Last week saw three very contrasting reports on technology adoption by care workers. The first, by NESTA, was a fascinating read entitled Which doctors take up promising new ideas? New insights from open data. Unsurprisingly for those of us who have attempted to peddle new technology to GP practices, the key findings are that larger practices are more likely to be early adopters, and that early adopting practices tend to influence those close to them, resulting in islands of early adoption. (The first is not an inviolate rule I found – sure larger practices can specialise so can focus more on innovation, however a larger workforce can also mean a greater probability of a technophobe with a bee in their bonnet about a pet project that the technology is drawing funds from.)
The report is a great example of big data in action : how to mine openly available data to obtain fascinating information on speed of adoption. Sensibly NESTA has supplemented it with some survey information, digging into the (scarily large number of) reasons doctors give for delaying adoption. To try to summarise the excellent conclusions all too briefly, recommendations include that:
- practices should engage patients more, as patients can often champion radical innovations;
- local GP practice clusters should be used to promote ‘me too’ innovation (CCGs & AHSNs have an important role here);
- ‘step-by-step’ adoption guides should be provided, to overcome adoption concerns;
- early adoption should be celebrated;
- open data should be used to increase transparency of adoption
The report is well worth a read by anyone involved in medical technology adoption.
Sadly the second report was not of quite the same calibre: Care Sector report: Cannot compete on size? Consider technology is produced by sourceforconsulting.com and sponsored by Advanced Health & Care. The report begins well by examining homecare providers’ attitude to technology, exposing for example that, organisationally, the ability to flag up a missed visit only scores 3%, whereas payroll management by technology is top of the list at 10%. As they point out:
But what is often forgotten is that innovative approaches to care can be the difference between winning a contract or not. In a time when there is strong competition for every new contract, technology can be the difference between a sustainable business and closing the doors.
However in the ‘interview’ with Nick Spratt – Sales Director at Advanced Health & Care he states:
I think the focus over the next ten years will be on the shift towards convergence of health and social care.
Not a bad forecast really, when a mere £3.8b was set aside by the DH last August for the health and social care Integration Transformation Fund (ITF) in 2015/16!
Where the report really falls down though is in just looking at automating the existing task and not looking beyond to redesigning homecare delivery. For example, intelligent use of telecare can transform homecare provision to reduce cost significantly and ensure focus of scarce resources on particular need. Thus, if a service user has got up in the morning of their own accord, there is no need to send in a care worker; likewise if they have taken their medication; and home care workers can provide responses to some telecare alerts too. Doubtless there are many other opportunities.
Intelligent integration of remote monitoring with an electronically managed home care workforce offers the best of both worlds and is surely the future..and what the ITF is all about. Numerous demographic reviews have pointed out that there simply won’t be the care workers available to deliver care in the way it has been in the past, at the same time as technology development has reached the steeper slopes of the exponential curve (“the singularity is near“), so surely if you are going to advocate the use of technology, you should not stop at current practice?
Finally, words begin to fail. The third report, by Kantar Media looking at the US, headlines “Research is showing that more than half of all physicians are using tablets for mobile health”. It goes on to report that the greatest contributor to this achievement was that, of clinicians:
…almost one in three were using tablets for reading up on the latest medical publications
We recently covered a new contribution to the ongoing terminology debate. This is undoubtedly an innovative definition of mobile health.
Hat tip to Prof Mike Short for first alerting me to the NESTA paper.