Strike while the iron is hot: why we need to go further on digital health

Digital tools are being used now more than ever in the health space as the world responds to the Covid-19 pandemic. Graham Kendall, the director of the Digital Healthcare Council, explores why there is much more to be done.

The Covid-19 pandemic has left the country and the world reeling, but the spotlight on digital health may, if we get it right, lead to profound long-term gains for our health services.

There is widespread recognition that healthcare technology is critically important to support the UK’s response to the virus, with the appetite for online consultations among clinicians and patients soaring.

Part of NHS England’s response, was to issue a tender for the immediate provision of online primary care consultation. The move aims to bring much needed capacity to deliver triaging and online consultation in general practice and primary care. The speed of this tender – the contract awarded just a week after it was issued – demonstrates what can be achieved quickly when minds are focused and decision making aligned.

The tender focused on general practice, which is understandable considering GPs are the first port-of-call for many patients. Yet, digital solutions are needed across all areas of healthcare.

Responding to Covid-19

Patient education and health coaching, triaging, mental health support, contact tracing, identifying high-risk groups and hotspots, robotics and workflow optimisation should all feature in our response to Covid-19.

Take, for example, the role of online pharmacies which have flourished in recent years. By combining expert online pharmacist consultations and offering medication delivery straight to patients’ homes, there are huge opportunities both to remove pressures from GPs and facilitate social distancing, particularly for the those in the highest risk groups.

We’ve only just begun to scratch the surface of that potential and it is notable that the growth in online pharmacy in the past few years has been almost entirely patient-led, rather than in response to commissioned services.

New lines of communication

As we move beyond last week’s tender process to implementation, we need to gear up to online working. Healthcare professionals must learn to communicate and work with patients in new ways.

This covers issues as diverse as what to do if a patient goes into distress midway through a remote consultation through to how to ensure confidentiality when a patient’s actions risk breaching their own privacy.

It’s clear that practices will face varied challenges. Some are already embracing and leading the digital healthcare revolution, but others will need support to upgrade their hardware, bandwidth and digital skill set.

This goes beyond each practice’s immediate capability – many patients also need help accessing digital consultations for the first time. This is why providing training, onboarding support and patient liaison is so important – especially as it is likely that many of the most digitally excluded communities will also be the worst affected by coronavirus.

This needs proper resourcing and it is exactly the sort of area where the mature players in the sector have invested so much attention to get right.

Of course, online consultations will never replace all face-to-face contact. Integration with in-person appointments and appropriate triaging to channel people to the right care first time is critical.

Global technology shortage

We also need to think about our digital response in the context of the shortage of global health technology expertise. The digital solutions we choose must deliver value to patients, clinicians and the public. To do that, they must be adequately funded. Everyone expects minimal margins, but if we squeeze so tight that we compromise the viability of the supply chain we need to remember that other countries are eager to offer more compelling propositions.

Similarly, cutting vital elements such as training and support may appear to generate quick cash savings, but risk creating an underutilised service. In the context of coronavirus, the opportunity cost of not fully utilising digital provision will be counted by increased infections.

The coronavirus pandemic has led to a revolution in public and professional opinion on the need for digital healthcare. As a society, we must make the most of this opportunity.

Like any revolution, there are risks, but we know from experience they are outweighed by the rewards.

Covid-19 has brought the immediate pressing need for digital healthcare into sharp relief. It’s never been more important to get it right, and we may well find that the shift to digital healthcare paves the way for the long-term improvements in NHS efficiency, patient access and wellbeing, leading to a stronger health service adapted to the 21st century.