Royal Berkshire NHS Foundation Trust UK

Antoni Chan

Digital health technologies (DHTs) have seen an unprecedented expansion of its use with COVID-19. There has been widespread adoption which holds the promise of transforming healthcare with the aim of improving patient care and population health. This will move the needle from a previously reactive system where the focus was on sick care, to a proactive role which promotes wellbeing and prevents ill health.

While many studies have investigated the user experience (Ux) from the perspective of the clinician, there is an important and crucial need to study and measure Ux from a patient perspective. Beyond the study of digital literacy among the population, there is also the need to examine the how the disruption brought about by DHTs affect the Ux in the full end to end patient journey. The term disruption is used widely to signify a radical longer-term positive outcome but may also raise uncertainty with regards to the safety and quality of DHTs in the implementation phase. For this reason, it is vital that the patient experience is measured to ensure the optimal outcome of health and wellbeing. In order to do this, I believe there are three important aspects of Ux.

Firstly, DHTs must be patient centric. The digital cultural transformation that is sought can only come when patients see the value of using the DHT. It’s the “What’s in it for me?” task that DHTs should provide for the optimal Ux. Patients should have access to data that allows improved clinician-patient interaction and shared decision making. Democratisation of data and knowledge using DHTs will lead to healthcare being more personalised. It also promotes equity and the democratisation of decision making. This leads the fully informed and consensus achieving high quality decisions which improve patient outcomes. It improves patient satisfaction and safety.

Secondly, DHTs must be interactive. In my previous article, I talked about the 3 I’s of successful DHT deployment which are Integrated, Interoperable and Interactive. DHTs should be a two-way interactive communication between the patient and healthcare provider. It should be user friendly and easy to access. It is vital to know where along the patient journey is the DHT interaction playing its role. This can include symptom tracking using patient reported outcomes, patient-initiated request for appointment and review, reminders for healthcare episodes as well as therapeutics and support. Digital therapeutics such as the use of interactive problem-solving, video education and interventions as well as virtual reality can be deployed remotely when there is a need based on the assessment made. Patients retain autonomy and choice in the use of the interactive DHTs. Clinician recommendation and support can increase the participation in the interaction with DHTs.

Thirdly, DHTs must be preventive. This is a paradigm shift and holistic re-examination of the use of DHTs. This is a move away from the reactive to the proactive health management. DHTs such as wearables and continuous measurement of data that is private and secure can help inform choices and decisions around health care topics that promote wellbeing. This gives insights into patients’lived experience while having a strong emphasis on data security and transparency.This will help address the full spectrum of the patient needs throughout the end-to-end pathway and go beyond just the clinic interaction.

DHTs hold the promise of transforming healthcare with its unprecedented adoption from COVID-19. It can improve safety and quality of care. This must be balanced with the Ux, democratisation of information and equity. With the promise of future benefits from DHTs, the investment should not be purely monetary but also into the cultural transformation where patients are involved from the early stages with co-production of DHTs. It is vital to develop a common goal in the design phase and move from concept to completion through collaboration. This will ensure increased uptake and adoption to achieve the primary goal of improved patient care and outcomes.