ABSTRACT
There are thousands of digital healthcare applications and many depend for their effectiveness on being integrated with existing health services. Three case studies are reported in which digital applications connected patients to healthcare services. The case studies are applications (1) to capture an ECG trace and (2) to manage outpatient appointments and (3) a new general practice service based on video consultations. The case studies show that achieving an effective link between the application and the existing health system is vital. Getting this right involves a sociotechnical systems change in which the new technical capability has to be harmonized with existing technical systems and with the processes and workforce deployments in the health services. The chapter introduces a “key” and “lock” metaphor to highlight the need to adapt both the application (the key) and the existing sociotechnical system context (the lock) to achieve an effective fit. Five requirements are identified to achieve this adaptation: (1) flexibility in both the “lock” and the “key,” (2) multidisciplinary team work, (3) an evolutionary approach to the development, (4) the creation of tools to support evolutionary sociotechnical developments and (5) mechanisms for passing on learning from one application to another.
