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Digital tech potential in health and social care not yet realised, says King’s Fund

Report by health policy think-tank says that although there is evidence that digital technology can support staff and patients, there are large gaps in the evidence base

The use of digital technology in health and social care can be hugely beneficial, but there are huge gaps between the digital maturity in health and social care organisations, according to the King’s Fund.

A report by the health policy think-tank, entitled Shaping the future of digital technology in health and social care, found that although the Covid-19 pandemic has caused a “rapid shift towards the remote delivery of care through online technologies”, the potential to transform the health and social care system through technology has yet to be realised.

“For the health and social care sector to make the most of emerging technologies, more evidence is needed on a range of factors, including the cost-effectiveness of such tools, the groups best suited to using these interventions, the effects of digital inequalities on access, and the impact of tools that use digital technologies on outcomes,” said the report. 

One of the issues causing the slow pace of realising the benefits of technology is that national leadership is often “reshuffled, with a lack of clear responsibility in many aspects of implementation or strategy-setting compounding issues with delivery of funding to the front line”, it added.

This is even more evident in social care, where there is a “a clear deficit in the amount of evidence on how digital technology is being used within social care settings compared to health care”, the King’s Fund found. 

It said the gap between NHS providers’ digital maturity and social care providers’ digital maturity is large and accounts for “the substantial difference in technology use between NHS providers”. 

During its research, interviewing experts, the King’s Fund found only isolated examples of digital technology deployments in the social care sector, and little evidence of any impact. 

Government initiatives often focus on generating ideas and launching pilots in the sector, it said, but “explicit investment and support for scaling and spreading approaches through the sector may be well beyond the efforts of the Local Government Association’s digital transformation programme”.

The report added: “Social care is being left behind health care with regard to the quality and level of evidence available to support the spread and implementation of new digital tools within the sector. Without more support, it is likely to be left even further behind.”

Although the NHS has come further than social care, there is still more that needs to be done across both sectors. The King’s Fund said the public must also become a stakeholder and partner in the mission, particularly as people’s data can become “a source of potential financial gain to the sector and private partners through the development of products built using patient data, in addition to helping the sector understand the impact of digital inequalities”.

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The pandemic has had a huge effect on how digital technology is being used in health and care, with technologies such as remote care, online consultations and GP appointments being deployed nationally.

Artificial intelligence (AI) has been hailed as having the potential to completely transform healthcare, but the report said there are “few examples of its use in health care, with a focus on diagnostic testing”.

It said there was “no evidence of large-scale impact to date, though some evidence of efficacy in performing diagnostic imaging tasks, which could support staff in these roles in the future”. 

It added that there are questions about where accountability will sit if an algorithm causes errors, or if the data is incomplete, and what the role of the regulator will be.

“Finally, more complete evaluation of systems in action in clinical settings will start to bring real evidence of the impact of AI in the near future,” said the report.

“As well as the adaptive nature of change, there is a risk that systems – again, particularly those involving AI – can be built that have stellar performance in controlled settings or test datasets, but do not translate to real-world impacts when they are tested.

“Without capacity to conduct research that assesses this, and a system that can use this evidence to act as a savvy commissioner of technology, there is a risk of failing to realise the benefits of such technologies.” 

The King’s Fund sees three possible scenarios for the future of digital technology in the health and care sector. The first is a “techlash” against new tools, where the public loses trust in how patient data is used; the second is a system where trust is retained, but there is an an uneven spread of digital technology, with low-quality evidence stifling uptake in new tools; and the third, more optimistic scenario is that the system overcomes “the considerable challenges it faces in supporting the development and use of digital technology”.

The report added: “The decisions taken in the next few years will have a huge effect on how the health and social care system is transformed.”

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