The Digital Health Critic is Born

So, this is it, the first digital health critic newsletter.

By now you know I live a life on the internet, eternally annoyed at digital health/health tech offerings. Today, I turn my sights to some decision makers who will make or break digital health going forward.

I was meant to start with an ode to emergency care triaging in the new healthcare digital age. But then I thought, it’s hard to solve problems without taking a step back and having an overview of the way things currently work and what is currently being screwed up so badly.

So in this newsletter, we turn our attention to 100 years into the future. A future that we may come to see if the pace and direction of change in the digital health landscape, continues as it is. Enjoy….

The year is 2123 and a newspaper article from “The Moon” newspaper reads:

“Ground breaking new deal to digitally transform the NHS, reaction from key stake-holders.”

After exhausting all other avenues, including asking the gardener and Irene down the road, the NHS is now definitely ready to begin it’s journey into digital transformation” said Pat Hancock, descendant of a former UK health minister. “It’s time to let go of those fax machines and pagers once and for all and reduce GP waiting times from 3 years to 2 years and 364 days over a period of 3 years, fulfilling a pledge made at the 2121 election by the New Old Conservative Party and agreed in a cross-party meeting with Old New Labour”.

In a sign of progress, one woman, one token coloured person and one wheelchair user were allowed to be at the meeting to be talked over by 57 balding men, to sign off on the generous ￡158 Billion deal. This will likely be spent on buying a modern horse with integrated cart system to further expand capacity and drive down A&E waiting times. The NHS decided not to opt for the latest Japanese innovation in digital health, made in conjunction with NASA, the Elon Musk Foundation, and several previous Nobel Prize in Technology winners, which has seen life expectancy improve by 10 years and also reduce A&E waiting times to 5 minutes. This is due to concerns around security of personal data. As such, the NHS will be using some of the funding and probably a lot more, to build its own instead.

To complete the transformation life cycle and return to NHS roots, it was also announced that the current Connected Care Units, formally known as Integrated Care Boards, will now be renamed Clinical Commissioning Groups (CCGs). ?Finally, the plan will be to re-privatise the re-nationalised NHS, thus accelerating funding into the new digital health transition.

Commenting on this deal we spoke to a variety of key stakeholders to get their reactions:

Prime Minister:

“with peace in the Middle East being achieved 50 years ago, world hunger solved and global warming improving, we thought now would be the right time to try to fix the last great challenge of this planet, the NHS digital transformation. Robots and computers will finally replace black and Asian doctors as we envisaged. By this, we will be altruistically handing back doctors to the 3rd world. Aren’t we good eh? We hope the electorate will take our effort into account when they vote in 6 months’ time”.

Leader of the opposition:

“the opposite of what the Prime Minister said”.

Chief Executive of NHS England:

“successive governments have promised digitalisation and transformation, we are finally able to realise this in the 22nd century. As a former retail consultant, I know first-hand the importance of healthcare digitalisation and transformation, especially from my 4 years as the head of NEXT, which closed due to bankruptcy while I lead it. I will be visiting a hospital for the first time in 6 months next week, to cut some ribbons and take some photos with eager staff.

We will also be launching a ￡70 million pound research project and asking our best and brightest from UCL to find out answers to very challenging questions such as: Is cutting down on the number of doctors affecting patient waiting times? Why are GPs not working hard enough? And of course, in case of another pandemic, who can we find to build a useless ￡37billion app?”

Royal College of Something or Other gave their opinion in the form of a whisper:

“We, in our neutral tone and neutered approach, reinforce that we have been telling the government for a long time to listen to us. They never do. So, our contribution to digital health will be a continuation of gala dinners, debate over tea and scones and a rise in membership fees”.

The GMC also gave their support:

"We would like to add that we will now be able to 'big brother style' audit all clinicians from their integrated digital health logins, thus making the disciplinary process far more efficient. We can now use AI to assess this data and analyse which clinicians are likely to make mistakes and thus get them disciplined before they make their mistake! We thank Tom Cruise from the movie "Minority Report" for the idea, and yes we will report many minorities."

The BMA continues to supports it’s staff members and issued an important message.

“The BMA has taken a serious approach to this and fully defend our members. We encourage all our members to download our template letter, and send it to their HR departments telling them that any impact of digital transformation on them will be highly illegal. We also repeat the recurrent refusal of any health minister over the past 100 years wanting to ever sit with us and hear us out”.

An MHRA spokesperson was asked for comment about the new deal who replied, “unfortunately, the question does not fall into the parameters of the box that requires our ticking, thus we are unable to comment at this stage”.?

The Dean of Ye Olde Traditional University Medical School praised the move.

“We will be supporting the digital transition by continuing with our traditions of hiring doctors who wear bow ties and smoke pipes. It is essential that our medical students understand digital health, so any extra funding we receive from the government will be put into bringing medical students from South Korea where they are extremely digitally literate and wealthy. Their high tuition fees and better digital literacy, means we won’t have to re-school UK students who are basically digitally handicapped by the schooling curriculum.

Unfortunately, we were unable to ask any doctors or nurses for their opinions as they were probably playing golf or something, and what do they know about computers, they still use Lloyd Georges don’t they?

In conclusion, we found that Meghan Markle ruined the NHS.

Final Thoughts

Joking about recurrent failed promises aside, healthcare and digitalisation is (in my opinion) being blinded by short sighted objectives and politicking. Short term answers to long term problems, leads to an unbelievably slow transformation, costing money and lives as well as political parties elections (hope some politicians are reading this one)!

How can effective digital transformation be expected to take place in healthcare, when there is such a large top to bottom mess, being met with a sticking plaster and reduced funding!? Changing names in the hope no one realises it’s basically the same thing doesn’t help either. As a nation we tend to shoot ourselves in the foot quite a bit and make change very difficult.

The problem with digital health is not just crap products, it’s crap everything and lack of foresight. Policies, regulatory processes, funding, education, integration. But the biggest component in my opinion is leadership, or lack of it. What exactly is the vision of digital health in the NHS? Who will drag us to achieve that vision or are we forever doomed to have a war between a naff NHS all for one and one for all solution vs a private digital health product race to the bottom with uber specific but disjointed care.

Are you as tired as me of awful NHS products but also can’t tell where the private apps will end? Will there be an app for when your small finger hurts and another app for if the ring finger hurts, with neither app really helping the other finger as its out of its remit?

Junaid.

(p.s. for those of you easily miffed - take the above lightly please, much (but not all) is meant in jest).

I advise on digital health solutions. Please dont be shy to follow, connect or message. Happy to set up a chat with like-minded people or companies that would like advisory input on their digital health/tech product offerings.