Barriers and opportunities to mainstreaming of a national digital health program
A new study led by the University of Glasgow reports on key barriers and facilitators to implementing a digital health programme – and provides recommendations to move the field forward.
The study, which is published in the Journal of Medical Internet Research today, suggests that while there are many challenges, these are not "insurmountable". The authors write that the current UK healthcare system, as well as the wider population and market, are not entirely ready for a wide scale digital health programme or digital health platforms.
Alongside revealing barriers and facilitators, the authors of the study also reveal their ten key recommendations to aid and accelerate uptake in the digital health field.
Digital Health programmes include apps, personal health records, telehealth and wearable activity trackers.
The researchers found that while there is receptiveness to digital health, key barriers remain at every level: market and policy level, organisational level and within the general professional and public population but intensive engagement, clinical endorsement and upskilling efforts can prove beneficial.
Factors hindering implementation included a lack of IT infrastructure (including universal broadband); uncertainty around information governance; and trust in the security of digital health platforms.
The commercial market was perceived as difficult to navigate, with concerns over accountability and liability voiced from within the commercial sector.
The authors' recommendations include further commitment and investment in digital healthcare at a national and local level, and support for those who are not digitally fluent. The researchers also suggest training the next generation of health professionals to make them more digitally able and upgrading the technical capabilities of the health service.
The study lead, Professor Frances Mair, Professor of Primary Care Research from the College of Medical, Veterinary and Life Sciences, said: "Given the current self-care agenda, the drive towards more personalised medicine and person-centred digital health solutions, this study is timely and has the opportunity to make an important contribution to understanding the implementation of digital health innovations."
The study, which was conducted in collaboration with researchers from the University of Strathclyde and Newcastle University, evaluated the £37m digital health programme 'Delivering Assisted Living Lifestyles at Scale (dallas)' between 2012 and 2015.
The dallas programme aimed to develop and implement a range of digital health products to enable self-care and preventative care. To understand the barriers and hurdles faced during the programme the researchers interviewed people involved and examined a vast quantity of documentary evidence over the course of the three year project.
Researchers took care to include representatives from all the types of organisations involved, including private, public and voluntary, along with persons from all levels of the project from management to those delivering it to patients. There were also focus groups held with digital health users including patients and health professionals to gain their insight.
Dr Marilyn Lennon, first author, from the University of Strathclyde's Department of Computer & Information Sciences, and co-lead of the study, said: "Digital health is a huge market with the potential to make a massive impact on society, but making it a part of routine care delivery has been much slower than expected.
"This is not due to any lack of technical innovation, but to uncertainty over the role of technology in delivering care. There's also uncertainty about managing and using health data – many people go online to do banking or to use social media but seem wary about doing the same for health. Sharing this data with doctors or friends and family for example could avoid GP visits or prolonged stays in hospital.
"Our research responds to calls for exploration of current barriers to the wide scale adoption of digital health, and offers recommendations that could help to realise its full potential."
The dallas programme was funded by Innovate UK, The National Institute for Health Research, the Scottish Government, Scottish Enterprise and Highlands and Islands Enterprise.
The paper, 'Readiness for Delivering Digital Health at Scale: Lessons From a Longitudinal Qualitative Evaluation of a National Digital Health Innovation Program in the United Kingdom', is published in Journal of Medical Internet Research. The study is funded by Innovate UK.