So much has changed for the world of digital health since the pandemic – or has it? We spoke to 14 healthcare leaders to understand what has changed in the health and care system and what comes next.
Alex Kafetz, Managing Partner and Director of Insight and Strategy at ZPB explores what this means for the whole system, including the NHS and social care, life sciences and private sector suppliers.
“In February the digital eco-system was like the wild west. Then the pandemic changed the market as if it was 1849, gold had been struck in California and every digital health company was trying to find the quickest way to get to San Francisco” – Panel member interviewed by ZPB
Data lakes and black holes
The overwhelming view from everyone we’ve spoken to over the past few weeks is that we are being told there has been a digital channel shift, we are sensing it, yet we don’t have accurate data – so we just don’t know. We all watched the huge efforts from NHSX and NHS England and Improvement as they raced to put in place technology to respond to the pandemic, including, unfortunately, its ill-fated contact app. There were lots of huge steps forward such as online outpatients appointments (for those who want it) by default. But what does this mean for pharma and private providers who are investing heavily in technology as a means of democratising healthcare information and access to services?
Graham Kendall, Director of industry body Digital Healthcare Council told us: “Decision-makers at the heart of government are making key judgements about digital channel shift in the belief they have reliable information, but this may be illusory. The only thing that seems clear is that there is no single agreed approach and as such, there is no single repository of robust data. Without data we can rely on, transparency is minimal, and we’re left guessing. This matters because the narrative about service transformation over the past few months can only truly be scrutinised if we have more robust data to confirm what is happening. Without understanding use, we risk investing in the wrong services – but without properly working the problem, we just don’t know.”
More positively in the data space, many of the data leaders we’ve spoken to talk of a “new era of data liquidity” with data stores that have been pulled together across multiple sectors and providers in the drive to understand the genetic make-up of the virus. This could show the value of pharma, academia, public bodies and NHS sharing data in the long term.
However, despite this optimism, the pandemic has exposed significant data deficits, especially in the care home sector which remains a black hole. Data infrastructure needs to further improve as we look towards the longer-term impact of non-COVID19 morbidities and mortality.
Our research across pharma and tech leaders revealed that the issues faced by the digital health and tech sector are striking in their similarities. Namely:
• A tendency for pricing to focus on a single feature or benefit, rather than a more holistic approach to assessing value across a wider service or pathway. • A level playing field requires fair pricing to support value across care. This is a win-win as patients, healthcare services benefit and it is the best way to ensure that digital providers can continue to scale up. These are the future of UK PLC. • Bullish attempts by the centre to own all IP (in tech, perhaps less relevant to pharma). • Confusion around the consistent implementation of standards from arms-length bodies such as the CQC, NHSX and MHRA.
There has been a distinct thawing of relationships with the NHS and pharma over the pandemic. Edelman’s Barometer and the more recent Future Brand Index show us this, but what’s interesting is that this comes at a time when tech and big data appears to be losing the battle to win public hearts and minds. Pharma companies are seen to have risen to the challenges in the way that perhaps data companies haven’t, with privacy and security issues remaining and a lack of cooperation in some quarters.
“Big data is now public enemy number one, not pharma. The industry must seize on this détente. The NHS cannot survive without a productive relationship with pharma and vice-versa.” Former CTO
Confusions and rushed decisions around tech – perhaps inevitable in a pandemic – were highlighted many times and a strong theme we’ve seen is that tech strategy, both locally and nationally will need a hard reset as we enter Phase Three in our response. In truth, it seems the last few months, at least in the eyes of those we interviewed, has shown us what not to do. Key emergent issues include:
1. A bifurcation of the market with clinicians split between using freely available “WhatsApp” style solutions with all the risks these entails and others using paid for bespoke industry apps and solutions 2. The resurgence of the telephone as the key medium raising questions as to whether patients and practitioners are demanding anything more sophisticated 3. Confusion from NHSX who (with their predecessors) have spent the last eight years promising to learn the lessons of connecting for health yet have reverted to similar costly and anticompetitive behaviour at the first sign of crisis 4. A lack of data to measure any of this anyway
And in spite of remote consultations playing a considerable role in building newinfrastructure and resilience across the health system, notably in primary care, NHSEI is insisting that we return to face to face GP consultations and these are offered first and foremost. Like a game of snakes and ladders, digital transformation in the NHS is never straightforward.
Get in touch to talk about what the next phase of COVID-19 planning in the NHS means for your organisation. Alex.Kafetz@ZPB-Associates.com