The Journal of mHealth Vol 1 Issue 3 (June 2014) | Page 27

The Value of Video in Modern Health and Social Care
Solutions need to be able to talk to one
another, system-to-system”.

Changing the culture of care
provision
A long term proponent of digital and
mobile health solutions, Dr Ali has spent
nearly a decade advocating the need for
institutional change in order to encourage the greater adoption and widescale deployment of digital and mobile
health systems. He believes that there
are a variety of barriers influencing the
wider adoption of these technologies
in the UK, but also that we are finally
approaching a tipping point whereby
the wider medical industry is beginning
to understand that change must happen
and that digital connected solutions are
a critical component in this equation for
change.
“In terms of where the push or pull for
greater use of digital and mobile health
solutions is coming from, it is not from
one individual source, but instead we are
beginning to see a multi-faceted push
towards the wider adoption of these
solutions. This is coming from: Demand
from patients – for these types of services; from industry providers; from
doctors and care providers; and from
government policy” states Dr Ali.
Technology in the health sector can often
be contentious, as it is perceived differently by various stakeholders. Developers and manufacturers of healthcare
technology often view the solutions that
they develop from a technical perspective
that doesn't always translate into clinical
benefit. One of the reasons for this is
that technology is often grouped within
the context of IT, something requiring
extra training or knowledge aquisition in
order to be used effectively. Because of
this it is often viewed as a hindrance to
care provision rather than as an enabler.
Providers must therefore demonstrate
the clinical compatibility of their solutions in order for them to be more
widely accepted. ‘v-connect’ recognised
the need to clearly define their product
within a clinical context, and have taken
significant steps to undertake 'cultural
shift' within the way that they, as technologists, communicate the potential for
their integrated video solution to healthcare professionals.

Cultural change is a major obstacle and
one which cannot be changed quickly
or without full cooperation between
all parts of the care-supply continuum.
Resistance to change comes from the
uncertainty that these solutions can have
upon working practices, the impact on
workloads, and the changes to the care
provider - patient relationship are all
concerns that need to be addressed in
order to encourage clinicians and care
commissioners to adopt digital health
into primary methods of working.
Resistance from staff was initially an
issue for Sandwell Council. This reticence, however, was very quickly overcome when staff realised the capabilities of the technology to support and
empower care recipients in new ways,
which freed up human resources for
more serious or difficult cases. Airedale
NHS Trust also witnessed similar early
sceptism from staff, particularly among
clinicians, in relation to data security and
compliance.
Rebecca Malin from the Trust states that,
“Once we had demonstrated to clinicians
that we had implemented effective rules
of governance, security and encryption,

then the concerns were quickly overcome. Clinicians quickly recognised that
these type of solutions deliver positive
outcomes to their patients, and therefore represent an effective method of
administering care. “Interestingly there
was little or no reluctance from patients
in terms of security, and in fact the adoption among patients has been extremely
straight-forward.”
“We did have initial concerns that by
offering 24/7 access to care providers,
that we would be flooded with incoming requests, which is why we started the
service small. However, this has not been
the case at all, instead patients seem content with the knowledge that the access
is there should they need it”.
Upstream cultural change in organisations is more problematic. The methods
in place to commission services, and
the tariff structures necessary to fiance
them, are often poorly designed to cope
with the commissioning of digital and
technological solutions. In fact the way in
which the current system operates in the
UK, means that NHS managers are often
Continued on page 26

The Journal of mHealth

25