Recent innovations in digital technology are transforming our lives, from the way we bank, to how we shop, yet it still has to make major inroads into how we plan and deliver our healthcare. Even at the most basic level, electronic medical records are still not a part of routine care and the use of digitally enabled tools for diagnosis, treatment, and healthcare management remains in its infancy.
As the National Audit Office for Digital transformation in the NHS point out, digital innovation can be a huge challenge. For many practitioners embracing digital technology can feel overwhelming, resulting in a reluctance to engage with the change process. It requires a willingness to let go of outdated processes, at the very same time that resources are stretched to the limit in the fight against COVID-19.
Some of the many benefits that digital technology provides include improved workflows, more efficient use of clinical time and greater ease of access. Use of remote consultations, artificial intelligence enabled devices, and blockchain electronic records are just a few examples of the digital transformation that is reshaping how data is shared and care optimised.
Historical reticence
Historically the process of change in the NHS has been slow and cumbersome compared with industry and the private sector. Poor past experiences such as failed IT programs have added to the general reluctance to embrace digital transformation. Taking a ‘one size fits all’ approach driven by top-down leadership can also cause resistance amongst consultants who often prefer to remain autonomous in their practice. Added to this, although there are pockets of expertise within the NHS, the level of knowledge about digital healthcare remains very poor overall. In fact, in a recent survey, only seven per cent of UK healthcare and pharmaceutical companies said they had gone digital, compared to 15 per cent of companies in other industries.
Change can be challenging
For many years now the potential of digital health care services have been discussed with little real change on the ground, yet with the advent of COVID-19 digital technology is suddenly being seen in a new light as face to face appointments need to be avoided wherever possible.
This requires large-scale process and behavioural change, as well as substantial financial investment in IT systems. Taken together these requirements mean that digital transformation is inherently difficult. It’s a process of transformation that is further complicated by major challenges such as outdated IT systems, complex governance arrangements, existing commercial arrangements with technology suppliers and the very nature of healthcare information itself. According to government guidelines, 2020 was the year the NHS was supposed to be paper-free, yet this long-heralded digital transformation hasn’t happened, with 94 per cent of NHS trusts still using handwritten paper records as recently as two years ago.
Data analysis tools
This is just the beginning of a whole new era of medical care where personal data becomes the foundation of personalised treatments and preventative care. The more data that can be collected and analysed, the clearer and more accurate the clinical picture will be.
In terms of the overall picture, big data can provide some important benefits, for example:
Lower rates of medication errors
Facilitating preventative care
More accurate staffing levels
Patient data from smart-watches, mobiles and tablets which can be stored in the cloud
Using AI to improve efficiency
AI or artificial intelligence can potentially add significant benefits to traditional models of healthcare but it also raises some big concerns. For example, the use of AI has raised many questions about medical ethics and whether it’s reliable enough to make decisions about a patient’s health without the backup support of a medical consultant.
Another example of AI in practice is the use of chatbots and virtual health assistants. Chatbots can fill a multitude of roles from customer service representatives to diagnostic tools and even as therapists, but their greatest value is undoubtedly in areas such as precision medicine, medical imaging, drug discovery and genomics. It’s an area of medical innovation that’s being closely watched by investors, with the global healthcare chatbots market likely to double in value by 2023.
Blockchain
Although a relatively new concept in healthcare management, blockchain enables data to be stored securely in a way that cannot be altered, which means it has a vitally important role to play in keeping electronic health records accurate and safe. It’s already proving to be an effective tool in preventing data breaches, improving the accuracy of medical records, and cutting costs. Not only are medical records 100% accurate, but they are also harder to hack.
From physical to digital
Transiting towards a predominantly digital system of healthcare certainly has its challenges, yet the potential payoff is immense. Members of the multidisciplinary team can come together via virtual meetings, offer support to colleagues in outreach clinics, provide peer supervision as well as easy access to continuous professional development. Perhaps of greatest value at this current time of stress within the NHS is the use of remote technology to improve team dynamics and morale.
With innovations in the field of digital technology coming onto the market all the time, patients can look forward to better treatment with virtual reality tools, wearable medical devices, video consultations, and 5G mobile technology. Doctors and nurse practitioners can also improve their efficiency with streamlined workflows created by AI-powered systems.
Even though these benefits are undeniable, many practitioners remain cautious, even reluctant to embrace change, creating a division of opinion, which it could be argued is an inevitable part of the change process. For example, it’s been suggested that remote consultations lose valuable information such as being able to fully observe a patient’s body language, yet it could also be argued that video calls can present new and valuable visual information such as insight into the patient’s home environment.
Change is a process and a key element of successful change management is allowing time for all team members to adapt and integrate the new learning that comes with innovation. Yet currently, due to the pressures of the COVID-19 pandemic the speed at which change is happening means that some services have been set up on shaky ground, without proper integration with existing pathways, processes, or working practices.
Future visioning
A recent King’s Fund article suggests that digital consultations aren’t perfect and terms like ‘digital-first’ and ‘remote by default’ can over-simplify digital transformation. In other words, whilst digital technology is important it should be considered alongside traditional care, not as a replacement. The COVID-19 pandemic has very obviously accelerated the pace of technological change transforming the landscape of health care delivery around the world and implementing digital technology at a pace that was previously thought impossible.
Successful innovation requires cultural and behavioral change. To make any transformation stick, staff need to feel empowered to adopt and champion new ways of working. To support this change, the cultural values that underpin the NHS and its workers must be understood, and technology must also reflect these values if successful integration is to be achieved.