Apps won't have a big impact on the NHS in the short to medium term: Use of the NHS is more common among the older and less wealthy and these groups are unlikely to have smartphones.
Do you remember when there was "an app for everything" – except for people who wouldn't stop saying "there's an app for that"? The catchphrase may have lost its ubiquity, but mobile apps are here to stay – Apple recently celebrated 50bn sold. The NHS has been slower off the mark than other sectors, but enthusiasm for health-themed apps is starting to permeate the health service.
NHS Choices has started a health app library, and there has been a proliferation of articles in the healthcare press about the potential role of apps in the future of medicine. The most recent I came across was a piece by Ashley Bolser.
Bolser's article made some good points, in particular his argument for a process to ensure health apps contained accurate, reliable information. Furthermore, apps have a great deal of potential uses in the healthcare industry.
I am yet to be convinced, however, that this particular kind of technology is going to have a big impact on the NHS – at least in the short-to-medium term. The reason is very simple: NHS core customers are unlikely to have smartphones.
A report showing UK smartphone ownership by age band, as of March 2011, showed that ownership is lowest among the older and less wealthy. Conversely, use of the NHS is more common among these same groups. Data for 2011-12 show that patients aged 65 and over accounted for almost 40% of finished consultant episodes in English NHS hospitals. The link between poverty and poor health is well established; see for instance Lord Darzi's year of life expectancy lost with every stop heading east on the Jubilee Line.
This fits with what clinicians are seeing on the front line. Dr Jonathon Tomlinson, a GP in Hackney and a medical blogger, is probably far from atypical in his estimate that 10-20% of his practice's patient list accounts for 80-90% of all appointments, and that the elderly, deprived and poorly-educated are disproportionately represented in this group.
If the NHS is going to cope with a future of static or negative funding growth, the big opportunities for cost savings are going to come from preventing these core customers from using as much healthcare as they currently do.
It is easy to conflate novelty with usefulness, especialy where technology is concerned, and it isn't hard to find NHS-specific examples of prioritising medium over message. Take Second Health that was once the future of healthcare communicationas an example. Early in 2007, online virtual world Second Life was approaching the zenith of its popularity. Imperial Healthcare NHS Trust spent an unspecified amount on purchasing electronic real estate and constructing a virtual community hospital and polyclinic.
The idea was to use this digital space to engage with patients, the public and clinicians. There were plans to incorporate sessions spent operating on computer-generated patients into medical training. An early highlight of the project was a surgical conference where 200 attendees were addressed by a mermaid. Today, however, Second Life's popularity has faded and the hospital and polyclinic seem to have disappeared.
Money, time and enthusiasm are all finite resources. The NHS needs to direct these resources to where they will have the greatest effect. The methods and technologies used to improve services can be arrived at by working backwards and asking: what does the customer need?
Cassander Grey works in NHS commissioning. He writes about health policy and NHS management. Cassander Grey is a pseudonym Guardian Professional.
Do you remember when there was "an app for everything" – except for people who wouldn't stop saying "there's an app for that"? The catchphrase may have lost its ubiquity, but mobile apps are here to stay – Apple recently celebrated 50bn sold. The NHS has been slower off the mark than other sectors, but enthusiasm for health-themed apps is starting to permeate the health service.
NHS Choices has started a health app library, and there has been a proliferation of articles in the healthcare press about the potential role of apps in the future of medicine. The most recent I came across was a piece by Ashley Bolser.
Bolser's article made some good points, in particular his argument for a process to ensure health apps contained accurate, reliable information. Furthermore, apps have a great deal of potential uses in the healthcare industry.
I am yet to be convinced, however, that this particular kind of technology is going to have a big impact on the NHS – at least in the short-to-medium term. The reason is very simple: NHS core customers are unlikely to have smartphones.
A report showing UK smartphone ownership by age band, as of March 2011, showed that ownership is lowest among the older and less wealthy. Conversely, use of the NHS is more common among these same groups. Data for 2011-12 show that patients aged 65 and over accounted for almost 40% of finished consultant episodes in English NHS hospitals. The link between poverty and poor health is well established; see for instance Lord Darzi's year of life expectancy lost with every stop heading east on the Jubilee Line.
This fits with what clinicians are seeing on the front line. Dr Jonathon Tomlinson, a GP in Hackney and a medical blogger, is probably far from atypical in his estimate that 10-20% of his practice's patient list accounts for 80-90% of all appointments, and that the elderly, deprived and poorly-educated are disproportionately represented in this group.
If the NHS is going to cope with a future of static or negative funding growth, the big opportunities for cost savings are going to come from preventing these core customers from using as much healthcare as they currently do.
It is easy to conflate novelty with usefulness, especialy where technology is concerned, and it isn't hard to find NHS-specific examples of prioritising medium over message. Take Second Health that was once the future of healthcare communicationas an example. Early in 2007, online virtual world Second Life was approaching the zenith of its popularity. Imperial Healthcare NHS Trust spent an unspecified amount on purchasing electronic real estate and constructing a virtual community hospital and polyclinic.
The idea was to use this digital space to engage with patients, the public and clinicians. There were plans to incorporate sessions spent operating on computer-generated patients into medical training. An early highlight of the project was a surgical conference where 200 attendees were addressed by a mermaid. Today, however, Second Life's popularity has faded and the hospital and polyclinic seem to have disappeared.
Money, time and enthusiasm are all finite resources. The NHS needs to direct these resources to where they will have the greatest effect. The methods and technologies used to improve services can be arrived at by working backwards and asking: what does the customer need?
Cassander Grey works in NHS commissioning. He writes about health policy and NHS management. Cassander Grey is a pseudonym Guardian Professional.
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