Improving digital services in health care

As I awaited with eager anticipation for the second day of the Digital Health and Care Conference in Edinburgh to see digital innovation and progression in the Scottish Health Sector, a sobering thought from one of the speakers on the first day came to mind.

Whilst many retail and banking sectors have embraced complete digital transformation in their operating models, I’m sure you’ll agree that many areas of the health sector lag behind. Indeed, according to the Department of Health only 2% of current interactions are digital.

Person-centred interaction will always be at the heart of health and care, but that interaction can be better informed, more efficient and better organised , if supported by data and technology? To clarify my point I wanted to provide some examples:

  • GP Referral to Treatment (RTT) – whilst we are progressing in providing information available to the patient, why is it still difficult to provide information to the citizen regarding all the critical points in their pathway? As a patient, the only information one currently obtains is by telephoning the appropriate Health Board, contacting your GP to get them to do it, or receiving one of the paper-based letters to tell you that you’re ready to be seen by the Consultant in XX weeks time.
  • Booking an appointment – online access to GP appointments is available, but if you’ve ever gone through the process with your GP practice (at least in Scotland) it is overly complex and convoluted. I consider myself to be IT literate, but this process doesn’t seem to have the most important person in mind – the citizen. In effect, this has made little impact on a citizen’s day-to-day experience with their practice and the business model within it.

At the risk of sounding obvious, these two examples – of which there are many more – cry out for a rethink of the way the citizen interacts with services. Do we ask how a user wants to interact with the RTT process? Well, here’s an example in point. One of my family members is going for a hip replacement sometime soon. I want to emphasise ‘soon’, as they don’t actually know when. I’m sure the medical speciality know, so why can’t we provide this information to the user who wants to know to be able to plan their life effectively? Indeed, can we take learning from other sectors e.g. retail where the user is able to track the progress of their product from purchase to receipt. Why can’t we make this possible for the above example…? And I’ve not even considered the potential financial savings.

How do you get into the hearts and minds of the citizen?

The challenge that most commercial organisations had when the digital revolution started was that they created brilliant online presences which nobody used. Picture technological tumbleweed… So, commercial organisations incentivised customers to use the online functionality by offering discounts, online-only tariffs, faster fulfilment, flexibility etc. But how does this transpose itself to health care?

Looking to our Nordic neighbours, Daniel Forslund, Commissioner for Innovation and eHealth, Stockholm County Council conveyed it so well during the conference. Digital has to become the new norm. However, in order to do so, we need to incentivise citizens to use these services. This means providing digital services that the public want to use, as  and when it becomes beneficial.

Using the GP appointments example above, citizens choosing to use digital services could be given preferential appointment times – i.e., most early session appointments could be reserved for online bookings, whilst still maintaining slots for other methods of booking later in the day. These early morning sessions could also be available to book using SMS facilities from the citizen’s mobile phone.

As many of the key speakers at the Conference mentioned, digital transformation doesn’t have to be difficult, but we have to focus on the value it brings to the citizen – what information do we expect, how do we want to interact, etc?

Using service redesign techniques with the focus on putting the citizen first will enable us to deliver transformational services. It’s been done in so many areas already, so why don’t we do more for our ‘Health Consumers’? Indeed, one of the delegates argued that it’s about applying good practice that already exists in other sectors and transforming its use to new areas. Whilst I agree partly with this, I don’t think a ‘one size fits all approach’ can be taken – what happens when good practice doesn’t exist for a similar service? For me, and it sounds obvious, driving the input from service users is the key to transformational change in the way citizens interact with Health, designed by the user for the user.

Interested in hearing more about our approach to transforming customer journeys through service redesign? Leave a reply below, or contact me by email.

The use of technology to improve health care outcomes

Knowledge, it is said, is power. The advent of wearable health monitoring devices is being seen as an enabler to promote healthy outcomes through the use of technology. Giving one the ability to track a diverse range of health indicators from sleep patterns and calorie monitoring has meant we now are capable of having real-time personal monitoring tools that potentially could improve our health and well-being outcomes.

However, unlike the next consumer gimmick, these devices are already beginning to have an impact on the health sector, with the ability to disrupt the traditional reactive patient treatment health care model. Recent studies show that the use of healthcare apps for Apple devices is growing more than 80% faster than the apps in the entire mobile industry.

But that’s not all…the use of these devices and the data harnessed by them has the potential to reach out and revolutionise patient care, to a much greater audience than those who want solely to measure their day-to-day exercise progress or calorie intake. Numerous examples are out there, but there are a couple that I want to share with you:

  • Accessing a patient’s electronic health record and broadcasting it to Google Glass, for example, allows a clinician to view patient data, including lab data and vital signs without the need to divert away to a computer
  • Linking a patient’s personal health data recorded on a wearable device to an electronic patient record (epr) in a clinic/hospital setting. Apple is working with a number of suppliers, towards transferring data between Apple’s Health Kit platform and the epr. Medical professionals could use the ‘right data’ to detect patient warning signs more easily and prevent diseases and complications before they worsen rather than reacting to them after they occur
  • Intel’s funded partnership with the Michael J Fox Foundation to research into improving the monitoring of Parkinson’s disease. Through the use of wearable technology, patient data is collected to measure symptoms and track the disease’s progression. Data collected from patients, for example, following a new therapy routine or taking new medication and the effects this has on movement frequency may lead to further insights into the disease

Whilst wearable device technology is attracting much interest in the health sector, it’s important that we do not lose sight that technology alone will not solve the sector’s problems – I have seen this many times where today’s tech becomes tomorrow’s doorstop.

The sector needs to look at ways to ensure that through the use of technology, society at large will benefit (…and assuming regulatory issues, buy-in from heath care professionals and personal privacy concerns amongst others can be resolved – but that’s for another blog!).

There needs to be a clear focus on the “meaningful” data to be targeted to improve specific health outcomes, otherwise the market will remain dominated by fad and noise and more big data. Technology should be aligned to areas e.g. chronic illness such as diabetes, or epilepsy where it can help shift from a reactionary care model to predictive and preventive care, leading potentially to a reduction in patient visits to surgeries/hospitals. This may in turn aid to the reduction in long term patient health costs.

Finally, it’s worth noting that at a recent conference I attended one of the speakers outlined that just under 2% of Scotland’s population account for approximately 50% of health expenditure; many of these will be chronic patients for whom these technologies may benefit greatly.

What do you think? Leave a reply below or contact me by email.