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Scotland’s new Digital Health and Care Strategy – big opportunities and complex decisions

On Wednesday, I went to the Health & Social Care Digital Leaders’ Summit 2018, which coincided with the launch of the Scotland’s new Digital Health and Care Strategy.

I’ve only skimmed it so far but there’s some good intent around supporting the more preventative, person-centred care that everyone in the sector wants to see.

I took away three main themes from the event, and it struck me that all of those had an inherent tension:

  1. There was a big focus on data and the need to generate meaningful insight from that. Obviously, impending GDPR issues and the climate created by data misuse via Facebook et al is relevant here; many contributors spoke about the challenges of how, when and why information is shared not only between patients and clinicians/care providers but when it’s aggregated for population-wide analytics and forecasting. But the tension here comes from different, possibly generational attitudes to technology: can there really be a one size fits all approach to data that covers generations of people happy for Snapchat, Twitter & Facebook to know everything about them as well as less tech-savvy more privacy-focused older populations?
  2. An implicit strand on efficiency, certainly through using existing technologies smarter. We don’t have a blank sheet of paper and several people today mentioned (and it is referenced in the new strategy) that the vast majority of us have the tools – literally – in our hands all the time to create, process, share or access information about ourselves or those we care for. We need to exploit that a lot better. But we also need to drive or enable better consistency across the 14 areas, removing unnecessary duplication or (shudder) ‘postcode lotteries’ – referenced as  a ‘once for Scotland’ principle, in line with the Digital First Service Standard. One of the speakers from NHS Education spoke very well about leveraging the enormous spending power of the public sector in Scotland to mandate and enforce standards.  There is obvious friction between allowing people to use their own kit and data, and the sensible desire for common infrastructure.
  3. There was only a passing reference to Artificial Intelligence (AI), automation and robotics today, and I noted that the Strategy sets out an aspiration for a ‘Horizon-Scanning’ function to assess emerging technologies. Again, there is undoubted complexity here: while the taxpayer will welcome opportunities to mechanise aspects of health & social care provision, it has significant implications for what is a large workforce in Scotland (and that speaks to other debates on initiatives like the Universal Basic Income). But it also – and I hadn’t thought about this at all until today – has profound impacts for us as patients. As Cath Cooney of Health & Social Care Alliance Scotland pointed out (paraphrasing Stanford University’s Dr James Doty): “If we don’t build empathy into AI, then the robots won’t be kind to us.…”.

Some complex decisions await.

I look forward to discussing the strategy and its implementation locally with our clients, partners and friends over the coming weeks, months and years.

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