The path to enlightenment involves looking inside one’s self, as well as at the world at large. Being mindful of your environment. Appreciating everything.
It is hard. It is all too easy to view things within your own world. Things are much more achievable if you have control. The NHS would agree; and healthcare technology has to fit within these limits.
It is one reason why integrated care will be so difficult. As put forward in a fascinating series of essays on the integration of health and social care, we need to move away from rationing treatment for illness to investing in health and social care. This means looking from a different point of view – one of the recipient, the patient (or person, to be more accurate).
To date, this has not happened. Organisations look from within. This is why The King’s Fund notes there needs to be wholesale changes in the way that care is designed, delivered and paid for if the NHS is to implement the new models of care envisaged in the Five Year Forward View. Five years looks like a very short period of time.
Looking at the world at large and trying to make sense of it all takes some doing – and some undoing. What was fit for purpose a decade ago is now outdated. Yet sometimes we have to live with this.
Healthcare technology feels this effect more than most. Despite having an advanced electronic health record system in place, one US CIO is using a fax machine to send out test results as recipient systems are still not talking to each other.
And as was recently noted in a study of the use of mHealth in supporting integrated care, the use of technology needs to go beyond just one part of the process. There needs to be “a higher degree of pervasiveness at all stages and in all health care delivery activities”.
Getting data to flow to support multiple parties is difficult. Not impossible, but often there are huge vested interests at play. Changing this will not happen overnight.
Those bodies that applied to be vanguard sites for the new models of care need to be mindful of the environment in which they exist – and remember that the path to enlightenment can take a lifetime.