Why does the NHS struggle to adopt eHealth innovations? A review of macro, meso and micro factors

Abstract

BackgroundHaving a tax-funded and supposedly ‘National’ Health Service (NHS), one might assume that the UK is well-positioned to roll out eHealth innovations at scale. Yet, despite a strong policy push, the English NHS has been limited in the extent to which it has exploited the potential of eHealth.Main bodyThis paper considers a range of macro, meso and micro factors influencing eHealth innovation in the English NHS.ConclusionsWhile barriers to eHealth innovation exist at all scales, the fragmentation of the NHS is the most significant factor limiting adoption and diffusion. Rather than addressing problems of fragmentation, national policy seems to have intensified the digital divide. As the recently published NHS Long Term Plan places great emphasis on the role of digital transformation in helping health and care professionals communicate better and enabling people to access the care they need quickly and easily, the implications for the digital divide are likely to be significant for effectiveness, efficiency and equity.

Using telemedicine and wearable technology to establish a virtual clinic for people with Parkinson’s disease

“…[9][10][11] While the NHS has published its 'Long Term Plan' on putting focus on digital transformation, it has been found that the fragmentation of NHS services is proving a barrier to change. 12 We have combined a phone clinic approach with the aid of the PKG as a surrogate for the clinical examination part of the clinical consultation. To our knowledge, this is the first pilot of a VC for patients with PD in the NHS.…”

“… 9–11 While the NHS has published its ‘Long Term Plan’ on putting focus on digital transformation, it has been found that the fragmentation of NHS services is proving a barrier to change. 12 …”

What Are the Changes and Burden Associated With COVID-19 in Diabetes Management and Delivery of the Diabetes Services?

“…Therefore, it is not surprising that many health authorities, including the National Health Service (NHS) in the UK, used telemedicine during this pandemic, especially for outpatient follow-up [20,21]. Other uses of telemedicine can be seen in (including pre COVID-19) electronic prescribing and retrieving patient records [22]. One of the UK's Department of Health aims is that by 2023 there will be an established electronic system where patients' records can be accessed all over UK hospitals [23,24].…”

“…One of the UK's Department of Health aims is that by 2023 there will be an established electronic system where patients' records can be accessed all over UK hospitals [23,24]. Different IT systems and financial readiness in different hospitals can represent a huge obstacle in connecting different hospitals [22]. Furthermore, telemedicine can be labour intensive [22].…”

“…Different IT systems and financial readiness in different hospitals can represent a huge obstacle in connecting different hospitals [22]. Furthermore, telemedicine can be labour intensive [22]. However, given the increase in telemedicine usage during the COVID-19 pandemic, we may see significant changes in the direction of how diabetes services will be provided.…”