Towards a Digital Health Ecology at the NHS: Healthcare Technology Adoption through the COVID-19 Looking Glass is about technology adoption in the U.K.’s National Health Service (NHS) as told from the inflection point of a disaster. In 2020 the world lived through a disaster of epic proportions, devastating humanity around the globe. It took a microscopic virus to wreak havoc on our healthcare system and force the adoption of technology in a way that had never been seen before. This book tells the story of digital technology take-up in the NHS through the lens of that disaster.
The COVID-19 pandemic is the most significant global health crisis to occur since the advent of digital technologies, ubiquitous data, and widespread use of mobile technologies. This book documents use of technology in the NHS through the lens of the first pandemic shock. This healthcare system, paid for by general taxation and free at the point of demand, was conceived and developed in a firmly analogue world. Created in 1948, the NHS predates the invention of the World Wide Web by some forty years. This is not a book simply about technology, it is a study of the painful process of reengineering a mammoth and byzantine system that was built for a different era.
This book is about more than technology. The digital health sector is a microcosm of the wider healthcare system, through which grand themes of social inequality, public trust, private versus commercial interests, values and beliefs are played out. The sector is a clash of competing discourses: the civic and doing good for society; the market and wealth creation; the industrial creating more efficient and effective systems; the project expressed as innovation and experimentation; lastly the notion of vitality and leading a happier, healthy life. Each of these discourses exists in a state of flux and tension with the other. Oscillating between them, this book is offered as a critique of the role of digital technologies within healthcare. It is an examination of competing interests, approaches, and ideologies. It is a story of system complexity told through analysis and personal stories.
Author(s): Victoria Betton
Publisher: CRC Press
Year: 2022
Language: English
Pages: 288
City: Boca Raton
Cover
Half Title
Title Page
Copyright Page
Table of Contents
Preface
Chapter 1: Introduction
Where It All Started
What Even Is Digital Health?
A Perfect Storm
Backdrop to Broken
Necessity Is the Mother of Invention
Relative Advantage
When People Drive Digital
Context Is King
The Social Determinants of Digital
The Jeopardy of Trust
Bending the Curve on Digital Mental Health
The Theatre of Tech – A Study in Solutionism
We Get the Market We Deserve
Momentum – Towards a Digital Ecology
Notes
Chapter 2: Backdrop to Broken
A Minor Inconvenience
Ill-fated Plans
Central Ambitions
Changes You Can See from Outer Space
A Competent Workforce
X Is for Experience
Diktat and Determination
Between Rhetoric and Reality
Notes
Chapter 3: Necessity Is the Mother of Invention
An Outbreak of Pragmatism
Logging on
A Hospital in Your Home
The Clinical Entrepreneur
Data Quality Rules Ok!
Attending Anywhere
Fighting Fires of the Future
Notes
Chapter 4: Relative Advantage
Relative Advantage
NHS Care Is a Relational Business
Saying Goodbye
Looking Forward
Notes
Chapter 5: When People Drive Digital
When People Drive Digital
Command and Control
First Responders
We Are Not Waiting
A Software Ecology
Notes
Chapter 6: Context Is King
In Celebration of Mess
Theorising Non-adoption
Context Is King
Thinking about Design
What Happens in the Margins
Culture Eats Digital for Breakfast
Thinking Systems
Nurturing a Habitat
Put a Dictator in Charge
Notes
Chapter 7: The Social Determinants of Digital
The Wellness Myth
Hello Inequality, Let Me Introduce You to COVID-19
The Drum of Progress
One Condition. Two Tales
Pay-as-You-Go
One Hundred Percent Digital
The Law of Inverse Care
Designing for Everyone
Data Shadows
Who Leads Digital Health Matters
Just as Vital as a Food Parcel
Beyond the Stats
Notes
Chapter 8: The Jeopardy of Trust
The Boundaries of Health Data
The Data That Didn’t Care
Amazonian Challenges
Notes
Chapter 9: Bending the Curve on Digital Mental Health
Introduction
A Mental Health Pandemic
A Salutary Lesson
Cinderella Services
The Fruit That Hangs the Lowest
The Detractors
A Faster Horse
In Search of the Gold Standard
A Digital Mental Health Pandemic
Bending the Curve on Digital Mental Health
To Save the NHS Click Here
An Open Future
Notes
Chapter 10: The Theatre of Tech – A Study in Solutionism
There’s an App for That
Silicon Valley Style Hubris
Do Something. Do Anything
We Don’t Have an App for That
Checks and Balances
In Love with Ada
A Masterclass in Mismanagement
The Beat of the Drum
A Footnote
Notes
Chapter 11: We Get the Market We Deserve
How the Money Flows
A Founder’s Story – Fixing a Simple Problem
The Scissors of Doom
The Elusive Return on Investment
Who Buys?
But Does It Even Work?
The Dark Art of Procurement
Who Holds the Purse Strings?
The Imperative Gap
A Static Market
An Open Future
You Don’t Win by Designing for Health Outcomes
What Business Models Actually Work?
Lessons Learned
Notes
Chapter 12: Momentum – towards a Digital Ecology
Towards the North Star
Entrepreneurs of the Future
The Characteristics of a Digital Ecology
Creating Curiosity
Notes
Index
