Advancing digital health – all about technology or does change begin with us? | Nicky Runeckles

Nicky Runeckles

All of us have a part to play in realising the huge potential digital has to offer healthcare, says Nicky Runeckles.

How is it that in this digitally enabled world, healthcare has been left behind and is still struggling to catch up?

Having spent most of my career in traditional, hospital-based, mental health services, I have been privileged to spend the last four years immersed in the digital health world, meeting entrepreneurs, technologists, disruptors, and those with imagination and the drive to create what they imagined. I have had my eyes well and truly opened to the power of technology to put the person at the centre of their own care. 

At last year’s NHS Confederation annual conference, I was asked to talk about ‘tomorrow’s world’ in healthcare. I described a day when we access health services as and when we need them, from where we are, as part of a community and empowered on our health journey. Basically, just as we currently bank, shop, travel and live the rest of our lives, where digital transformation has already taken place. Given the numerous successful digital innovations and solutions that already exist, it’s difficult to understand why we are not yet closer to this in healthcare.

Roz Davies similarly asked in her NHS Voices blog in January, how has the adoption of digital health still not reached its tipping point, despite the growth in digital health solutions? 

Of course the reasons for this are many and complex. The Accelerated Access Review, chaired by Minister for Life Sciences, George Freeman, is currently looking at the drivers and the barriers to rapid access to innovation and health technology in the UK. The interim report sets out five propositions that are currently being developed into a framework and final recommendations, which are due out imminently. 

I worry that we focus too much on the technology itself when, in reality, technology is simply the enabler. Making progress in the digital health space is about people and about the change process. 

Each one of us has our part to play in realising the huge potential that digital has to offer healthcare. This is no longer the realm of the digital innovators and entrepreneurs; many of the solutions have already been created. Whether we are the innovators or the digital service users, it’s now about how we all embrace the change necessary for these solutions to maximise their potential.

I have recently completed the School for Health and Care Radicals [archived content] (#SHCR) five-week virtual learning programme and was reminded of the transtheoretical model of change (Prochaska, DiClemente and Norcross (1992)). It struck me how relevant this model is in digital health adoption. The cycle goes:

  • Pre-contemplation (we have no recognition of the need or interest in changing)
  • Contemplation (we are thinking about changing)
  • Preparation (we are planning for change)
  • Action (we are adopting new habits)
  • Maintenance (ongoing practice of new behaviour)
Maybe it is time for some personal reflection? Where do we currently sit in this model? Are we at stage one, with our heads in the sand and no interest in changing our current practices or feel threatened by the prospect? Are we at stage four - fully embracing everything digital has to offer, implementing new solutions and adopting new habits?

According to this model, we can only move one step at a time. So it’s worth remembering that if we, or those around us, are currently at stage one, it is not possible to jump straight to the action stage and implement a new technology solution, whatever extrinsic motivation or incentive is placed upon us.

So, for anyone still skeptical about the place for innovation and technology in health, I would recommend taking a look at The internet of healthy things by Joseph Kvedar.

For those who are already convinced, that’s fabulous! We don’t need to wait for the output of the Accelerated Access Review though (as constructive as it will hopefully be). We can all take steps today given our role and where we currently sit on the model of change. There are innovations and digital health solutions aplenty in the UK right now. As writer William Gibson says: “The future is already here – it’s just not very evenly distributed.”

Let’s each play our part to distribute that future more evenly today. Change is needed to accelerate adoption of digital healthcare and as I recently learned at school - change begins with us!

Nicky Runeckles works freelance in digital health and mental health as founding director of Monticola Consulting Ltd. 

You can find Nicky and Monticola Consulting on Twitter: @nickyruneckles and Linkedin: /nickyruneckles  

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