Digital Health & Care Policy Agenda in Scotland
ADLIFE consortium members, Professor Roma Maguire and Dr Lisa McCann, reflect on the digital health & care policy agenda in Scotland, Scottish digital health developments in relation to the COVID-19 pandemic and the promise and potential impact that future integrated care systems such as ADLIFE will bring to the Scottish population.
Scotland’s digital health and care requirements have evolved since the publication of the Digital Health and Care Strategy of 2018 and given the impact of the COVID-19 pandemic, a refreshed strategy is imminent. However many of the broad ambitions set out by the Scottish Government in April 2018 are likely to remain relevant: focusing on using technology to reshape services; supporting person-centred care; and improving outcomes.
The use of technology in a variety of ways to support the Scottish response to the COVID-19 pandemic has been strongly supported by the Scottish Government. Scotland has demonstrated its capacity to work in partnership across health and social care to use technology to keep patients safe and at home as much as possible. For example, the rapid deployment of Near Me, the Scottish health service video consultation platform which was already in place before the pandemic was scaled up considerably, with about 300 virtual appointments per week at the end of February 2019 (pre COVID-19) to over 20,000 per week in December 2020.
By November 2020 half a million appointments had been conducted using Near Me and one million appointments are expected to have taken place by June 2021. Given that some 14 million travel miles have been avoided and patients and clinicians have engaged with the system, (now social care and third sector also using Near Me) it is to be expected that more examples of digital interventions to support care delivery will be included in the refreshed Strategy. As we move through the phases of COVID-19 response towards recovery and remobilisation of services, it becomes more important to consider how a range of technology solutions such as Near Me, Remote Health Pathways, Telecare, etc, can support integrated health and care services.
There is a clear legislative framework in Scotland to support the delivery of integrated care, with not only a high level of awareness of integrated care across health and care professionals, but also a strong sense of citizen ownership of health and care services. The Digital Health and Care Strategy recognises, amongst other things, that people should have appropriate choices around how they can access and manage their health and care information, the potential of the remote monitoring of long-term health conditions to support prevention and supported self-care within priority care pathways, and that collaboration with people and professionals is essential to exploit the potential for digital health to transform health and care services and support people in their self-management. And the recent publication of the Independent Review of Adult Social Care in Scotland places an emphasis on integrated health and social care, when it works well, as the lever to improve access and delivery of services that jointly focuses on the wellbeing of the person using care and supporting carers to continue caring for loved ones.
Dr Whoriskey (Head of Technology Enabled Care and Digital Health Innovation of Scotland’s Digital Health and Care Directorate) comments:
‘Supporting people through digital approaches to have more choice and control over how they access services and support is a key aim in the Digital Health and Care strategy and Digital Citizen Delivery plan for 2021/22. Partnership and collaboration will continue to be our key approach ensuring the best digital journey that citizens in Scotland go through to access first class health, housing and social care services.’
The Scottish context provides real promise for implementing integrated care pathways and the success of projects such as ADLIFE. Supporting patients (and their caregivers) to live at home as independently as possible for as long as possible, despite the challenges of advanced chronic disease, using a digital platform that assists health professionals to provide such support, fits well with the current priorities of the Scottish Government in relation to the implementation of digital health and care interventions and its ultimate goal of Scotland being a leading nation in the provision of a truly national digital health and care system that continually learns and improves.
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