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Blog: Key barriers in digital transformation

Much has been made of the speed at which patient-facing technology has been deployed during the Covid-19 pandemic to support remote communication between people and their healthcare professionals, and to begin to create new models of care. Indeed, I haven’t seen a single health strategy globally that does not include digital technology as a key priority in building sustainable healthcare systems and harnessing health data to inform decision-making towards better outcomes.

There are pressing challenges that we must address if we are to achieve value from technology, that its benefits are equitably distributed and that unintended adverse consequences are avoided.

The proliferation of applications over the last few years has the feel of a Yukon Gold Rush. However, it reflects a very real desire for rapid innovation on the ground to respond to unmet need and operational pressures in healthcare systems.  Many of these applications are standalone. In other words they do not connect to other information systems in the local healthcare system. Interoperability with, for example, the electronic patient record is essential so that patient-inputted data is visible to all clinicians who need to receive it and that there is one version of the truth.

Multiple disconnected applications create a potential for problems with information governance, cybersecurity and clinical safety. It is vital that we can all have faith that our data is safely held and only seen by those who need to see it.

But the challenges of digital health transformation go far beyond the technical. What about us humans and our preferences, our experiences of care and our personal context? Digital transformation is not about digitising existing services and baking in old ways. It requires meticulous work and a deep understanding of the human condition, both from the perspective of those receiving care and the professionals that care for them. Investment is needed not just in the technology but in effective change management of care processes so that clinical teams and patients do not feel additional burden and feel that these tools are truly helpful.

Effective therapeutic interactions are relational. We must not dehumanise care and we must invest in supporting those who cannot or choose not to use digital technology in support of their care. Similarly, in our ‘Gold Rush’ enthusiasm for technology we must bear in mind what it is to navigate this landscape from the perspective of people seeking and receiving care. We must design our digital landscape like a town planner, easily navigable and with relevant landmarks clearly mapped. Ten separate apps on a smartphone does not achieve this.

The Digital Services for Patients and Public Programme in Wales is taking on the ambitious task of creating a better experience for patients and the wider population of Wales. It seeks to achieve that delicate balance between local innovation and national interoperability so that information is where it needs to be. Finally and importantly, it seeks to govern the ‘Gold Rush’ so that everyone can feel secure that digital health transformation is safe, secure and to be trusted.


By Dr Sally Lewis

Value in Health