Towards a Digital Health Ecology at the NHS: Healthcare Technology Adoption through the COVID-19 Looking Glass

Description

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. 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