Scotland’s health and social care services are failing to make use of new technologies according to a new report from the Scottish parliament’s Health and Sport committee.

The committee heard evidence from a wide range witnesses, including industry associations, health care organisations, educational institutions, NHS trusts and technology leaders, seeking views on the successes and failures of existing telecare and telehealth strategies, as well as future opportunities for new technologies.

Despite the government’s ambition to position Scotland as a digital health care leader, much of the evidence in the report points to a system which is unable to take advantage of existing technologies, let alone innovate and create a single, secure, patient-owned approach.

In the conclusion of the report, the committee states:

“When we agreed to carry out this inquiry we thought we would be investigating ways of modernising the health and social care sector through the use of modern
and ground-breaking technology and innovative and fresh ways of working. We expected to hear many stories of cutting-edge technology making dramatic changes in the way the sector works. We did not expect to hear of a culture that was reluctant to adapt new ways of working and where innovation is not encouraged and heavily out-dated IT systems still cause major barriers.”

Several major issues were raised by multiple witnesses, including:

• The lack of decision-making at a national level, leaving individual boards making decisions with little or no long-term strategy
• The use of multiple, incompatible legacy systems, which do not allow data to be shared across all participants
• The inability to share access to a patient’s records across relevant health and social care providers
• Outdated procurement processes, which are undertaken at an individual board level
• Basic misunderstanding of data protection and data sharing requirements
• A lack of collaboration with universities in terms of innovation and technology

Some of these issues, such as the use of legacy systems, are widely known. However the fact that patient records cannot be shared between appropriate healthcare professionals seems inexplicable to people outside the sector.

Person-Centred and Empowering

The Scottish Government’s Health and Social Care Delivery Plan, published December 2016, states: “Digital technology is key to transforming health and social care services so that care can become more person-centred. Empowering people to more actively manage their own health means changing and investing in new technologies and services, by, for example enabling everyone in Scotland to have online access to a summary of their Electronic Patient Record.

“The time is right to develop a fresh, broad vision of how health and social care service processes in Scotland should be further transformed making better use of digital technology and data. There is an opportunity to bring together all IT, digital services, telehealth and telecare, business and clinical intelligence, predictive analytics, digital innovation and data use interests in health and social care.”

In addition, the Scottish Government also published A Digital Strategy for Scotland in March 2017, which aims to: “ensure that Scotland is recognised throughout the world as a vibrant, inclusive, open and outward-looking digital nation”. It also states “The Scottish Government will create the conditions which encourage continuous innovation and improvement in our public services.”

New Strategy Imminent

The committee also noted that the government’s new Digital Health and Social Care Strategy is due to be completed in ‘spring 2018’, providing a new opportunity to address the ongoing problems and build a new approach to technology in health and social care.

The vision for the new strategy is bold and focused on the patient. The draft states:

As a citizen of Scotland:

• I have access to the digital information, tools and services I need to help maintain and improve my health and wellbeing.
• I expect my health and social care information to be captured electronically, integrated and shared securely
• to assist service staff and carers that need to see it,
• and that digital technology and data will be used appropriately and innovatively to help plan and improve services,
• enable research and economic development
• and ultimately improve outcomes for everyone

The report notes that a number of advances have been made in the sector.  Several witnesses praised the creation of the Digital Health and Care Institute and the Scottish Centre for Telehealth and Telecare. Improvements in the delivery of national programmes of work were also noted with improved communication, visibility and oversight coming from the e-health Strategy Board.

The contribution of the Clinical Change Leadership Group was noted, along with the Technology Enabled Care programme and several pilots of telehealth and telecare projects, which have run across the country.

The report concludes:

“More must be done by the Scottish Government to increase the use of technology across NHS boards and social care. This cannot be left to be agreed on a board by board basis. Such a piecemeal process leads to increased variation in health outcomes across Scotland. We expect the use of technology should also lead to a reduction rather than an increase in health inequalities.

“We believe the new strategy provides an opportunity for the Scottish Government to lead the way and radically develop the way technology is used in the NHS and social care. It also presents an opportunity to ensure innovation in health and social care flourishes and that Scotland is a leader and is not left behind. It is essential the Scottish Government is bold and offer strong leadership on how and when this will be achieved.”

The full report can be read on the Scottish Government website.