Since the early 1990s the increase in digital capability has grown exponentially in our society, we now expect to interact with all manner of services digitally, indeed the government instructs public services to be 'digital by default'. We are without doubt out the other side of the Information Revolution and well into the Information Age, including in health and care.
Those of us who remember the early episodes of Star Trek, celebrating its 50th anniversary this year, recall how the crew communicated via wearable technology in the form of the badges on their tunics and how 'Bones' the medic, used a handheld device to assess the health status of patients in the field or in the Enterprise sick bay. That imagining of the future 50 years ago is now increasingly commonplace reality - digital communication between patient and healthcare professional: smartphones giving access to a wealth of health apps and even clinical interventions and services; wearables such as Apple Watch, the Microsoft Band, and the Fitbit encouraging healthier lifestyles; digital portable ECG machines, heart rate and other vital sign monitors enabling better management of chronic conditions.
Looking back over the last ten years it is interesting to consider the question: where has the most progress been made in applying digital technology to personal health? There are certainly many more easily accessible channels to access information, advice and services, in both the public and private health sectors available today than ten years ago. Online and telephone services such as NHS 111 provide a comprehensive and increasingly reliable 24/7 route to NHS services, directing people to the most appropriate services, information and support. The growth in private online services is now well established and growing apace. Development and delivery of interventions and treatment through digital channels has been particularly helpful to people living with mental health conditions where examples include the Big White Wall, and AXA PPP Health Tech & You Awards winner Psyomics, which support clinical trials for psychiatric treatment. The rise of the smartphone giving instant access to such services and innumerable other health and wellness Apps is arguably the biggest contributor to opening up these instant access channels to the population at large.
As digital channels have expanded people have increasingly taken the opportunity to join together in online communities, sharing knowledge and information and providing peer support. There are online communities for every aspect of health and wellbeing, as well as for common and rare conditions, such as the international community, Patients Like Me, which links people and families facing similar health challenges all over the world. Other examples abound: from key life stages, such as new mums getting support and advice from Mumsnet or Apps such as AXA PPP Health Tech & You finalist Baby Buddy; Apps that link people and their personal data together to share experience and even compete in physical challenges, such as the cycling App Strava; and geographically focused 'digital localities' providing online support systems for vulnerable groups, such as Sheffield Flourish, which coordinates and communicates support for people managing mental health conditions in that city's community.
This progress has underpinned an ever more knowledgeable population; people are becoming more informed about their health conditions, chronic and acute, and about how to stay healthy in the first place. There are clear signs of a shift in the relationship between individuals and their health care professionals. Patients now increasingly attend consultations having accessed their own records, using online services such as 2016 AXA PPP Health Tech & You Champion Award winner, Patients Know Best, researched online beforehand and prepared questions and considered treatment options available, to an extent unseen even ten years ago. When considering where and by whom to be treated, people now have instant access to information about the care providers available via both government sponsored information services such as NHS Choices and myriad independent sources. The consumer generation who demand ever more choice and flexibility from their services are increasingly seeking it from their health services, as illustrated by the politicians pressing for a 'truly 7 day service'; despite the culturally embedded reverence for the NHS that sometimes inhibits change, even for the better. As we look back over the past ten years or so, we can also see that there are some things have not progressed as anticipated, and consider why that is.
Back in the 1990s the government and the NHS were actively supporting the development of digitally enabled 'telehealth' and 'telecare' as a key factor in delivering more efficient and consistent services to patients and to shift health record keeping from paper to digital. The reality has been slow and patchy adoption by our health service providers, both public and private, and the evidence of value and benefits has been mixed. We need to understand and learn from this experience. Looking ahead, what is important is that we learn from our mistakes and build on success. As Newton understood, to advance human knowledge we need to look beyond the current horizon, and acknowledge the development of those who went before, as he remarked about his own achievements he was "standing on the shoulders of giants".
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