Internet-era healthcare: a short talk

I gave a short talk on Friday at the GIANT Health Conference.

You can see the slides here.

I spoke about the importance of service design (because bad service design isn’t a policy option) and the need for adaptive change (cf. the Wachter report).

My main theme, though, was the Internet and its impact on healthcare.

First, I argued that healthcare is a web: a living, connected system of patients, carers, services, devices and institutions.

Credit

Healthcare is much more like a bazaar than a cathedral.

Making change in a system like this is not straight forward. There are no simple levers to pull.

I didn’t have time to get into this further in the talk, but I’d like to explore what healthcare can learn from the way the web works (and doesn’t) properly in a future blog post.

I’ve written before that the NHS has remained largely unchanged since the dawn of the Internet, in contrast to many other sectors.

We have partially computerised health, but you’d struggle to find any natively digital healthcare systems out there.

I’ve heard some claim that health is special/different.

That technology can be simply ‘harnessed’ but things continue largely as before.

That the NHS is too big/bureaucratic/slow to change.

That state-funded/monopoly provider systems like ours will be shielded from the economics of new consumer healthcare platforms.

My view: it’s happening. And it’s happening at a rate that big institutions like governments and healthcare systems can’t keep up with.

Just last week, Echo launched what journos are no doubt already dubbing ‘Deliveroo for prescriptions’.

Really impressive. Not just the UX — what’s remarkable is what small, digital teams like Echo are able to do in a matter of weeks that would have taken years with the usual IT ways of working.

While we invest billions in implementing yesterday’s IT systems, new digital business models are popping up that we can’t ignore.

I don’t know if AI will replace doctors and nurses, or if we’ll be subscribing to online medical services through our smart underpants from Apple in a few years time.

QTWTAIN

I don’t think the NHS is going to get ‘Ubered’ — certainly not overnight — but I do think healthcare delivery will look very different in the future.

In any big shift like this there will be winners and losers. There’s some big questions we need to grapple with, like:

  • Will technology increase access to healthcare, as some claim?
  • Who will lose their jobs?
  • What about digital exclusion — will all this simply increase health inequalities?
  • Does the NHS become a provider of last resort for those who can’t afford to use a (private) consumer health platform? Whither universal heathcare?
  • Who will control the platforms and specify how they use our data?
  • Will all this just magically happen thanks to the power of free markets?

There’s much more to discuss here than I could in my talk, or in this post.

My simple message is that:

a) We cannot pretend this is a straightforward technical change. We cannot create a digital ‘front-door’ to our existing services and declare victory. There are some — potential — profound implications for how healthcare works, here.

b) It’s happening, so we need to make sure it happens in the right way. We all need to be involved in this, especially if you value universal healthcare.