Review by: John Cruickshank, Partner
I have the pleasure of being a member of the scientific committee for the Kings Fund Digital Congress www.kingsfund.org.uk/events/digital-health-and-care-congress-2017 . As such, I recently reviewed some 40 abstract submissions to evaluate which should be invited to present at the Congress this July.
The portfolio of submissions provides an interesting proxy for the state of digital health in today’s NHS, both from the perspectives of what was covered and also what was not covered.
First, what was covered. I was impressed most by innovation in the following areas:
- Shared care records – their increasing importance to support integrated care is widely recognised. What particularly impressed me from the submissions were those specifically aligned to new ways of working and organisational models flowing from the NHS 5 Year Forward View https://www.england.nhs.uk/ourwork/futurenhs/, and those oriented to addressing known bottlenecks in the system.
- Big data – there were interesting examples in both primary and secondary care, driving improvements in treatment and productivity through access to open data sets.
- Mental health – we know that this is such an important priority to improve services with limited resources. Example solutions included those for eLearning and cognitive behavioural therapy both for clinical professionals and patients, but also impacted families and related professionals (e.g. teachers)
- Acute productivity – an ever-present ambition for hospital systems. I particularly liked the idea of trackers to optimise patient flow within hospitals.
- Virtual clinics – to relieve bottlenecks in access to services. Examples I liked included the evaluation of their effectiveness in both primary care and in specific acute service areas.
- Apps – the explosion of health apps is both an opportunity and challenge to the NHS. I was impressed by clinically-validated apps prescribed by doctors, that both benefit the patient and provide valuable feedback to the clinician on behavioural compliance.
What was not being addressed?
As a practice, our Partnership specialises in investment decision support and business case development. So I was slightly surprised in the lack of robust evidence to demonstrate the effectiveness of these innovations. Too often I found the benefits quoted were theoretical or based on small sample sizes. Perhaps, as a result, I wasn’t clear that the best-in-class innovations were being scaled up and replicated. My sense was that too many still exist in pockets and are not being adopted more widely. Does the ‘not invented here’ syndrome regrettably still prevail around the NHS?
Moving on, innovations to drive change in patient behaviours were somewhat lacking, which surprised me in that several of our Partners (including myself) are closely involved as advisers or leaders of consumer health technology organisations. I had the prevailing sense that the NHS system still aspired to ‘do things’ to patients, rather than patients embracing the digital paradigm to care for themselves better. Furthermore, I did not observe much around the integration of wearables into solutions or the uptake of telehealth solutions for remote monitoring of patients with long term conditions (whatever became of the 3 million lives and then the TECS initiatives?).
Overall, I was impressed by the generally high quality and the breadth of innovations submitted, and contributors’ enthusiasm to show case them at the Congress. I am looking forward to the event itself and hope to hear of commitment to these innovations from within local Sustainability & Transformation Programmes.
 Caveat – the submissions are of course the IPR of the authors and so I am restricted by confidentiality in their disclosure