“Creating a more digital NHS has the potential to transform care for patients, save valuable time for staff and benefit the local economy”. This recent enthusiastic comment from one of digital healthcare’s most vocal advocates, Secretary of State for Health Jeremy Hunt, was made last month during a visit to GP software suppliers.
According to statistics, the global market for digital health was worth £23 billion in 2014 and is expected to almost double to £43 billion by 2018, with the UK market size expected to grow from £2 billion to £2.9 billion in the same time period. As digital health technology grows in popularity and usefulness, and public demands for more control over personal healthcare similarly gain momentum, will this be the year of digital health technology?
The rise of digital services projects
Following an explicit commitment to embrace the information revolution as detailed in the Five Year Forward View and supported by the National Information Board (NIB), a quick perusal of developments in the health service suggest ‘digital’ has become a core mantra heading into 2016. For example, NHS.UK Alpha launched at the end of 2015 with a mandate to explore and address digital delivery challenges facing the health and care system.
An encouraging early blog by Digital Services Manager Katherine Benjamin concluded that to improve uptake the digital offer must be better than the non-digital alternative and that ‘pretty digital things’ may be attractive, but the focus should remain on patient needs, and digital tools must be embedded within the wider care experience.
Echoing these sentiments, the NIB ended 2015 with a series of refined workstream roadmaps. These reports outl ine their strategies to improve digital services, including facilitating digital access to health and care information, access to social care ‘apps’ and supporting innovation and growth. Notably, the various roadmaps include details on various practical projects to be implemented. These include the NHS.UK platform, a single access point for citizens for information, advice and transactions, as well as an assessment framework for digital applications.
Earlier this month, NHS England launched DigitalHealth.London, a collaborative venture between MedCity and London’s three Academic Health Science Networks (AHSNs). According to the founding members, the new service is designed to ‘provide a single way in for digital health companies and entrepreneurs, and give them access to the best clinical advice to refine their products’. Focusing on crossing the divide between providers and clinicians, this effort to facilitate implementation could prove critical to advancing the digitisation of the health service.
Finally, the NIB also recently launched a review of computer systems across the NHS that will focus on assessing ‘where IT has worked well and those areas that need improving'. This will take place alongside the government’s new £4 billion strategy to improve the use of technology in the NHS, where funds will support diverse projects including a paperless NHS, transforming out-of-hospital care and medicines and digitising both social care and emergency care.
Persistent barriers to digital health in the NHS
As Roz Davies, the managing director of We Love Life and Recovery Enterprise concluded early this year, 2015 was not the monumental year for digital health that many had hoped it would be. While access to summary records, online prescription services and online appointment bookings became more common, there was still no significant or reliable means of online communication with clinicians and no real progress towards the more personalis ed management of conditions. Thus heading into 2016, the NHS had not changed significantly.
In reality, there are still undeniable barriers to overcome before the NHS can fully embrace digital health technologies. For example, beyond the restrictive funding gap and related emphasis on efficiency savings that will complicate any strategy to develop and implement new technologies and services, it has been suggested that there is a 'lingering distrust of private enterprise’. Both the Five Year Forward View and the NIB’s Personalised Health and Care 2020 reports barely mention the importance of accessing digital healthcare innovation from SMEs and each report only makes a passing reference to one company.
There are of course also the persistent challenges of data sharing, something the PHG Foundation has weighed in on, as well as navigating the NHS bureaucracy and modernising a culture built around clinician control and pharmaceutical treatment rather than patient control and personalised prevention. Finally, the NHS has to not only provide digital services and technologies, but also convince a doubtful population to trust and engage with these new products. Thus while recent developments are encouraging and the government does seem convinced of the value of digital health technology, it will be years before patients routinely see practical improvements to the way their care is provided and managed.