The Journal of mHealth Vol 1 Issue 3 (June 2014) - Page 27

The Value of Video in Modern Health and Social Care Solutions need to be able to talk to one another, system-to-system”. Changing the culture of care provision A long term proponent of digital and mobile health solutions, Dr Ali has spent nearly a decade advocating the need for institutional change in order to encourage the greater adoption and widescale deployment of digital and mobile health systems. He believes that there are a variety of barriers influencing the wider adoption of these technologies in the UK, but also that we are finally approaching a tipping point whereby the wider medical industry is beginning to understand that change must happen and that digital connected solutions are a critical component in this equation for change. “In terms of where the push or pull for greater use of digital and mobile health solutions is coming from, it is not from one individual source, but instead we are beginning to see a multi-faceted push towards the wider adoption of these solutions. This is coming from: Demand from patients – for these types of services; from industry providers; from doctors and care providers; and from government policy” states Dr Ali. Technology in the health sector can often be contentious, as it is perceived differently by various stakeholders. Developers and manufacturers of healthcare technology often view the solutions that they develop from a technical perspective that doesn't always translate into clinical benefit. One of the reasons for this is that technology is often grouped within the context of IT, something requiring extra training or knowledge aquisition in order to be used effectively. Because of this it is often viewed as a hindrance to care provision rather than as an enabler. Providers must therefore demonstrate the clinical compatibility of their solutions in order for them to be more widely accepted. ‘v-connect’ recognised the need to clearly define their product within a clinical context, and have taken significant steps to undertake 'cultural shift' within the way that they, as technologists, communicate the potential for their integrated video solution to healthcare professionals. Cultural change is a major obstacle and one which cannot be changed quickly or without full cooperation between all parts of the care-supply continuum. Resistance to change comes from the uncertainty that these solutions can have upon working practices, the impact on workloads, and the changes to the care provider - patient relationship are all concerns that need to be addressed in order to encourage clinicians and care commissioners to adopt digital health into primary methods of working. Resistance from staff was initially an issue for Sandwell Council. This reticence, however, was very quickly overcome when staff realised the capabilities of the technology to support and empower care recipients in new ways, which freed up human resources for more serious or difficult cases. Airedale NHS Trust also witnessed similar early sceptism from staff, particularly among clinicians, in relation to data security and compliance. Rebecca Malin from the Trust states that, “Once we had demonstrated to clinicians that we had implemented effective rules of governance, security and encryption, then the concerns were quickly overcome. Clinicians quickly recognised that these type of solutions deliver positive outcomes to their patients, and therefore represent an effective method of administering care. “Interestingly there was little or no reluctance from patients in terms of security, and in fact the adoption among patients has been extremely straight-forward.” “We did have initial concerns that by offering 24/7 access to care providers, that we would be flooded with incoming requests, which is why we started the service small. However, this has not been the case at all, instead patients seem content with the knowledge that the access is there should they need it”. Upstream cultural change in organisations is more problematic. The methods in place to commission services, and the tariff structures necessary to fiance them, are often poorly designed to cope with the commissioning of digital and technological solutions. In fact the way in which the current system operates in the UK, means that NHS managers are often Continued on page 26 The Journal of mHealth 25