Lessons for implementing digital health technologies

With digital health technologies growing at an exponential rate, there is a temptation for health organisations to implement them in clinical settings as quickly as possible to enable safe and high quality patient care.

However, when implemented poorly, these technologies can exacerbate the very problems they are purported to solve.

For digital health technologies to have desired outcomes in practice, not only should they be evidence-based, but health organisations should also implement them in a safe, iterative and human-centred manner.

Guidance and awareness has increased on the crucial need for digital health technologies to be evidence-based for safety and effectiveness. However, there is limited coverage on best practices of implementing new digital health technologies in clinical care.

In Public Digital's recent engagement with a health organisation, we learnt how digital health technologies used in inpatient mental health wards were impacting staff and patients’ experiences. We saw just how harmful the impact could be, if implemented poorly, especially in highly emotive areas like this one.

To build an understanding of mental health care as a system in which digital health technologies were used, we started with user research.

During our 20 semi-structured interviews with patients, carers and clinicians, we heard their first-hand experiences of life on mental health wards, and individuals' experiences of digital health technologies.

Although opportunities for technology as a potential enabler were widely recognized, we found examples of poor implementation undermining these potential benefits:

• Staff were instructed to use the technology when they came on shift without being told why and where the data from the technology was being stored.

• Patients were unable to obtain a clear explanation from staff as to why there were new technologies on the ward, and how this bettered their care.

This massively impacted staff and patients' experiences on the wards.

Patients told us that regardless of the positive impacts of technology, the consequences of “not knowing” (the reasons why they were used), caused “fear”, leading to “mistrust” towards the healthcare staff. This affected therapeutic rapport and trust between staff and patients, therefore affecting safety and the quality of care they received.

In some cases, these approaches exacerbated poor practices and hierarchical cultures in which patients and staff were being told what to do with limited opportunities to critique and ask questions.

We concluded that new technology may function well and be supported by ample evidence of its safety and effectiveness. However, in a setting like this where the consequences of misunderstanding and conflict can be severe, poor implementation can be extremely harmful.

Based on this learning, we have shared lessons aimed at health organisations to consider when implementing new technologies.