ABSTRACT

Towards a Digital Health Ecology : NHS Digital Adoption through the COVID-19 Looking Glass is about technology adoption in the UK’s National Health Service (NHS) as told from the inflection point of a disaster. In 2020 the world lived through a disaster of epic proportions, devastating humanity around the globe. It took a microscopic virus to wreak havoc on our healthcare system and force the adoption of technology in a way that had never been seen before. This book tells the story of digital technology take-up in the NHS through the lens of that disaster.

This book documents use of technology in the NHS through the lens of the first pandemic shock. Our healthcare system, paid for by general taxation and free at the point of demand, was conceived and developed in a firmly analogue world. Created in 1948, the NHS predates the invention of the World Wide Web by some forty years. This is not a book simply about technology, it is a study of the painful process of reengineering a mammoth and byzantine system that was built for a different era.

The digital health sector is a microcosm of the wider healthcare system, through which grand themes of social inequality, public trust, private versus commercial interests, values and beliefs are played out. The sector is a clash of competing discourses: the civic and doing good for society; the market and wealth creation; the industrial creating more efficient and effective systems; the project expressed as innovation and experimentation; lastly the notion of vitality and leading a happier, healthy life. Each of these discourses exists in a state of flux and tension with the other. This book is offered as a critique of the role of digital technologies within healthcare. It is an examination of competing interests, approaches, and ideologies. It is a story of system complexity told through analysis and personal stories.

chapter Chapter 1|14 pages

Introduction

chapter Chapter 2|20 pages

Backdrop to Broken

chapter Chapter 3|24 pages

Necessity Is the Mother of Invention

chapter Chapter 4|13 pages

Relative Advantage

chapter Chapter 5|17 pages

When People Drive Digital

chapter Chapter 6|22 pages

Context Is King

chapter Chapter 7|26 pages

The Social Determinants of Digital

chapter Chapter 8|23 pages

The Jeopardy of Trust

chapter Chapter 9|22 pages

Bending the Curve on Digital Mental Health

chapter Chapter 10|20 pages

The Theatre of Tech – A Study in Solutionism

chapter Chapter 11|30 pages

We Get the Market We Deserve

chapter Chapter 12|12 pages

Momentum – towards a Digital Ecology