Scaling digital uptake

Scaling digital adoption - the tech, the data and the people

In the NHS we have not been able to engage at scale with tech and digital in health care at the pace the opportunity affords. There are pockets of success, such as electronic patient records, but these are far and few between.

Throughout our time working in digital transformation the Healthwave team have recognised there are three key ingredients needed to support the adoption of digital technology and drive uptake with our frontline teams, management and most importantly citizens.

Firstly, it's the tech, secondly it’s data and thirdly, it's about people. There's also a key barrier to overcome called digital exclusion, which is leading to major health inequalities.

The Tech

There are around 1 million people in the U.K. who are seriously excluded from digital pathways and need multidisciplinary support. Organisations like the Good Things Foundation have made it their mission to tackle digital inequality and close the digital divide.

For Healthwave our vision is to create a world where people are empowered to embrace the possibilities of digital services at significant magnitude.

We see poor uptake of digital on a wider scale. In the U.K. 92% of adults (16+) own a smartphone. 95% of people in the UK have accessed the internet and >80% of the UK adult population have at least the most basic digital skills. But how many use digital for things related to health care for example? Well, if you take the NHS App which saw a surge in uptake during the pandemic and was the most downloaded app in the UK in 2021, still just 40% of patients have registered for it and utilisation has significant room for improvement.

Our mission is to develop the most scalable ways to engage with citizens and harness the power of their insights to drive uptake of digital services.

The Data

There’s enormous amounts of data out there on our health care, but it's not all brought together in one place. Often people don't understand how to make the best use of that data to gain insights.

Sometimes uptake failure can be caused by making processes more complicated than necessary, where a more personal, human approach is required. For example, take IBM Watson Health that provided clinical advice, powered by AI. When confronted with real world scenarios, the product was found to issue dangerous advice in some instances.

There is also the case of the digital therapeutics company Proteus Digital Health who attempted to tackle some of the most complicated medical conditions associated with our central nervous system. The costs associated with doing so meant financial ruin: the company never made it to market, because it was spending $2 million a month in development.

Solutions don’t have to be extremely complex or experimental to be effective. Many improvements in people’s health can come from simple but needed changes.

The People

It's not just our operational managers and leaders, but our citizens too. All of these groups need access to trusted information and resources when considering digital health services. In some circumstances they may also be excluded (Archer-Brown 2021).

How people interact and feel able to use the tech is make or break for uptake. That’s why user centred design data is critical if we are to provide appropriate digital services which people use.

And we wonder why we cannot navigate with this complex problem around how we can transform our services through digital?

The answer is simple. And complicated. It's the tech, it's the data, it's the people.

What can be done

This is a complex issue with lots of interlocking problems. And there is no one simple panacea that is going to bring this transformation of services forward.

At Healthwave we are helping teams across the UK solve the issues around engagement and communication when it comes to digital switching and driving uptake at scale. Since Healthwave was formed in 2018 we’ve been focused on developing scalable ways of doing this and applying our approaches to public services.

On the tech, we take user-centred design approaches to validate whether digital solutions work for people. In practical terms this means UX, personas, attitudinal and behavioural research. Our approach often involves users from groups of people who are normally excluded from routine sampling methods. This can be for new services or for organisations looking to refresh a particular strategy. And we do this at pace, without having to compromise on rapid delivery of evaluations.

On the data, we gather insights rapidly and feed those into the design process or to inform behaviour change approaches towards digital channels. This includes consideration of primary and secondary data. In a post Covid world context we’ve been working with Integrated Care Systems to understand how citizens' communication preferences have changed. This has often led to digital first comms plans, which also use strategies to reach individuals not necessarily online.

Our mixed method approach helps us triangulate data, using surveys, multichannel interviews and usability testing. This allows us to work with any digital technology regardless of the stage of development or delivery method i.e. Apps, wearables, web-platforms etc.

We’ve partnered with a number of organisations to complete similar work from cancer care, community health, maternity services and special educational needs where digital solutions are being considered or need optimising.

On the people - as the world shifts towards digital delivery of services, the central challenge is how to get citizens to engage with new technology-driven ways of accessing information - including those who are excluded.

We know that a third of adults in the U.K. support others with digital services on a regular basis and often need support themselves. Given the prevalence of digital, which we embrace in so many aspects of our lives, with the right support this group of people could help unlock digital exclusion challenges and significantly improve uptake.

And it’s not just the public sector that encounters digital uptake issues. Even in the private sector, lots of commercial apps have less than 10% of people that are regular users for their digital offers. For example, of those mHealth App users who return to their apps regularly, 62% of vendors report fewer than 1,000 monthly active users, illustrating that retention remains an issue. [Medica magazine. Diagnosing disease with big data. 2018]

In combination with our data and tech approaches, we provide communities with access to tailored resources and toolkits to drive greater awareness of digital channels and to address barriers to uptake. Local and national resources can be aggregated, like access to kit, connectivity or digital skills in addition to information about the digital opportunity. Reach and engagement is amplified through campaigns and feedback loops and the power of peer to peer networks, which are the cornerstone of our platform.

The future of digital uptake

For many organisations, the shift to digital delivery is a no brainer - investment now, for a long term, more streamlined return.

However, with so much effort going into the creation of digital services, we need equal energy and investment going into considering how the end user will engage in the transition and if they have the skills - or confidence - to engage with this new technology-driven frontier.

That’s where we come in. We gather insights into the attitudes, behaviours - and fears. We validate whether people are likely to use the digital solutions at sufficient scale and we discover how to help them access the resources they need.

We then create scalable solutions to help engage and embed your technology into their life - so they feel empowered to embrace the possibilities of digital services and organisations can reap the rewards associated with digital uptake.

That’s what we call real digital adoption - when the tech, the data and the people come together to improve outcomes and transform lives.