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Scotland’s digital health and care strategy highlights need for collaboration

The Scottish Government will create a joint decision-making board, a national approach to service redesign and a national digital platform to ensure interoperability

The Scottish Government has launched its digital health and care strategy, highlighting the need for a national and collaborative approach to ensure the entire country benefits from digital technologies.

The strategy said the government will develop a national digital platform for Scotland, which will ensure all relevant information from patients’ health and care records is integrated and available.

“We will develop at a national level a digital platform that enables the appropriate creation and use of information at source and facilitates the interoperability of existing and new health and care technologies,” the strategy said. “This will be delivered through the development of a new architecture, the use of secure cloud-based services and the use of common shared international standards.”

The platform will allow for information capture and point-of-care access – with role-based, secure access – and includes specialist health and care information, as well as knowledge sources for staff and citizens.

It will also allow for new products to be made available through the platform, and the government is encouraging a broader ecosystem of development and suppliers, particularly small and medium-sized enterprises (SMEs).

Citizens will also be given the ability to access and update information about their own health, “including their records and from personal monitoring, and to interact with services”. “This will build on work that is already starting to be taken forward on a Health and Social Care Services Portal and through developments such as NHS Inform,” the report said.

It added that previous e-health strategies have helped certain services and information to be shared on a regional or national basis, and while some of these will continue to “be essential to the effective operation of the national digital platform” and most of them are essential to care currently being delivered, they “may not be suited to the way we want care to be delivered in the future”.

National approach

The strategy also commits to establishing a national decision-making board by July 2018, to ensure a national and collaborative agenda.

The board will be made up of representatives from national and local government and the NHS; as well as being supported by industry, universities and the third sector.

The board’s aims are to make national decisions on issues such as interoperability standards, coordinating developments across regions, monitoring progress on the strategy and sharing best practice.

All health and care organisations in Scotland will also have to “formally adopt” the Scottish Digital Service Standard as a bare minimum. The standard is based on 22 principles focused around user needs, capability and technology. 

This follows on from the Scottish Government’s digital strategy, published in July 2017, which launched plans for the country to be seen as “an international pioneer of citizen-led service design” and developing and implementing a Scottish approach to user research and service design. 

“We wish to empower citizens to better manage their health and wellbeing, support independent living and gain access to services through digital means. We know this is leading to a shift in the balance of care by using the tools and technologies we are already increasingly using for all other aspects of our lives,” the health and care strategy said.

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“But the scale of what we are proposing indicates the need for a new delivery and leadership model that clearly supports national, regional and local implementation, as well as transformation across all aspects of digital health and care.”

Scottish cabinet secretary for health and sport Shona Robison said the strategy aims to be “inclusive and collaborative”.

“The new strategy represents a real opportunity to build on achievements to date and maximise the opportunities for digital for the future, supporting the more preventative, person-centred care that we want to see,” she said.

By the end of 2018, the government will put in place a “clear national approach to supporting local co-designed service transformation with clearly identified leads”.

Cyber security and information governance

It also recognises the need for strong cyber security and information governance measures to be put in place, as health and care services become more digitally focused.

“We heard consistently that there needs to be a national approach to information governance in order to address, amongst other issues, inconsistencies in decision making about appropriate sharing of information, and misunderstandings and myths around existing legislation – which can impede the effective delivery of care, but also the timely introduction of new models of care, research and innovation,” the strategy said.

By 2020, the government will have set “clear arrangements” for a consistent national approach for information assurance, as well as provide clarity around information sharing across health and care, which is compliant with the EU General Data Protection Regulation (GDPR).

This includes reviewing already-established information governance boards and groups to streamline activities and ensuring consistency.

The strategy added that citizens need to be given “appropriate choices” around accessing, sharing and managing their own data, and that there needs to be more transparency so people “understand the importance of the use of information” for other purposes than direct care, such as research into new treatments.

Digital skills and access

In order to ensure the uptake of digital services, all organisations involved in the delivery of care will be expected to sign up to a digital participation charter, which focuses on ensuring people have basic digital skills. 

In health and care organisations, the strategy said leadership is key, and that a group of organisations, including NHS Education for Scotland, the Local Government Digital Office and the Scottish Social Services Council will “have in place clear approach to developing the modern workforce and the necessary leadership to drive change” by September 2018.

The publication of the strategy coincides with a report on digital health and care in Scotland by an external expert panel. 

The panel’s report calls for every person in Scotland to have access to a personal health and care record (PHR), which they can contribute to themselves, by 2020.

“This should include access to laboratory tests, medical notes and care plans among other types of information with advice for the citizen on how to interpret these data,” it said.

“It should, in time, include both read and write access for citizens. The PHR should also allow citizens to upload data from vetted ‘apps’ from digital devices which can link into core systems used by health and care providers,” the panel said.

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