Here, Andrew Gardner discusses what is really going on under the surface of the NHS digital revolution and what further needs to happen
In the last year, there have been several moves by NHS England towards increasing the provision of digital health services. It comes amidst pressure on budgets and services, with the NHS now looking for ways to both save money and continue providing high-quality services for patients. With healthcare one of the last sectors to adopt technological change, it is far behind other industries.
The recent NHS 10-year plan and the 5-year GP contract signify a shift in policy thinking; how we can explore the possibilities that digital health has to offer, such as through digital triage and video GP consultations. I’ve worked in tech and digital healthcare for many years, now serving as CEO of Doctorlink, a digital health start-up working with the NHS. In my career, I’ve seen how digital and process transformation can benefit organisations significantly, improving quality and reducing cost at the same time, so this focus on digital has been a welcome change.
Of course, it is one thing to promise that digital health can improve the NHS, it’s another to deliver it. To achieve its goal, the NHS can learn a lot from how other countries have used digital innovations to improve healthcare. For example, Israel has become a world leader in storing health data. The Israeli government recently announced a $300 million initiative to build upon decades of progress in collating health data. The large grouping of anonymised data can be made available to medical institutions and academics, assisting researchers in developing new treatments and ascertain more accurate information, utilising machine learning algorithms to do so.
Furthermore, we can look to the exciting initiatives in Nordic countries like Finland, Iceland and Denmark to use data, telemedicine and triaging to improve access to healthcare.2 Denmark, for example, is using telemedicinal home monitoring and digital transformation to revolutionise the role of a patient in primary care. They have plans underway to use digital and telemedicine to improve primary care for COPD, type 2 diabetes, pregnancy monitoring and dementia support.
Applying innovations to improve primary care
We can use these examples for inspiration when solving problems in NHS primary care. General practice is the gateway into healthcare for so many. As a result, I would argue that primary care has the most urgent need for digital to make an impact due to the amount of people who need GP services. There is much to be done, not least assessing whether digital innovations can align with older NHS systems.
However, considering the following can be a start.
Digital triaging is an area that can really help. At present, GPs spend much of their time triaging patients to other healthcare professionals, whether it be hospital doctors, physios, mental health support or social care services. By implementing digital triaging, where patients can use algorithm-based tools to rule out certain conditions, patients are far more likely to be directed to the right place at the right time. With GPs doing less triaging, they will have more time to focus on the patients that they need to see.
I would argue that digital triaging is also critical to sustain the system as we see the demand for GP services rising at a time when there are increasingly not enough GPs to meet such demand. From my time at Doctorlink, I’ve seen how digital triaging really can help GP surgeries to ease pressure on resources and provide patients with the service that they need, whether that is within the GP surgery or not.
Another area where digital innovations can help is through video consultations, namely by making appointments more convenient and accessible for both patient and GP. For patients, their use can be greatly beneficial; reaching people in rural areas or socially isolated situations, allowing people to fit appointments around busy schedules, avoiding missing work and enabling use from abroad where healthcare access is much more difficult.
Flexibility around work also applies to the GP, with video consultations meaning that they can have the option to work from home and have more flexibility with the time slots that they provide. This is an exciting solution to the shortage in capacity. GPs living abroad but with UK registration will be a new source of capacity. Video consultations are not a catch-all solution, but they can supplement where appropriate whilst ensuring that cases most appropriate for face-to-face get that treatment.
Embracing digital tools can also make it easier for healthcare commissioners to access and analyse health data across numerous demographics, helping to identify the spread of certain health conditions. Equipped with these tools, doctors and health bodies will be better equipped to make diagnoses and anticipate trends in their practice areas. However, safety and data protection are also paramount. Safety is something I’ve prioritised in my role at Doctorlink, and I know it will be the first thing on the mind of any GP as they consider digital services.
Finally, whilst not traditionally considered when it comes to talking about digital health solutions, surgery management is also an area where technology can help. Many GPs and surgery staff are under immense time pressures and have wide-ranging administrative burdens. Digital solutions can assist with things like booking appointments and improving access to patient records, changes which may seem basic but can go a long way to helping relieve burdens.
Overcoming the barriers
For digital transformation to work, any path to NHS digitalisation needs to ensure that barriers are overcome. Key areas to consider are interoperability and patient adoption – it has to work, and it needs to earn and maintain patients’ trust so that they use it. In addition, it is vital that NHS Digital works with GPs to address any barriers or misperceptions. Behavioural change is just as vital as technological change when considering the move to digital. I’m confident that GPs who’ve already experienced the benefits of digital innovations can champion them to their colleagues but there is still some way to go and we are all on a journey together.
In summary, there has been an encouraging shift towards the benefits that digital can have in NHS primary care. There is still a way to go however and healthcare still falls behind other industries when it comes to embracing the benefits of digital technology. Innovations such as digital triage, video consultations, online chats and digital surgery management would be best placed to advance positive transformation in the NHS, it’s a matter of ensuring that rollouts are smooth, effective and considered, ensuring that barriers are overcome, and all stakeholders can input in the change.
With this, the NHS can truly feel the benefits that digital technology can bring. Ultimately, using digital may be the only way to enable the evolution to truly integrated care systems and help join up the local services being provided to patients.
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