By Matt James, Senior Researcher at 2020health
In our previous blog we were looking at the value of the personalised health agenda. But having vision and developing policy based on that vision is one thing. Identifying the ‘how to’ steps to achieving it in reality is quite another.
Re-reading Malcolm Gladwell’s bestseller ‘The Tipping Point‘ recently and reflecting on the first year of HT&Y has got me thinking about the future of both health tech and the HT&Y initiative.
Gladwell helped to popularise the term ‘tipping point’ as that seemingly magical moment when ideas and trends reach a certain point and spread like wildfire.
What lessons can we learn from this as the HT&Y initiative develops? How can we achieve a tipping point which goes beyond just a deluge of new tech to one which ushers in a revolution in people using technology effectively in order to take responsibility for their own health and well being?
In his book Gladwell identifies three key factors which help to achieve the Tipping Point, two of which I think have relevance to the health tech revolution:
- • The Stickiness Factor
- • The Power of context
A) The Stickiness Factor
In any form of epidemic, the messenger matters. The message is important but if the messenger is not effective in communicating the message, it will not spread. Messengers are what makes something spread. In Gladwell’s words, the message becomes sticky.
In the health tech revolution we are witnessing this in a very clear way. Once health advice and support becomes practical and personal, be it through an app or piece of wearable technology, it becomes memorable. It can help create change so much so it can spur someone to action.
In response this calls for a radical rethink of the role of clinicians and the expectations of the public of them. The traditional doctor-patient relationship is changing from patriarchical to more of a dialogue marked by joint decision making.
Technology should certainly not ended up replacing the GP but a new form of relationship needs to be established based around the clinician and patient partnering together. With more information at their fingertips the patient is becoming more proactive as opposed to passive, entering into a dialogue with the clinician as opposed to just acting upon the advice given. As an expert, the clinician has a key role to help bring understanding and educate the patient as to what the information and data really means for them.
This represents a significant change in the way medicine is practiced and will inevitably be seen as a challenge by some clinicians. However if the move to more personal responsibility for health and well being is regarded as the only effective way to respond to the corresponding demographic, economical and social changes in our world then this change needs to happen. It will involve a shift in culture which promotes the active participation of patients, supporting them to manage their own health – staying healthy, making informed choices of treatment, managing conditions and avoiding complications – and the use of health tech to do this in the most appropriate way.
b) The Power of Context
Put simply humans are sensitive to and strongly influenced by the environment in which they live. Cultural attitudes influence health care behaviours and if there is no clear sense of what actually motivates people to engage in a particular behaviour, there is no point in introducing new technology, however innovative it might seem, that is thought to change behaviour.
Research indicates that innovation in healthcare can only work if people are in a position to change their behaviour. Behaviour modification specialists say this requires capability, opportunity and motivation.
This calls for change. Change not only in how the NHS operates and is designed but how the clinical workforce is trained and equipped so that they can help maximise the capability, opportunity and motivation that health tech solutions can offer.
It is difficult to imagine the NHS prescribing health and well being tech devices to patients today. Looking to the future though, this could become a 
reality but requires a change in the model the NHS uses and combines technology to deliver care, a point highlighted by the recent NHS
Five Year Forward report. The National Information Board’s report Personalised Health and Care 2020 recognises that better data can help to “transform innovation, helping to create new collaborations between the NHS, technology companies and patients to unlock the potential of data, technology and digital to create products for smarter, faster and better healthcare”. ¹
As the Chief Executive of Proteus Digital Health – creators of digital medicines which promise to connect each pill you take to the wealth of information available online – tweeted just this week, “Innovation in digital health is about value to the patient, not the developers”.
It’s not just a case of more new tech, it is identifying and recognising the value it brings to peoples’ lives.
Skating to the future
Health Tech & You has only just begun. In order to realise its full impact and reach the tipping point it will be crucial to look to the future and try to interpret where it is going.
When asked the secret of his success, the great ice hockey player Wayne Gretzky famously said: “I skate to where the puck is going to be, not where it has been”. The HT&Y initiative is positioned to play its part in helping us all skate to where the puck of health tech is going, rather than merely where it has been.
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¹National Information Board. 2014. Personalised Health and Care 2020: Using Data and Technology to Transform Outcomes for Patients and Citizens. A Framework for Action. p. 43
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