Associate feature: A digital-first healthcare system – an opportunity for Scotland to lead the world

While it is stating the obvious, COVID-19 has had a huge impact on healthcare services.

Beyond the strain it continues to place on the frontline, COVID-19 has also been a powerful catalyst for the greater adoption of new technologies, and creation of new processes, across multiple industries including healthcare – video conferencing and remote working come to mind.

Herein lies the opportunity - this catalytic effect can be harnessed to go even further with the development of a ‘Digital First’ strategy for Scotland.

Such a strategy need not be complex, nor require years for benefits to be reaped, but instead be deployed in a way that enables a collection of digital innovation-enabled marginal gains from which, collectively, a greater and more impactful transformational change can be achieved.   

When assessing the current situation, there are clear opportunities to make immediate impacts to not only alleviate pandemic-related strains but to also be truly prepared for what is to come beyond the COVID-19 response – as an example, tackling the ever-growing patient waiting list backlog.

Indeed, even prior to COVID-19, the patient backlog was a major concern for the NHS.

An ageing population with increasing demands alongside technology that is often patchy and struggling to truly transform, are both major contributors to the already stretched waitlists.

Further, the initial and ongoing postponement (in some board-specific cases) of all non-urgent elective care has undoubtedly added to the ongoing challenging situation.

Freely available data reveals in August 2020, as an example, Scotland’s surgery related backlog alone grew to approximately 71,000 patients – nearly tripling pre-COVID-19 figures over approximately a 4-month period.

Over 100,000 people are still waiting on cancer-related diagnoses and certain medical specialties (such as dentistry and cardiology) have seen up to an approximate 70 per cent drop in planned procedures when comparing to 2019 figures.

This paints a concerning picture and one with some estimates suggesting potentially 3+ years to catch-up and clear (assuming no other pandemic-like surprises come along!).

The unique geography of Scotland presents further challenges or, depending on how you view it, opportunities.

Although reliance on mainland health boards is understandable, to a degree, there is a real opportunity to maximise remote patient monitoring capabilities in view of reducing requirements of inconvenient travel whilst still retaining, if not enhancing, specialist related monitoring and care.

Additionally, there is evidence which supports specific solutions being able to contribute to solving staffing related challenges by reducing administration burdens for existing staff and, in turn, enabling a better patient experience whilst reducing operating costs via improved efficiencies.

In terms of a digital first strategy that can successfully deliver enduring transformation we, at DrDoctor, describe this in the context of our ‘Theory of Change’ and this has 3 key stages:

1. Respond – make immediate improvements by digitising areas such as patient communications to help, for example, reduce the waiting list backlog. These are typically simple solutions that are easy to deploy.
2. Improve – bring about digital transformation through automation of processes such as appointment scheduling for longer term management. Integration of artificial intelligence could be explored for various applications – for example, patient booking prioritisation.
3. Transform – change the way patients interact with healthcare providers to a digital first model with the explicit goal of preventing future backlog and backlog growth whilst continually enhancing care delivery.

What does this look like in real terms and what does the data show?

As examples, our work with NHS Wales has brought about immediate reduction in waitlist volumes for hospitals (by up to 12 per cent in less than 7 days including deployment time) by changing a phone call made by the admin team to an automated SMS.

We save a cardiology department 158 admin hours every month with our 2-way appointment scheduling service. Further, solutions like Patient Initiated Follow Up (PIFU) and Remote Monitoring specifically aim to ensure patients enter a hospital only when necessary whilst still retaining (if not enhancing) the quality of care being delivered – this alone has helped healthcare providers save in excess of £1 Million per year.  

COVID-19 could be used, and should be used, as the catalyst to drive a digital first strategy nationwide.

A national rollout, underpinned by the 3 stages mentioned above, would have a significant impact in enabling NHS Scotland clear its backlog in much less time than current estimates suggest and, in doing so, would help get waiting list back under control whilst also significantly reducing a range of associated operating costs.

Further, and most importantly, such an approach will also make meaningful contributions to improving patient experiences as well as patient health outcomes over the shorter and longer term.

In summary, there is a real opportunity for Scotland to be the global leader with a Digital First Healthcare System that comprises of a complete end-to-end solution and one which is fundamentally driven by value-based care.

The current climate provides a real opportunity to further lay foundations and accelerate progress that, not only, addresses current pressures but is also ready for the future and the exciting new innovations it will undoubtedly bring.

Dr Ramzy Ross is strategy lead for Scotland at DrDoctor. This article was sponsored by DrDoctor.