Accepted for/Published in: JMIR Formative Research
Date Submitted: Aug 15, 2023
Date Accepted: Mar 8, 2024
The Landscape of Digital Technologies used in the National Health Service in England: Content Analysis
ABSTRACT
Background:
In England, digital technologies are exploited to transform the way health and social care is provided and encompass a wide range of hardware devices and softwares that are used in all aspects of healthcare. However, little is known about the extent to which healthcare providers differ in digital health technology capabilities and how this relates to geographical and regional differences in healthcare capacities and resources.
Objective:
The purpose of this paper is to draw the landscape of digital technologies adopted by the National Health Services Clinical Commission Groups (NHS CCGs) in England. In doing this, we respond to the calls of health service regional differences, and health diversity, inclusion and equality, to shed light on the internal dynamics and variation in the form of digital capability and patient engagement in England.
Methods:
We collected 135 annual reports that belong to 106 NHS CCGs in England, comprising more than 18 thousand pages in total, released from 2020-2021. Using this dataset, we identified 2163 pages related to digital technologies and labelled them using content analysis. We operationalise the digital option theory in our content analysis to understand the themes emerging from observed technologies. We then use a hierarchical clustering method with Euclidean distance to extract groups of NHS CCGs that implements similar technology themes.
Results:
We found thirty-three technologies from the reports and grouped them into nine digital themes. The nine themes are further assigned to one of the three constructs of the digital option theory. Firstly, the identification of patients' requirements includes information portals (76/106), digital health engagement (67/106) and digital inclusion support (59/106). Secondly, the development of new work patterns includes remote monitoring (87/106), TeleMedicine (35/106), and Care Home Technologies (40/106). Finally, the realisation of improvements in efficiency and public accessibility includes online booking (26/106), online triage (104/106) online mental health services (74/106). Three clusters of CCGs are identified based on the themes (Hopkins = 0.724, silhouette =0.22), namely digitally engaged, digitally exploring and digitally disengaged.
Conclusions:
Our findings show prominent digital themes within each construct group, namely Information Portals, TeleHealth and Online Triage, covering people’s fundamental health information needs. Almost two-thirds of CCGs fall into the digitally disengaged group, in which all London CCGs (5/106) belong to this group. We propose that practitioners should offer specialised assistance to regions with limited digital engagement, emphasising digital health literacy, inclusion support, and ongoing evaluation, rather than concentrating solely on technical advancements.
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