A Framework For Moving From Ideas And Pilots To Adoption At Scale

14 March 2022

The vision of the DHI highlights that “innovation in digital health and care will help the people of Scotland live longer, healthier lives and provide sustainable and inclusive growth for our economies.” How do you plan to transform this mission into solutions and outcomes?

In general, we are focused on supporting collaborations between different stakeholders to converge three types of innovations; technical, service and business innovation. Secondly, we demonstrate what possibilities digital health and care can bring to our partners service. We have many tools; one effective approach in the last few years has been our simulation environment where people can experience the “art of the possible” and opportunities of digital technologies with a real emphasis on how the data can move from the consumer world into statutory services.

So instead of reading academic papers on what chances digital health create, they can see its value and de-risk investments early in the innovation process. It includes targeted knowledge exchange, industry collaboration, simulation environment, co-design research activity – elements of our unique innovation process model. And we mean by that converging service, technical and business innovation, with the sole aim of making all partners ready for scale.

One of the biggest barriers when scaling digital health is with service innovation, in particular change management and skills. You have to make sure the service has the ability and appetite to change conditions for the innovation to be embedded and realized. Thus, our innovation process model includes digital skills and workforce development.

Another necessary element is building a robust evaluation for scale, which includes the financial resources. Most of the projects in other industries have to be preceded by the cost-benefits analysis. However, for digital health, cost savings often dominates the conversation. Therefore, before implementing digital health interventions, you should not only estimate the strengths and weaknesses of alternative interventions but also look at the best approaches to achieve savings while preserving costs.

To go back to your question about how we are going to meet our mission, we have several different support services to offer our partners together in clusters; projects that take people systematically through readiness levels to scale. We help them build evidence, co-design, uncover what demand and problem that they are trying to solve, and then test it in a real-world environment.

To wrap up, our goal is to shift the balance of care. In the traditional approach of the care continuum consisting of prevention, detection, treatment, post-event care, and independent living, currently in most health and care systems globally most of the resources are focussed in the middle of that continuum – mostly on treatment. We want to optimize it using digital health technologies in a way to place prevention and independent living in the centre of the system.

You have a great professional background, just to mention your experience in NHS24 and Institute for Future Cities. What are the lessons learned from both workplaces that help you drive digital transformation in healthcare?

In healthcare, similarly to the city environment, you have to think more about the whole system, not just one siloed part. When developing smart city strategies, there are many interconnected parts. And what underpins all of that is data. If you don’t have data infrastructure and don’t empower the system to use that data effectively, you will not get the impact. Another aspect is better connectivity; I mean quick, seamless data exchange in the way of infrastructure and better equitable connectivity like 5G.

But I would always emphasize it’s not about technology. It’s about applying those innovations to a real-world problem and trying to accelerate them to scale quickly within services. Unfortunately, there are still too many pilot technical projects that never scale up. Scaling enables the change to happen and the uptake of digital health to the mainstream, which I believe is now essential.

Can you please outline the approach to digital health in Scotland?

The recently updated digital health strategy prioritizes digital health to be embedded within the service, shift from the hospital environment to the community, and healthcare delivery at the place of living. On top of that is patient-centricity. There’s also been a big shift moving towards prevention and wellness. The priority is to make the system more intelligent, so everybody gets the required services when and where suits them best. I would call this approach “not just health but working across the system,” where all elements of health – social care, social security, environmental issues, behaviour – are addressed and embedded in the strategy.

In other words, on the top of the agenda is answering the questions: How to keep people healthy and wealthy for longer? How to keep people out of hospitals? How to enable them to do more self-management so they can respond to their evolving personal needs, share data with their  peer networks – which I call circles of care? All of which will lead to better outcomes, as one of our Scottish leaders stated in a recent presentation “Digital should be in service to better outcomes.”

Click here to read the recently published paper “Scaling Digital Health Innovation: Developing a New ‘Service Readiness Level’ Framework of Evidence.”

This interview for ICT&health was prepared in cooperation with the ECHAlliance – Global Health Connector for Digital Health, facilitating multi-stakeholder connections around ecosystems, driving sustainable change and disruption in health and social care delivery.