What will it take for digital technology to finally fulfil its potential?

This was the question we recently asked Professor Robert Wachter, author of The Digital Doctor and chair of the 2016 Wachter Review of NHS digitisation. It’s a topic that’s central to the Health Foundation’s goal of supporting radical innovation and improvement in health and social care.

Bob Wachter certainly thinks that with the arrival of better data, health records and now generative AI, a tipping point has been reached in the use of technology in health and care. You can watch our recording of his presentation and read his blog in this newsletter. Our interview with Tara Donnelly also offers some interesting perspectives on the future of technology in the NHS and how things are already changing. 

And indeed, a lot is resting on this potential role of technology, including to help improve productivity, which was the topic of this month’s REAL Lecture with Professor Dame Diane Coyle. But, as our projections of future illness have shown, greater productivity by itself is not going to be enough to address the cost and workforce pressures facing our health and care system today and in the future. With one in five of us projected to be living with major illness by 2040, even the most dramatic efficiency improvements will only have a limited impact on reducing these pressures.

Transformation is needed

What we need is also a fundamental transformation in how care is delivered and experienced by patients – making good on longstanding policy objectives to strengthen preventive care and deliver more coordinated care in the community and people’s homes. 

In the past, attempts to do this have focused on top-down changes to structures and organisations, particularly in the NHS. Not enough attention has been paid to innovation and transformation expertise, as well as the capacity and incentives needed to help staff and service leaders make difficult, complex changes to their ways of working, processes and cultures. And we must involve patients and care recipients in a way that ensures they support these changes and benefit equitably. This will all need much faster testing, evaluating, and spreading of the innovations enabling such changes. 

New technologies, digital and indeed AI can be the enabler of such a transformation, but only if we genuinely focus on supporting the changes needed to make their implementation a success. While this is unlikely to be a vote winner for politicians on the doorstep, it should be the backbone of any government’s future vision for health and care.

What are we doing to help?

Drawing on nearly 20 years of learning about how to make change happen, at the Health Foundation we’re aiming to support the implementation of much more radical innovation and improvement in health and care, driven by new technologies. We’ll do this by providing insights and practical tools, such as our recently published resources setting out the evidence for improvement and equipping leaders to embed improvement approaches. 

We also want to help demonstrate what works, and so earlier this year we launched a new funding programme to help identify new approaches to care at home using technology. With our Improvement Analytics Unit, we also have work underway with NHS England to evaluate the roll-out of virtual wards, and elective surgical hubs. 

Through our investments in THIS Institute, the IMPACT Centre, and the Networked Data Lab we also help demonstrate better evidence generation, evaluation and spread of changes. Research and evaluation will also help us stay alert to the unintended consequences of introducing new technology, for example the increase in antibiotic prescribing associated with remote consultations. 

Of course, successful implementation is only possible if we understand the implications for working processes and cultures, and this month we published the first in a series of long reads about what tech and AI mean for the future of work in health care. 

Successful implementation also means understanding the attitudes and needs of people using services. The latest results of our regular survey of public and staff attitudes to technology show that there is a lot of appetite for solutions that complement how care is being delivered and support management at home, but less where it replaces human interaction. Any successful implementation needs to start by engaging with these views, particularly if we want to see a shift towards greater personalisation of care and self-management.

While these technologies have tremendous potential to improve people’s health, making sure the benefits are realised by everyone and that they are designed to reduce health inequalities, is crucial. This has been our focus over the past three years in a research and public engagement partnership with the Ada Lovelace Institute.  

Finally, the pace of developments in generative AI mean that we are also increasing our focus on its responsible and ethical use in health and care. Last month saw the publication of standards to ensure that AI tools are developed using adequately representative data, developed with funding from the Health Foundation and the NHS AI Lab. We are also building our international links in this area, including through a recent symposium with Harvard Medical School on responsible AI. 

We are committed to helping health and care staff, services and the people they support to benefit as much as possible from new technologies and AI, and to enable their successful implementation. It’s time to fulfil the potential of digital technology in health care.

Malte Gerhold (@Dr_Malte) is Director of Innovation & Improvement at the Health Foundation.

This content originally featured in our email newsletter, which explores perspectives and expert opinion on a different health or health care topic each month.