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18th March 2021
Defining digital health and care is challenging*. The sector is multidisciplinary, cross-professional, fast-developing and evolving. Most definitions consist of lists of different types of technologies that relate to or represent digital health and care.
When technology changes as fast as it does today, these definitions can have a very short shelf-life. The ambiguity surrounding “digital health and care” has led to the term being used loosely to refer to anything “digital” relating to health and care, for example:
In an emergent and evolving sector, this type of fluidity of meaning may be beneficial for innovations and ideas to develop. However, when “digital health” is used in conjunction with workforce development and skills questions, more accuracy is needed.
In the Digital Health & Care Innovation Centre, we make the following distinction between people working in digital health and care as opposed to digitalising** health and care processes and services:
The skills and capability requirements of these groups of staff are quite distinct from one another, yet equally important, for the successful development, implementation, scaling up and use of digital in health and care.
HIMSS (2020) adopted a new way to approach this problem. Instead of trying to describe “what digital health is”, HIMSS research team asked: “what digital health does?”
“Digital health connects and empowers people and populations to manage health and wellness, augmented by accessible and supportive provider teams working within flexible, integrated, interoperable, and digitally-enabled care environments that strategically leverage digital tools, technologies and services to transform care delivery.” [HIMSS, 2020]
This is a whole-systems-based definition, which encompasses not only technologies, systems and infrastructures, but also workforce, service users (i.e. citizens) and services; standards, information governance, interoperability; emphasis of care moving towards wellbeing and preventative care; collaboration, integration and service transformation. This type of definition could also be applied to digital care. While this is one of the more insightful descriptions that I have come across so far, does it actually define digital health? For when the question is: “what does digital health do?”, we tend to describe how digital is changing health (and care), i.e., digitalising the sector. The HIMSS definition illustrates the aspiration or the direction of travel for digitally enhancing and enabling health and care.
Furthermore, when looked at from the point of view of workforce development, the HIMSS definition focusses solely on staff that work in delivering digitally enhanced and enabled health (and care) services. It does not encompass people who design, develop, deliver and facilitate the implementation of digital solutions for use by the “accessible and supportive provider teams working within flexible, integrated, interoperable, and digitally-enabled care environments--”.
To really define digital health and care, should we not ask instead: “what does the digitalising health and care sector need?”
That would produce a holistic definition of digital health and care that would include not only the digital solutions, infrastructures, information governance, standards etc., but would also include the workforce required both to create and to use the solutions, not forgetting citizens as end-users of the digitalised health and care services.
Anyone up for working with DHI to crack this nut?
If you wish to participate in the conversation, please email email@example.com, we would love to hear your views.
* In Scotland, health and care services were integrated in law in 2015. Since then, health and care are generally discussed under the same banner, even if in practice service integration is a work in progress.
** “Digitising” is a better-known term than “digitalising”. Digitising refers to converting information into a digital format (e.g., converting a piece of paper into a pdf). “Digitalising”, however, is used to refer to transforming processes and services into a digital format (like doing banking online). For an explanation, please see: https://nextservicesoftware.com/news/digitize-vs-digitalize-know-the-difference/