The third wave is about the complete digitization of whole services. With this comes the possibility of new ways of working and living that will impact on everyone. What will this look like for healthcare?
Personalised or precision medicine: is defined as the application of emergent technologies (such as genomics) to better manage patients’ health and target therapies to achieve the best outcomes in the management of a patient’s disease or predisposition to disease. Precision medicine should both improve patient outcomes and deliver benefits to the health service, including reducing the cost of ineffective treatment and multiple tests.
Electronic health records (EHRs): The integration of health and health and social care to support joined up patient pathways requires shared records.
Mobile technology: advances in smart phone design has meant that patients and carers can research information online, study treatment options and share experiences. From a health provider viewpoint the benefits can mean minimising avoidable service use, reducing paperwork and increasing patient face time (Deloitte 2015).
Alongside digital developments are what have been called social innovations (Nesta 2015) – innovations that harness the power people (patients, carers, communities and citizens) to improve health. Both digital technologies and social innovations are shaping health care now and in years to come.
Biesdorf S, Niedermann F (2014) Healthcare’s digital future. McKinsey & Company.
Deloitte Centre for Health Innovations (2015). Connected health. How digital technology is transforming health and social care.
Nesta (2015) The NHS in 2030. A vision of people-powered, knowledge-powered health system.
National programmes / strategies
Department of Health: Digital-first public health: Public Health England's digital strategy (2017). This document explains how Public Health England (PHE) will make best use of digital to meet the needs of our users and fulfill our remit to protect and promote health and reduce inequalities.
Department of Health: The power of information (2012). This strategy sets a ten-year framework for transforming information for health and care. It aims to harness information and new technologies to achieve higher quality care and improve outcomes for patients and service users. Underpinned by the Health and Social Care Act 2012, it covers public health, healthcare and social care in adult and children’s services in England. The vision set out in the strategy is that "patients are in control of the information they need to improve their health and wellbeing and NHS information systems are designed to support clinicians and other front-line staff to deliver safe, high quality care to their patients".
NHS England: Leading Change, Adding Value: A framework for nursing, midwifery and care staff (2016). As part of 10 commitments to delivering and improving care, NHS England encourages health care professionals to champion the use of technology and informatics to improve practice, address unwarranted variations and enhance outcomes.
NHS Five Year Forward View (2014). The NHS Five Year Forward View sets out a new shared vision for the future of the NHS based around the new models of care. It has been developed by the partner organisations that deliver and oversee health and care services including Care Quality Commission, Public Health England and NHS Improvement. Patient groups, clinicians and independent experts have also provided their advice to create a collective view of how the health service needs to change over the next five years if it is to close the widening gaps in the health of the population, quality of care and the funding of services.
Northern Ireland: Information and Communications Technology Strategy. The way forward for Northern Ireland's eHealth and Social Services was published in the Department for Health, Social Services and Public Safety (DHSSPS) Information and Communications Technology Strategy in March 2005. Northern Ireland is in the process of reforming its public body structures, which will result in a single Health and Social Services Authority. The proposals for future reform of health and social care in Northern Ireland are currently out for consultation.
Northern Ireland: eHealth and Care Strategy. This eHealth and Care Strategy sets out a range of measures for the increased use of digital technologies to support the delivery of health and care services between now and 2020. The Strategy is built around the key objectives of supporting people, sharing information, using information and analytics, fostering innovation, modernising the eHealth infrastructure and ensuring good governance.
Scotland: e-Health strategy 2011-2017. This eHealth strategy sets out five new strategic eHealth aims. They are: supporting people to communicate with NHS Scotland; contributing to care integration; improving medicines safety; enhancing the availability of information for staff; and maximising efficient working practices.
Scotland: A digital strategy for Scotland 2017 and beyond: a view from the professions. This digital strategy sets out the changes that need to take place within health care services to improve patient care and health and wellbeing outcomes across Scotland.
Wales: Enabling integrated care in Wales. The Health and Social Care strategy for enabling integrated information services in 2012. This draft strategy “describes how the delivery plan for the NHS and Social care is translated into software applications that people can use to do their job better. It is driven by current and evolving policy and professional practice and brings these together with modern information services and communications technology.”
eHealth Forum community: this is a forum for nurses who are working or interested in the use (collecting, recording, storing, retrieving and sharing) of clinical data and information for the advancement of patient care and nursing. It aims to promote, develop and integrate an awareness of eHealth and health informatics into every area of professional nursing practice, research and education.
RCN Principles of Nursing Practice. The Principles describe what everyone can expect from nursing practice, whether colleagues, patients, their families or carers and provide a framework for care and quality improvement. This resource introduces the Principles and describes how they relate to other publications about the quality of nursing care. Principle E focuses on communication, handling feedback, record keeping, reporting and monitoring.
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