Indra Joshi: What does the digital experience look like for patients at the moment?

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  • Posted:Thursday 23 May 2019


Indra Joshi, Digital Health and AI Clinical Lead, NHS England, explores the digitisation of services and the impact this has on patients. Speaking at our Digital health and care explained event in March, Indra discusses why patient experience should be at the heart of digital innovations in health and care.


I think it's important to understand why it's important to empower people. How many of you in this room have been ill and have turned to a device, to the internet? Not many people understand that actually, you don't have to pick up the phone to book an appointment to see somebody and actually you can do some of this stuff by yourself.

How do we empower people to actually understand and manage their care better? The idea is that you as the public have your own set of tools, your own set of devices and you can understand how to manage your health and care better by yourself with the support of the system if you need it. And overall it's about creating efficiency, we all like to create efficiency. But we all want better experience don't we?

We have national platforms, so these are things. These are things that you can use. And then we have toolkits and standards. And that's about understanding that those things can be trusted and trust in the digital world is fundamentally important. And then it's what we're doing to support local teams and regional teams to actually enable that.

These are our programmes. We have a programme called 111; it's the national helpline, it's now online, that you can use. We're doing some local programmes as well on child health. It's really important from the very beginning to try and start that digital journey, as we say. Right from the start when you're a baby, all the way to when you're a grown up.

Everybody likes to have KPIs or 'what does success look like?' and for us it's being realistic and saying here's the data we've generated, here it is. People are using these services, they're in the real world. But for us, empower the person and as I say, this is just one part of the whole digital transformation portfolio. Patients are key, patients are key and at the centre of what we do. We have really good working groups with them, we work alongside them when we do our personas, we encourage them to tell us realistically what it is that they want from us.

Those of you who may be familiar, you know, it's a really weird world in digital health. You're all sitting there with your mobile phones and your iPads and your FitBits and your Apple Watches. How do you create that trust?

So I'm just going to go really briefly over some of the standards and tools we're doing to try and enable that trust, and enable the whole market to understand that there are standards in this place and it's not like, oh yeah I'm just going create an app that's really amazing but actually, it's not usable, it's text is so tiny, if you've got sight impediment, you can't see it, and actually there are things that you should consider that not everybody does.

We wrote a code of conduct. The idea is to say, it's a really confusing space. There's regulations, there's bodies that you've never even heard of and then there are things like, you know, ISO standards. So what we're trying to do in this document is just put some of them, not all of them because there are hundreds, but some of them that are important to health, in one place. We try to think of how to make the journey and the behaviours in this space quite important. People quite often like to develop something; is it what the user needs? What's the impact you're having? And especially, I know we're not talking about AI, but if you start talking about big uses of data that are doing a bit of machine learning that are ending up automating stuff, what impact is that then having, either on your workforce or the care pathway?

In the medical world we're all really good at what evidence we should be doing for drugs. We know it, we've trained in it. But in the digital health world, who knows? You know? There's this school of thought that RCTs, randomised control trials, this is the gold standard, but actually it might not be. So we work really closely with NICE with PHE, Public Health England, with MedCity and a lot of the accelerated programmes, Digital Health London being one of them, to come up with a set of standards and frameworks of what we thought, actually in the evidence world of digital technologies, what could you have?

Look and feel. For the NHS we're a brand, we're a brand that people trust. So actually, when you're designing something or you're creating a site or a product, you need to have that same kind of service design standard. So the guys at NHS Digital have been amazing in creating this really good manual, so I do encourage you to go and have a look at that. And then again if you're developing things, what are those KPIs? What are those standards? How do you link in to stuff? We've got the developer network to have a look at.

It's great to have programmes like this but actually, what are we trying to create? We're trying to create an ecosystem where you have standards, where you know something is working well, where you then have platforms or products that you can go and access and then how you actually integrate that into the system, so at the frontline and within a care pathway, it makes sense.