Why 2020 was the year of digital health

In this article, Tom Russell, Programme Manager for Health and Social Care at techUK, explains why 2020 was the year of digital health... or was it?

Undoubtedly, the past year, by anyone’s standards, was not a normal one, and much has been made of the response to Covid-19 from across many sectors such as Education and Financial Services. Health has been an important outlier given how much Covid-19 has been affecting the way that health and social care services are delivered as well as the obvious strain that a global pandemic places on the people who work within it. It has been through a general ‘can-do’ attitude that much has been achieved, and as we have seen from the public’s enthusiastic adoption of digital services, once the genie is out of the box it is hard to go back.

Undoubtedly, the health and social care workers who have unreservedly put themselves in harm’s way have made a sacrifice that will be long remembered. The pandemic has also exposed inequalities within the system that continue to disproportionately harm those from ethnic minorities, as well as others who are digitally excluded for social, geographical, ethnic or economic reasons. Health technology has a role to play in helping to alleviate this fact, as well as ensuring that the decision-making processes are carried out with diversity and inclusion as a core component, rather than an afterthought.

Moreover, it has also exposed many of the systemic challenges that have held back the pace of digital transformation in the past, such as a fear of failure and a general risk aversion that stymies progress.

The successes
For the most part, digital health has been successful where organisations and individuals have taken steps to dissolve the structural and cultural barriers that have unduly held back the potential of health technology to make a meaningful difference in the way that care is delivered. The biggest changes this year have taken place in how the NHS and industry work together more effectively, across boundaries and in collaboration with each other.

Out of necessity, many clinicians and technologists have had to change their attitudes to digital health, such as through widespread adoption of video consultations. Indeed, 2020 has been the year when the roles of the Chief Clinical Information Officer (CCIO), Chief Information Officer (CIO) and Chief Nursing Information Officer (CNIO) have come to the fore and their critical importance has come to be recognised.

Although there are many such examples, one of the standout cases is the relaxation of the COPI notices that have allowed faster information sharing across the system, which has enabled clinicians to deliver care without the fear of prosecution for breaching information governance rules. What this has enabled is the bringing together of data and data sets to enable more advanced and useful insights from different parts of the system.

At the outset of the pandemic, it became clear that Covid-19 had created a surge of interest in the potential uses of technology across health and care, which led many suppliers to make offers of products and services to NHSX, NHS Digital and other local organisations. With the volume of offers available, the triaging and organisation became something of a challenge - enter Tech4CV19.
A team of James Norman (Dell CIO and techUK Health and Social Care Council member), Hassan Chaudhury (Department for International Trade) and Nicola Haywood-Alexander (Healthcare CIO) came together to form Tech4CV19, now a Community Interest Company (CIC).

The community helps to ‘match-make the health and care challenges with the technology offers to ensure we can work together to benefit all’ . They are supported by Highland Marketing, a specialist health tech PR and marketing agency who have helped to guide their communications work as well as provide the logistically support to get this sort of project off the ground. With 2020 in the rear-view mirror, this sort of community driven model has highlighted the best of a British response to the pandemic.

While regular face to face meetings have seemingly disappeared into memory, it is Microsoft Teams that has been adopted across the NHS since March 2020.  Used as a platform to enable collaboration and secure information sharing, reducing face-to-face contact, and maintaining social distancing. The solution has played a key role in ensuring the NHS can still care for its patients accordingly, with over 65 million messages exchanged on the platform by staff by October.

In the social care sphere, NHSX have been working with tech companies to roll out the deployment of iPads to enable the most vulnerable to maintain contact with their families. Facebook has provided up to 2,050 of its Portal video calling devices for free to hospitals, care homes and other settings including hospices, in-patient learning disability and autism units.

Before the start of the pandemic, NHSX had already been working with NHS Digital to improve access to the internet in care homes and had negotiated a range of connectivity offers to help staff in care homes and their residents to stay connected.  

Quoting Matthew Gould, the CEO of NHSX, who spoke at a recent techUK event; “although progress has been made this year, it was a bit in the spirit of a faster horse rather than in different vehicle”. This sentiment is one that is echoed by many parts of the system, as in many cases it was the wider adoption of existing technology and the refinement of current processes that made the difference rather than a hitherto unknown Deus ex machina-esque intervention.

The near misses
Through an exhausting nine-month sprint, the sheer volume of activity is likely to cause a degree of burn out as the system adjusts back to something closer to resembling normality. Continuous innovation and change tend to have a built in time limit before there is a readjustment and it is probably that there are a number of unseen costs coming down the line. Projects and initiatives are coming to the end of their free use period and plans to either sunset them or pay will come into play.

Looking ahead to 2021
In line with NHS England and Improvement’s plans for the future, digital transformation in 2021 will focus on the roll out of Shared Care Records across the country and the role of Integrated Care Systems (ICSs) as they move to a legal footing. This pivot to the local and regional as the primary place for transformation will reflect many of the changes that have taken place during this past year, as well as helping to put public need first when designing systems. Continuing digitisation of health will be accelerated and as services move to the Cloud the important of data utilisation, analytics and Robotic Process Automation will increase.

Furthermore, the move to remote working has also made the NHS and care workforce more flexible, and allowed industry to operate with clients remotely, which is a change that will be tough to unpick. Remote ‘go-lives’ of electronic patient records have been successful enough to make an argument for that to be the default in the future.

Ultimately, the key to the success of digital health in the future will be embedding the positive, can-do attitude that was established in 2020. As people have become more confident in their ability to adapt at pace, this confidence will ensure the hard work and success continue.

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