Nuffield Trust publishes lessons learned to support patient engagement with digital innovations

The Nuffield Trust, an independent health think tank, has published a new report following an evaluation to explore the factors that support patient and staff engagement in the use of digital healthcare innovations.

The paper, ‘Supporting patient engagement with digital health care innovations: Lessons from the Care City test bed’, produced by Rachel Hutchings, Fellow and Chris Sherlaw-Johnson, Senior Fellow at Nuffield Trust, details a review of a programme that involved the implementation of digital innovations and the lessons learned from implementing those.

The Care City Test Bed involved six digital innovations between June 2019 and August 2020, to test the innovations through a mixed-methods evaluation, to bring together findings relevant to support patient engagement with digital innovations.

Innovations in the programme included a digital platform providing cognitive behavioural therapy for people with insomnia, a digital health coach tool for people with recently diagnosed type 2 diabetes, a home-based albumin-to-creatinine ratio urine test, an app for remote cardiac rehabilitation, a digital tool measuring vital signs, and a platform for digital urine analysis.

Included in the paper are a range of key findings, lessons learned, implications for policy and practice, and concluding thoughts.

The authors noted: “While the COVID-19 pandemic led to a large increase in the use of technology in health care, many are concerned about the impact of the increased use of digital tools on access to services and quality of care, with the pandemic also putting a spotlight on the risks of digital exclusion. While digital innovation has the potential to help alleviate some of the pressures the NHS finds itself under following the pandemic, implementing innovations and supporting people to use them are not a quick fix.”

Some of the key points and “things that can be put in place to optimise the process for those that use them”, the authors highlight:

  • The point at which the innovation is offered can have a significant impact – face-to-face referral by a trusted person may influence the willingness of a person to begin using digital innovations. Staff who offer innovations and support people to use them should receive sufficient training. This includes identifying and, where possible, addressing technical concerns that people have at the beginning, by providing support with downloading or getting started, for example. Ongoing training needs should be identified and addressed throughout.
  • The process for implementing innovations and supporting people to engage can be time-consuming and resource-intensive – capacity, time and resources should be built into implementation programmes to enable this to happen effectively.
  • Regular, ongoing support from the health care team is essential – digital innovations are one part of a person’s pathway of care and should be integrated with their wider care plan. Some initial concerns were raised by patients that they would not receive the same level of support from their health care team if they were using an app. It was therefore fundamental to reassure them that this would not be the case. Maintaining access to existing modes of care is essential in order to ensure that those who do not wish to use digital innovations do not miss out. It is important to recognise the value of friends and family in providing support and encouraging motivation, but also consider exploring opportunities for enabling peer support for people using digital health innovations.
  • Issues with technology access can arise throughout – it is not just an initial barrier and can affect ongoing engagement from people who would otherwise be keen to use technology for their health care. Innovators and implementation teams should remain open and flexible to amending the innovations or the way they are being applied to address emerging challenges and improve accessibility.

To read the paper in full, please click here.