagnostic power of artificial intelligence with a human understanding of a patient’s life and expectations.
How healthcare systems should approach technological innovation
Mark Zuckerberg‘s approach to innovation of move fast and break things won’t work here; in healthcare the rule is move slow and don‘t kill people.
Teams need to develop creative approaches to understanding their patients, such as storyboarding people’s lives. Technology needs to be tested with clinicians as well as patients; products that make the lives of staff harder will not work. Infrastructure, such as Wi-Fi in care homes, is essential.
Focusing on the hardest to reach groups first – those with the greatest health and digital inequalities – will deliver the greatest benefits.
Innovators need to be sure they are trying to answer the right question. Senior leaders often have a poor understanding of technology and its potential, so they need to be educated about its importance to patients’ lives. The NHS and its staff have a duty to inform the tech market, such as highlighting apps with a good evidence base, but should not seek to control it.
Innovation will be slow and success may be limited because tech is being grafted on to poor systems that are resistant to change. Dogged determination to execute is essential – vision is not enough.
Read the full write-up from DigitalHealth.London/collaborate – Why tomorrow’s patient needs a digital NHS, here
Check out DigitalHealth.London/collaborate’s Storify