Embracing a digital future for health

In September, The King’s Fund will hold its first International Digital Health and Care Congress. We speak to George Crooks OBE, Medical Director, NHS 24 and the Scottish Ambulance Service, and member of the scientific committee of the conference, about the potential for digital health to break through to the mainstream.

In which areas do you think digital health is already having an impact?

Digital health applications have been with us for many years and are having considerable positive impact in the service areas where they are already used. The challenge for us across Europe is to move from pockets of innovative practice to a position where digital health-supported services are regarded as’ business as usual’. 

In Scotland, a national video conferencing supported stroke thrombolysis service, allowing early diagnosis and treatment for patients in remote and rural locations, has been very successful. 

Web-based services have given people easy access to health information advice and support. These solutions are increasingly being used to make GP appointments, order prescriptions and even deliver e-consultations. Also, innovations that allow individuals to monitor their health and care at home are growing in popularity as a way not only to empower patients but to support their active participation in the management of their own long-term conditions. There is growing evidence that this type of monitoring for hypertension, cardiac failure and diabetes can improve outcomes – to support people to live longer and more fulfilled lives in their own home or in a community setting.

How do you think digital health can help us to meet the challenges faced by health providers?

One area where digital health solutions can play a significant part is demand and capacity management. The key issue here is not technology but safe and effective service redesign, which, if underpinned by appropriate ITC solutions, can create capacity within a health and care system by moving activity away from health and care professionals to the patient/service user or their informal carer network. There are some very good examples of this. However, the challenge is ensuring that before the service is deployed, plans are already in place to use the released capacity. If not, the risk is that capacity will simply disappear and the redesigned service will have wasted a key opportunity.

In which areas of health and social care do you think digital innovations could bring the most benefits?

Most benefit will come from the analysis of all the data generated by our current and future digital systems and processes. The field of health informatics and in particular information science will become increasingly important. However, currently in Europe and the United States there is a shortage of information scientists. This needs to be addressed now so that we can reap the future benefits. 

On a practical basis, innovation in terms of service redesign and technology will help to deliver a shift in the balance of care from hospital to community settings. We know this is what patients want but if planned and implemented effectively it may also help reduce costs and secure sustainable health and care services into the long term.

What sorts of developments will we hear about at the September conference and what do you think is on the horizon for digital health?

There is a general belief that the digital health ‘market’ is going to increase significantly over the next few years. Many people are talking about the opportunities that mobile digital technologies – from smart phones to tablets through to wearable devices and ‘smart’ pharmaceuticals – will bring. However, we need to understand more about which sections of the population will benefit most from digital health solutions, while at the same time continuing to research and refine the algorithms necessary to support them. I hope we’ll hear about all these areas. 

What sorts of barriers are there for the implementation of technological solutions? How can these barriers be overcome?

The key challenge being experienced by all health and care systems is how to move from small-scale pilots to at-scale deployments. The challenges are seldom with technology but are the same as those experienced by our forefathers when mechanisation was introduced into the mining and textile industries. The barriers are all about people and culture – so we need to focus on organisational change; patient and professional education and empowerment; and understanding the advantages that can be gained from using digital technologies. Understanding the barriers and focusing planning and design efforts on overcoming those will be key to success.

Our International Digital Health and Care Congress is on 10–12 September.