For example, as recently announced in the UK, users of the NHS app will now be able to collect medicines from pharmacies without having to visit a medical centre, and the usual paper slip given by a doctor will now be replaced by a barcode within the app. will be replaced by
Innovations like these have brought tremendous benefits to millions of patients. However, these benefits of digitalization are not evenly distributed. According to his Ofcom report in 2023: 1 in 13 households do not have access to the internet And a similar proportion do not have a computer at home. But even within connected households, the so-called ‘digital skills gap’ means many people may still struggle.
Imagine this typical case. Dorothy and Bill are retired factory workers in their mid-70s. They have their home computer connected to their TV and have a machine that allows them to (almost) send e-mails to their daughter who lives abroad.
It’s hard to use, but I love watching my family’s news come through the TV screen. However, I don’t use my computer much for other purposes because websites take a long time to load. Bill has a smartphone and receives photos of his grandchildren through an instant messenger app, but he doesn’t know how to send them back.
Prompted by a text message from their doctor, the couple confirms they have internet access and enters their email address. A few weeks later, I received a message inviting Bill for his annual checkup and treatment for shingles. However, subject lines are unclear and long messages are impersonal and difficult to understand.
The couple had only ever received emails from their daughter, so they thought the message from their doctor was spam and deleted it. As a result, Bill neglected medical checkups, ran out of blood pressure medication, and was left susceptible to shingles.
digital skills gap
The problem is that entry-level home computing is primarily designed for basic gaming and simple email exchange, and it’s not easy to interact with data-intensive web platforms or send high-resolution images of body parts. It is not intended for this purpose. The same goes for budget-level data bundles offered by mobile phone providers.
For people like Dorothy and Bill to navigate the digital health space, they need not only better technology, but also technical skills to interact with technology, such as comfortable typing, using a mouse, and navigating drop-down menus. Skills are also required.
Also important is “information literacy.” This is the ability to recognize when information is needed (such as an old address or login code) and how to provide it. Second, health literacy, or the ability to find, understand, and use health information and online health services.
Generally, individuals are either digitally equipped, technologically proficient, information literate, and health literate, or they simply are not. There is very little in between. And as A major analysis from the University of Oxford found that, the more indicators a person has of a disadvantage (low income, older age, preference for a language other than English, to name a few), the harder it is to access digital services. Several of these factors combine to make it even less likely that these disadvantaged patients will be able to connect to health services through digital means.
Unfortunately, such inequalities are nothing new. In fact, it was 53 years ago that British physician Julian Tudor Hart first proposed the Reverse Care Act, a principle that was developed to protect people who need health care the most: the poor, the less educated, It was argued that people (older people and people with frequent illnesses) are healthier. It is the least likely that you will receive it. There is no easy solution to the “digital reverse care” method. A person who lacks the necessary digital skills may be willing to go to the local library for computer training, but with an empty bucket he can safely “replenish” the complex skills he has missed. You shouldn’t think about it.
What is the solution?
What should NHS organizations do to ensure everyone gets a fair contract in today’s digital world?
First, digitally supported services should be designed or improved primarily for patients who have difficulty accessing them. A service that works for someone who is not familiar with or unable to use a computer or smartphone will almost certainly work for someone else. “Digital navigators” – human staff who can help patients find directions about services if needed – can be a big help here.
Second, healthcare providers need to look beyond the binary when assessing people’s digital connectivity and skills. Instead of asking patients if they have an internet connection, you should ask them to describe what they are actually comfortable doing with technology and customize their care package accordingly.
Third, for the most disadvantaged patients, those with complex health and social care needs, there is no need to use technology at all, especially when their needs are not adequately met by technology. Keep in mind that your approach may be the most appropriate. technology. For these patients, their records can be marked with electronic flags that remind busy staff to use no technology or provide a technology-free option.
And finally, we need to see digital exclusion first and foremost as a moral issue. NHS founder Nye Bevan said: “No society can legitimately be called civilized if the sick are denied medical assistance because of lack of means.”