A key question in our increasingly technological world is how can we really help people to have a better quality of life by maximising their health and care outcomes in a digital society?
- Health and care should be citizen centric, irrespective of where the apparent funding is sourced from or who the responsible organisation is for delivering the provision
- Use of citizen data should be consented and all related processes should be transparent with explicit feedback at all points. Trust is key and will ultimately be maintained by those organisations that are able to manage the tension between broad based consent and transparency of the use of data within their processes
- Digital is not about technology but about ubiquity of scale and access delivering near nil incremental cost with the following features
- disaggregation of existing value chains, removing costs and increasing speed of adoption and collaboration
- accelerated, targeted communications with enhanced feedback loops across the community
- easy to adopt workflow processes with no training requirement
The “So What” could be:
- Citizen adoption, facilitated by early adopter clinicians and funders, is likely to continue to be ahead of regulators and policy makers and such tolerance should be designed for within the system. At the margins, there is likely to be sufficient overlap between early adopter citizens, funding providers and engaged clinicians to generate scale demand within the health and care environment
- The fear of failure will probably continue to dominate large institutional providers but citizen tolerance of failure through adoption of self-selected services, underpinned through digital technologies and data analytics, may mitigate this tendency in the longer term. One option to build long-term trust would be to enable near missed reporting in the same way as airline and other industries.
- Evidenced based successes will likely ultimately crowd out the current eminence models of health and care, which should improve the pace of adoption of success and call out less effective models
- There could well be an emergence of a small number of citizen centric healthcare providers that own no hospitals, employ no clinicians, undertake any research but who have huge influence on the provision and use of resources. The risk is that (like Uber, Airbnb, etc) these services would sit in a grey world outside existing regulatory and policy maker reach and continue to scale with citizen satisfaction that enhances their relative political power
- Understanding how these might emerge from an organisational perspective is likely to relate to what are the key points that underpin some existing successes
- The trust covenant is the core glue that binds all parties together
- A compelling need (patient safety, budgetary problems, wider access, etc)
- A core group of leaders
- An ability to align with or circumvent perceived beliefs
In summary, digital technologies have the potential to be a disruptive and ultimately liberating force for good from a citizen perspective in the delivery of health and wellbeing. However, there are likely to be numerous false dawns before the entrenched systems are changed beyond their current recognition.