The Digital Health Revolution | What is digital health?

I recently had the opportunity to talk to a group of community clinicians about the advances in digital health. In preparing the content, I had made an assumption that the audience had prior knowledge of the national digital objectives. On the day it was quickly apparent that this was an error on my behalf. I discovered that at a conversational level the concepts and even the language I was using were unfamiliar to my colleagues. In my clinical practice, I have been very fortunate to experience the benefits of an electronic patient record system that is shared with primary care, mobile working and applications, provision of wifi, electronic pathology requests and a cloud based platform to share diagnostic results across the different healthcare sectors. These digital tools have brought much efficiency, access to better quality patient information and joy to my clinical practice. This experience led to me to reflect and question;

How do we do a better job at ensuring all of our clinical colleagues are a part of the digital health journey?

This blog series will introduce some of the key drivers behind the need to think differently about health. It will provide operational managers of health services and clinicians with information and advice on how to be more aware and involved in shaping the future of digital healthcare.

There are three parts and at the end will answer the following questions:

Part one: What is digital health?

Part two: Can digital health save the NHS?

Part three: How to get with the digital health programme?

 

What is digital health?

Digital health is a discipline that involves the use of information and communication technologies to help address the health problems and challenges faced by people. Digital health can be used as an umbrella term at times, so it is useful to further break it down into four key areas:

Digital Health

Examples

Telehealthcare

 

Telecare (Activity and fall monitoring and medication management)

 

Telehealth (Long term condition monitoring and video consultation)

 

mhealth

Wearables (health, wellness and activity measures and progressing to digitised medical devices)

 Applications (Medical apps, gamification, online resources, social media, wellness and fitness apps)

Electronic Health Systems

 

Patient record systems for urgent, acute, primary and community care

Diagnostics results and images, prescriptions

Health Analytics

 

Genomics

Prevention medicine

Data analytics

(Table source: London Health Tech Meet up Group, facilitated by Mr. Charles Lowe).

Paul Sonnier, a digital health social entrepreneur, likes to refer to digital health as the ‘convergence of the digital and genomic revolutions.’ Click here for a short video by Paul to help further explain. In the video he talks through how digital can be an empowering approach to health promotion, disease management and prevention.  

Here are some of my favourite local and international examples of the health and digital world coming together:

City University London’s Technology Enabled Care Studio click here.

Andiamo using 3D printing to deliver empathetic orthotic services click here

Mobile app Babylon providing virtual GP consultations click here.

The use of algorithms to map thought processes and facilitate upper limb movement for people living with quadriplegia click here.

Robotic use in surgery at Guy’s and St Thomas’ Foundation NHS Trust click here.

Virtual reality treating phantom limb pain click here.

The provision of digital health tools in my practice has ignited a powerful drive to adopt new approaches to use to ensure my clients get the best healthcare I can offer. However, I have experienced some considerable barriers to embracing digital health.  

Digital transformations: IT ‘project scope’ mentality of implement and move on, often does not provide adequate transitional nurturing. It takes time, resources and funds to digitally transform a clinical process and to then see the benefits.

Cultural change: Digital health challenges what we know and how we practice. Staff need support and strong leadership to change working behaviours.

Digital skills: We cannot assume that the adoption of technology in our personal lives is sufficient to drive the digital skill sets required in our professional lives. Staff need protected time and learning environments to master new digital health skills.

Disconnected populations: There is a digital divide in society that is influenced by cost and access to the internet and mobile devices. The telecommunication industry needs to be lobbied to provide more affordable options for people with health and disability needs in order to engage with digital health.

Proof of concept: Fundamental to healthcare is evidenced based practices. Digital solutions need documented proof to be robust, reliable, safe and effective to be implemented and ensure uptake.

Best fit tech: When it comes to ‘IT’ the health landscape have suffered from poor choices of hardware and system design for far too long. Collaboration with clinicians to co-design and develop is essential for digital health usability.

Clinical leadership: Nationally there are still too few clinical leaders in health IT and informatics. NHS Trusts need to invest in CCIO and digital clinical lead roles at a board, service and transformation project levels.

Scalability: The ‘start small and think big later’ approach to digital health implementation increases the risk of geographic or service ‘pockets of excellence.’ There needs to be greater continuity planning across the health and care sectors to strive for digital health equality.

Digital health is now an important part of my personal life. I use EMIS Patient Access to engage with my GP and primary care record. It gives me great confidence that I can access my own record whenever I may need to do so. I track my wellness on my apple health app. I set myself fitness goals using my Fitbit.  I use digital medicines such as a cognitive behavioural app to improve my sleep routine and online meditation and mindfulness programmes for my mental health.

If we are truly practicing from a client-centred paradigm, we should be very excited about the potential digital health has to not just deliver greater efficiency and join up care, but to give the people we work with much more control over their own health and wellbeing.

In part two of ‘The digital health revolution: Are you ready?’ I will question whether digital health can save the NHS. I will start by taking a look at the problems the NHS is currently facing, as I feel that this helps to put in context the uprising of digital health innovation. I will then share the top down governance and initiatives to demonstrate some of the objectives and timeframes we have to make digital changes to service provision. 

Melissa Andison

Occupational Therapist 

OTTech Healthcare Consultancy 

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