Liz Ashall-Payne, Founding CEO of ORCHA, the Organisation for the Review of Care and Health Apps and Head of the new ORCHA Digital Training Academy, discusses why we must support frontline health workers with world-class digital health training
Two years ago, a colleague of mine watched the matron of a busy hospital ward in London switch on her computer. It took ten minutes for the machine to whirr into life.
PCs should be more responsive now, following a huge rollout of Microsoft 365 across the NHS in England during the pandemic, but the scene still resonates. It distils the reality for many in front line healthcare. Time-poor staff are often frustrated rather than helped by tech, yet faced with the pressure to embrace new – and unfamiliar – technology in the form of digital health.
The barriers to the adoption of digital health are many. The average GP appointment is just eight minutes. In that short time, doctors have to assess, diagnose and prescribe. If they are to prescribe digital health options, it must be an easy process with which they are familiar. Added to this, there are infrastructure issues: digital health tools must be able to communicate with older tech, such as patient records.
Despite these challenges and more, digital health represents a massive resource for health services globally. In England, for example, a new ‘patient-initiated follow-up’ process will remove scheduled appointments for high volume, low complexity areas which could be exceptionally well supported by digital health. Key areas for this approach will include oncology, rheumatology, ENT and ophthalmology. We already know, from a recent report, that the oncology support app Vinehealth can increase patient survival rates by up to 20% simply by allowing patients to track their symptoms and medications effectively. Imagine the potential digital health can offer across all these areas combined.
Who is delivering digital solutions?
But we have to remember who is delivering digital solutions to patients. At the absolute heart of the digital health revolution are the doctors and nurses feeling the pressure on busy ward rounds and with growing waiting lists.
A recent survey by ORCHA found that whilst two-thirds of patients were willing to try digital health (and a staggering 87% were satisfied when they did), 21% were finding apps themselves. Doctors recommended apps in 17% of cases and nurses in just 2%.
A digital education needs to begin with student medics and be part of continuous professional development thereafter. And better still if digital education could begin in our schools, so that a new generation grows up familiar with this new approach to healthcare.
In research compiled by the European Health Parliament (2016, Digital Skills for Health Professionals), respondents saw education through training as the way forward. They commented that basic training should begin in schools, with compulsory refresher courses provided for each stage of education and clinical practice. Training — whether online or face- to-face — was welcomed by the survey participants.
Embracing digital training
Back in England, one example of a health provider which has embraced digital training is Our Dorset, a partnership of health and social care organisations. Faced with an ageing population and all the accompanying long-term conditions this brings, plus finite resources, the Integrated Care System established a digitally-enabled Dorset programme.
“At the absolute heart of the digital health revolution are the doctors and nurses feeling the pressure on busy ward rounds and with growing waiting lists.”
When a trial run of the programme with 20 nurses revealed the team didn’t know where or how to find good health apps, or who to ask for advice, the ICS team worked with digital health experts to set up a dedicated app library and once this was ready, the team ran a series of 30 onboarding sessions across all ICS providers and governance leads, including all non- clinical teams, including link workers, health coaches and social prescribers. Over two sessions, teams were briefed on the value proposition of health apps, how to find them in Dorset’s curated app library and how to recommend them. The result: an enthusiastic staff body, with thousands of apps downloaded and recommended.
The team at Dorset are a shining example of what investment in real people can achieve. And this will be helped by a new generation of roles (under NHS England’s Additional Roles Reimbursement Scheme) where digital literacy is inherent – social prescribers, wellbeing coaches, physician associates and first contact physiotherapists, to name a few.
I began my career as an NHS speech and language therapist. The pressures and frustrations experienced by staff today are those I was all too familiar with in my own clinics. Despite my passion for digital health, it is clear to me that we could have all the tech in the world, but unless our doctors, nurses, clinicians and carers understand its potential and are supported in how to use it, as they have been in Dorset, digital transformation will be held back.