Initial findings have been published on the progress of a £37 million pan-UK programme, called Demonstrating Assisted Living Lifestyles at Scale (dallas), which has been tasked with making such technology-assisted health and wellbeing a reality.
Researchers, from the Universities of Glasgow, Strathclyde and Newcastle, have identified five key challenges and three key issues that should be addressed for future large-scale implementation of digital healthcare tools and services.
Launched in 2012 by Innovate UK, the dallas programme comprises four consortia that bring together multiple partner agencies to work together to use a wide range of technologies including interactive, person-centred digital portals, telecare, electronic personal health records and mobile applications to help people manage their health and wellbeing.
The four consortia are:
- i-Focus – a nationwide programme offering people a range of products and services to help them feel more comfortable in their homes. The Warm Neighbourhoods scheme uses online and mobile technologies to enhance and organise informal care networks that help families, friends and neighbours to support others in the community in a practical way.
- Year Zero – an online application that empowers individuals to actively manage their health information from cradle to grave. The tools include a digital version of the paper-based Red Book that is given to all new parents to record their child’s health, and Family Health Tree, to help people plot their family’s health genealogy and Rally Round, a social networking and planning tool to connect family, friends, carers and health and care professionals.
- Mi Liverpool – encourages people living in Liverpool to plan for their future in order to better manage their health and social care needs, supported by Life Enhancing Technologies.
- Living It Up – focuses on developing innovative solutions that will enable people in communities across Scotland to live happy, healthy and safe lives, enabling choice and better control over their health and wellbeing. The Hidden Talents element also encourages people to identify their talents and share them with other members of the community.
The initial findings by the team leading the independent evaluation of the programme, Professor Frances Mair, of the University of Glasgow, and Drs Marilyn McGee Lennon and Matt-Mouley Bouamrane of the University of Strathclyde, are published in the Journal of the American Medical Informatics Association.
The five key challenges identified were:
- The challenge of establishing and maintaining large heterogeneous, multi-agency partnerships to deliver new models of healthcare;
- The need for resilience in the face of barriers and set-backs including the backdrop of continually changing external environments;
- The inherent tension between embracing innovative co-design and achieving delivery at pace and at scale;
- The effects of branding and marketing issues in consumer healthcare settings; and
- The challenge of interoperability and information governance, when commercial proprietary models are dominant.
The present study suggests three key issues that should be addressed for future large-scale implementation of digital healthcare tools and services:
- For a program of this scale, there should be a longer timeline between signing the contract to program initiation and a minimum 5-year timeline (5–10 year plan ideally) for the overall program of innovation at scale;
- There should be significant time invested in assessing the digital readiness of the local health economies and;
- The current status of Information Governance (and lack of interoperability) represents a barrier to the meaningful deployment of innovative digital healthcare services at scale and merits attention.
Prof Mair said: “Around the world, healthcare systems are having to adapt to accommodate unprecedented changes in population demographics and increases in chronic diseases.
“Interactive, person-centred digital tools and services offer a means of promoting a more citizen-led, self-care and preventative health and wellbeing agenda and this is what the dallas programme set out to explore.
“Our paper explores what the current barriers are to achieving digital healthcare at scale and initial findings on how the dallas programme worked to shift the paradigm of care in the UK.
“Flexibility, adaptability, and resilience were key implementation facilitators to enable shifting to new digitally enabled models of care. Large-scale digital health deployments are feasible but significant barriers remain to their widespread routinisation.”
The dallas programme is funded by Innovate UK, the National Institute for Health Research, The Scottish Government, Scottish Enterprise, and Highlands and Islands Enterprise.