Digital technologies and a paperless NHS are critical to improving both the quality and the efficiency of care delivery. And many of the digital technologies and projects that providers need to secure these improvements were set out in the Five Year Forward View and Paperless 2023 initiatives. Our experience tells us that none of this will happen without really good collaboration between IT and the clinicians who are going to have to use the new technology.
To collaborate successfully, all parties need a real understanding of why digital matters for healthcare. Our recent work developing a digital strategy for a major London teaching hospital underlined that IT is no longer just a service. The latest developments in digital healthcare are integral to the care patients receive. And it doesn’t stop there. The work we’ve done in developing Local Digital Roadmaps shows that IT will facilitate healthcare transformation. Healthcare IT teams have the capability to design and build products that would cater to the needs of clinicians. But IT teams have to think holistically about IT delivery. They need to think across a number of organisations in wide geographies and across patient pathways and they need to have a good understanding of the sometimes complex business needs.
It may seem obvious, but it’s worth highlighting that the best way to make this work is for IT and the clinical business to talk to each other. They need open channels of communication – clinicians must have the opportunity to voice clinical business needs – because they have a common purpose: delivering the best care to patients.
It’s clear the clinical workforce is getting more digitally savvy. Clinicians have perceptions and expectations of digital technology from the devices they use in their personal lives, but that doesn’t mean they’ll understand the implications of introducing different technologies. They’ll also be expected to find substantial time savings from the new technologies so will have a view on how realistic this is.
To ensure clinicians drive change, these tech-savvy clinicians must be engaged and empowered, and the clinical workforce needs to become more digitally aware. One way to make sure this happens would be to take up the Wachter review’s suggestion of creating a Chief Clinical Information Officer role who could champion digital from a clinical perspective.
Understanding the degree of business change
There’s no point in providing new technology if clinical users don’t know how to use it. So there’s a real need to provide the right level of learning and development support. And none of this can be done without addressing concerns around patient safety and quality and the pace of change. Front line clinicians who will have to change their practice and know what the challenges are will have to help evaluate potential pitfalls and risks.
We’ve learned from the implementation of large scale digital change in health organisations in the USA that there’s a real impact on productivity during the transformation. Productivity may be limited in the short term as new systems are deployed and new ways of working are being established. Technologists and clinical users alike need to be clear on the true timescale of this effect, and the degree of change involved when beginning a transformation.
Learning from others
Another challenge is the real variation in the digital maturity of NHS organisations. The global digital exemplar programme is trying to address this disparity. It allows NHS providers who deliver efficient and good quality care using digital technology and information to share their experiences with other trusts. In the first instance this will be through pairing with ‘fast followers’ – the hospitals and mental health organisations seen as digital pioneers. This is good but the variability in the quality and capacity of digital infrastructure may limit the pace and scale of transformation.
The future of digital health
Putting clinicians at the centre of digital may only be the start. We could see a future where digital health technology will be owned and driven by the patient rather than the clinician. Technologies such as artificial intelligence and cognitive computing could create proactive rather than reactive care. So, for example, wearable technology could monitor specific health indicators that would alert patients to the need to take medication or rest – preventing a problem and a trip to the doctor’s. That means clinicians need to join the debate now and orient themselves around their ‘customers’ – eg patients. Doing so will help them ensure digital healthcare technology is developed to best meet these patients’ evolving needs