Health and Social Care Technology Challenges

With Health and Social Care technology booming, it is so important to review the challenges and share any lessons learnt.  

In my work as an NHS CIO, delivering both large- and small-scale digital transformation programmes, I have heard first-hand about the challenges and difficulties customers face. To mitigate these, it is vital we share our practices to prevent and improve the delivery and deployment of our technological enhancements within health and social care. 

Here are some of the issues we must consider: 

Clinical issues: such as quality assurance and safety monitoring, the ability to provide outcome measurement, and evidence generation, which require rigorous evaluation and validation of remote monitoring and telehealth interventions. This is key to understanding what is working well and what is effective.  

Organisational issues: such as workflow integration, change management, staff training, and incentives, which require effective and collaborative implementation and adoption of health and social care technology. Ensuring user-centred design and driving digital culture could be used to prevent such issues in the future. In other words, communicate, collaborate, design, create, train, deploy, and review.  

Social issues: such as digital literacy, the digital divide, privacy, and trust, which require inclusive and participatory design and delivery of digital solutions. Understanding the culture and digital maturity of the organisation is vital, and encouraging your operational teams to take a leadership role in all deployments is the secret to success, digital transformation ownership, and stakeholder management.  

Funding challenges: there was a substantial increase in public and private funding for remote monitoring and telehealth initiatives after the Covid-19 pandemic. This was supported by the evidence of the effectiveness and efficiency of these technologies for health and social care. There was also a favourable policy environment for remote monitoring and telehealth technologies, with more flexible and comprehensive regulations and standards for these technologies.  

However, it’s necessary to ensure these solutions are accessible, monitored, integrated, and secure. Supportive clinical pathways need to be changed, reviewed, and adopted by the clinical and care teams to ensure successful deployment and streamlined processes. This is not simply digitising a paper process but creating streamlined processes that are integrated with live information to inform efficient and effective pathways of care.  

Blockchain and distributed ledger technology (DLT) emerged as a promising solution for addressing some of the challenges and opportunities in health and social care data management. They offer a secure, de-centralised, and transparent way of storing, sharing, and verifying health and social care data while preserving privacy and consent. Ensuring data quality here is essential, and this must be built into the process with support from the business intelligence and clinical governance teams. For example:

• Electronic health records (EHRs) for creating a unified, interoperable, and patient-centric record system; improving data quality, availability, and portability. 
• Digital identity and credentials for verifying the identity, qualifications and permissions of patients, providers, and organisations; enhancing trust and accountability. 
• Smart contracts for automating transactions, agreements, and workflows, reducing friction and overheads. 

Other challenges that blockchain and DLT technologies face are: 

• Technical issues such as performance, scalability, interoperability, and usability; requiring constant innovation, optimisation, and standardisation of blockchain and DLT platforms and tools. 
• Legal issues such as compliance, jurisdiction, enforcement, and dispute resolution; requiring harmonisation, clarification, and adaptation of blockchain and DLT regulations and policies. 
• Cultural issues such as awareness, education, acceptance, and adoption; requiring extensive communication, engagement, and collaboration amongst stakeholders. 

The funding situation for blockchain and DLT technologies in 2024 and beyond is uncertain. On one hand, there is a growing interest and curiosity in this for health and social care, especially in relation to personally owned care records. This leads to other pilot projects, experiments, and collaborations. On the other hand, there was a lack of clear vision, strategy, and leadership for blockchain and DLT technologies for health and social care; resulting in limited funding, support, and guidance. 

Controversially, a single, UK blockchain-based approach would allow patients to become the owners of their data. It would allow the information to travel with them digitally to every emergency department, GP practice, and hospital in the country, both safely and securely. It would be updated as soon as new data was entered, anywhere in the country. It could also connect all our medical information for the rest of our lives. 

We are not there yet, and it is not clear when we will be. The use of technology in healthcare is a huge opportunity, but one that needs to be approached with caution. Transitioning to innovative technologies need not be a takeover, it should be as a facilitator and support function to ease the burden and reduce waste and costs, resource intensive processes. It should help to improve health and social care for all.  

As we look forward to the rest of 2024 at CDW, we can expect more innovation, integration, and impact from these technologies, as well as new ones that will emerge or evolve.