There is a strong Government and policy push for digital transformation within the NHS. Despite this push, the digitalisation of healthcare has been slow to develop with evidence of variation in progression, causing a ‘digital gap’ and inevitable healthcare inequalities. Digital readiness, defined here as a motivation and competence to effectively adopt, use and spread digital healthcare technologies, has grown in recognition of its importance for digital transformation. This has been greatly accelerated by necessity during the Covid-19 pandemic.
The report author, Matt Hammerton, is a GP Partner at St Clements Partnership, Winchester, and Digital Primary Care Clinical Lead for Wessex AHSN. Prior to this Wessex HEE Digital Fellowship, he spent 6 months helping to research, write and edit the 2019 Topol Review: Preparing the healthcare workforce to deliver the digital future. This was an independent report on behalf of the Secretary of State for Health and Social Care. His current fellowship with Health Education England developed through his desire to apply learning from the Topol Review within the local healthcare environment in order to develop pragmatic and empathetic recommendations for supporting effective digital transformation.
Digital readiness has a greater impact on digital transformation than technology itself. However, research into factors impacting on general practice digital readiness is limited. As such, this service evaluation study set out to gain a better understanding of digital readiness by asking:
1. How does digital readiness vary between technologies and individual aspects?
2. How do micro (human) factors impact on digital readiness?
3. How do meso (practice situation) factors impact on digital readiness?
4. How do macro (external) factors impact on digital readiness?
5. Do practice digital readiness competency measures correspond to related digital healthcare technology use?
This was done via a sequential mixed methods design using both quantitative and qualitative evidence between December 2019 and September 2020. Staff at 33 practices within the North and Mid Hampshire Integrated Care Partnership and digital companies linked to innovations operating at these practices provided the study boundaries. The digital healthcare technologies considered were: electronic patient records, telehealth, patient online access, patient apps and wearables and social media.
Reliably measuring digital readiness in a complex and varied health environment is challenging. As such, a review of the literature was conducted before developing a 90-second digital readiness survey tool provided to all practices within the study. This comprised short user-reported experience measures for digital competency, contextualised digital competencies and innovation readiness. The digital competency measures looked at confidence, motivation and self-efficacy (an individual's belief in their capacity to execute behaviours necessary to produce specific performance attainments). Responses were collected pre and post-lockdown commencing on the 23rd March 2020. The results guided the qualitative semi-structured interviews with clinical and non-clinical general practice staff and digital technology company representatives. These were analysed for emerging themes before being triangulated with the quantitative findings.
The staff of 33 General Practices participated in the evaluation, with staff from two practices and three technology companies (Nye Health, eConsult and Mymhealth) agreeing to take part in the qualitative section of the evaluation. Dr Hammerton has also been supported by Tim Benson from R-Outcomes, and by the wider Wessex AHSN team, particularly Rachel Dominey, Nadia Kuftinoff and Andrew Sibley.
You can read and download the report from the Resources section on this page. Should you have any questions about this report and its findings, please do contact us.