Digital technology for patients and staff in primary care is one of the brightest hopes on the NHS horizon – but the impact of this new digital capability is far from certain.
That’s the conclusion of a new report today from the Nuffield Trust.
The report’s authors set out to examine the impact of digital technology for patients - that is, computer-based information systems such as those used on PCs and smartphones - in primary care on both the NHS and patients themselves. (Medical technologies for use by doctors, such as devices to assist in performing surgery, were not included in the research).
The authors point out that whereas digital technology is transforming almost all areas of our lives – enabling us to order shopping online or book airline tickets, for example – its use in the NHS is still limited. They explore the evidence to date from seven types of technology for patients in primary care, including online triage programmes such as symptom-checkers, so-called ‘wearable technology’ like Fitbits, online GP appointment booking, video consultations, and health-related apps.
Technologies that patients can use offer some of the brightest hopes on the NHS horizon. Digital tools that help people stay healthy and manage their conditions at home will be critical to the future of the health service. The good news is that this is increasingly becoming a reality in the NHS. But this technology could be a double edged sword, and there’s still a lot we don’t know. Without regulation and a careful look at the evidence – not all of which is compelling – these digital tools could compromise the quality of care and disrupt the way care is provided.
Sophie Castle-Clarke, report author
The report concludes that digital tools are already transforming people’s experience of care, and in particular helping patients manage chronic conditions such as diabetes or asthma. That in turn has the potential in the long term, the authors say, to reduce demand on stretched NHS services. But they warn that there are pitfalls too in introducing such technology into the health service.
Firstly, some of the 165,000 health apps on the market have not been properly assessed yet, and of those that have, some have been shown to be inaccurate or ineffective. The app evaluation programme currently in development by organisations including NHS Digital and NICE will enable GPs to prescribe evidence-based apps in the future – although these will make up only a fraction of apps on the market. The authors point out that the lack of evidence around the effectiveness of apps extends to other technologies too, like online triage systems.
Secondly, the report points out that supporting patients to use the technology can be difficult. Patients often lose interest in consumer devices like apps and wearables, complex log-in processes to view records or book appointments can be off-putting and some do not trust new technology. With 12.6 million people in the UK currently lacking basic digital skills, the NHS will also need to take great care to guard against the ‘digital exclusion’ of some patients.
Thirdly, to encourage patients to use technology more, NHS staff need to work differently. For example, patients are likely to get greater benefit from accessing their online records if they are shown how the information in the record can support self-care. Changing ways of working in this way will take time, and require a change in health service culture – the authors warn that the technology will not act as a ‘magic bullet’ for staff.
Furthermore, the authors warn policy-makers and politicians against assuming that this sort of technology – particularly for patients with long-term conditions – will produce big savings, at least in the short term.
Leader author Sophie Castle-Clarke, Fellow in Health Policy at the Nuffield Trust, said:
“Technologies that patients can use offer some of the brightest hopes on the NHS horizon. Digital tools that help people stay healthy and manage their conditions at home will be critical to the future of the health service. The good news is that this is increasingly becoming a reality in the NHS.
“But this technology could be a double edged sword, and there’s still a lot we don’t know. Without regulation and a careful look at the evidence – not all of which is compelling – these digital tools could compromise the quality of care and disrupt the way care is provided”.