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Are digital technologies the answer to modern healthcare challenges? MSc Applied Digital Health student Aditi explores nuanced answers to this question, emphasising the need for a people-centred approach, considering space, place and context.

Aditi Kapadia, an MSc in Applied Digital Health student at the University of Oxford, standing outdoors in her matriculation attire. She is wearing a white collared shirt with a black ribbon tie, a black pleated skirt, and a dark academic gown draped over her shoulders. She has short, light brown hair, glasses, and a bright smile.

Headshot of Aditi Kapadia

About the author: Aditi Kapadia is an MSc in Applied Digital Health student, committed to advancing equitable healthcare. She is a management consultant with seven years of experience, primarily at KPMG in Australia. During the COVID pandemic, she spent six months with the Victorian State Department of Health, leading efforts to help the government respond to the rapidly evolving operational and strategic challenges. This experience ignited her passion for the health and human services sector, particularly in addressing large-scale health challenges. Aditi hopes to focus her career on improving health outcomes through strategic leadership, particularly in the integration of digital solutions in healthcare. 

 

Digital health is often hailed as the future of healthcare, a game-changer poised to revolutionise care delivery, disease diagnosis and patient health monitoring. There is no denying the tremendous potential it holds. From virtual wards to AI-driven diagnostics, the possibilities seem limitless. 

However, as with any new technology, the reality is far more complex – and far less certain – than the hype suggests. 

I have spent a large part of my career considering and reflecting on large-scale digital transformations and technology implementation issues. In the corporate world, implementation is often approached in a structured, linear model – thinking in terms of budgets, resource constraints, and maximum efficiency. Since taking time to immerse myself in the MSc in Applied Digital Health at Oxford and learn from the remarkable people here, my professional orientation has been significantly challenged. I no longer think of implementations as static activities. Rather, I think of them as evolving beasts, influenced by an array of socio-technical factors across the healthcare ecosystem. The use of digital tools will change over time with the contextual needs of the users, and as decision-makers we need to be cognisant of these as we consider everything from the evidence of the tools through to the health economic analyses to assess their long-term sustainability.

As a result of my learnings from the course, I now view the potential of digital health with a fresh perspective, considering the bigger picture beyond the jargon and headlines. One of the most valuable insights I have gained so far is the importance of understanding that digital health is an enabler, not a panacea, and the criticality of considering context, space and place in the implementation of any digital tool.  

At the heart of any digital tool is people. Whenever you implement a tool, you are asking stakeholders across different levels of a usually stretched healthcare ecosystem to change their behaviours in ways that may not work in their daily contexts. So when thinking about resource use, you must carefully consider the context of the users. Will it truly help themor will it hinder their daily life? Does it threaten or fundamentally change their professional identities in ways they might deem unacceptable? Is there space to use the tool in their operating contexts? One experienced doctor at Oxford shared with me his frustration at having to use computers on trolleys that required him to turn his back to his patients in the hospital whilst taking notes. This is an example of how space, place and context matter so greatly for technology to work. For every amazing digital tool out there – and there are many – there is a human element that is crucial for successful implementation. 

During a recent course lecture, Professor Lord Lionel Tarassenko emphasised a crucial point: digital health's role should be to enable innovative operating models, not to exist as standalone entities. He argued that while we often credit digital technology as the catalyst for innovation, it is frequently the reverse – new operating models demand the development of supporting digital health tools. This distinction is vital; digital tools should ideally be viewed as enablers of healthcare transformation, but not necessarily drivers of change. The crucial drivers of change and transformation will always be the people within the ecosystem, no matter how incredible and new age a digital health technology is.  

The Case for Nuance

From my professional experience, I believe we must consider the unique needs of patients, healthcare professionals and the system at the procurement stage well before implementation planning. Is the technology designed with the end-user in mind? How will it fit into the current healthcare infrastructure? Who defines what success looks like? And crucially, it is economically feasible to invest in a digital health innovation, given the investment is often derived from government health budgets, which could be used to fund other critical and core healthcare expenditures?

Without a comprehensive understanding of these factors, we risk turning the promise of digital health into a ‘digital wasteland’ – initiatives that fall short, fail to scale or worse, actively harm patient care. 

Take virtual wards as an example. The idea of delivering hospital-level care in the home is transformative, particularly in reducing hospital overcrowding. It can also empower patients to manage their health in a more familiar environment. However, the success of virtual wards is not solely about the digital technologies behind them. The operations behind virtual wards are what matter most – the multidisciplinary workforce caring for patients, the escalation systems that detect patient deterioration, the protocols and procedures for remote patient care, and the coherence of the overarching operating model itself, with staff, patients and technology all coming together to  determine the effectiveness of virtual wards. We need innovative models of care where digital delivery plays a key role but is not the focal point. Technology is just one piece of a much larger puzzle. 

The Risk of Over-Simplification

The biggest challenge in the healthcare sector today is navigating the tension between two extremes: techno-optimism and techno-pessimism. Techno-optimism – where digital health is seen as a cure-all – can lead to unrealistic expectations, poor implementation strategies and eventual disillusionment. On the other hand, techno-pessimism can stifle innovation, preventing us from exploring solutions that have the potential to improve care delivery. 

I have seen both sides of this coin. In my view, a more balanced approach is required – one that acknowledges the potential of digital health with a critical eye. Technology can certainly enhance care, but it’s not a replacement for the human elements that make healthcare effective.  

Embracing Context, Not Universal Solutions

Successful digital health interventions must consider the environment in which they are designed to operate. Instead of searching for a one-size-fits-all solution, we need to think critically about: 

  • How these tools can be integrated into the existing healthcare landscape – space, place and context matter;  

  • Where they can provide real value and  

  • Where their limitations lie.  

From my experience in both consulting and academia, digital health will not be the sole saviour of our healthcare system. However, it can be a powerful enabler when used thoughtfully in the right contexts. 

Instead of pursuing technology for the sake of innovation, we should focus on creating models that have broad buy-in from the majority of stakeholders (especially the front-line workforce who are the lifeblood of our healthcare systems). Technology should enhance care, and evidence-based decision-making should drive progress. It is unlikely that doctors and nurses will be replaced by AI. Rather, I hope we can make AI tools that help alleviate some of the very real pressures on doctors and nurses, resulting in a happier, more sustainable workforce down the line.  

I am so glad to be learning these nuances through the MSc in Applied Digital Health. The course is without a doubt helping me become a critical consumer of research and think of digital health in a systems-based, non-linear manner. As I progress in my career, I hope to take on budget-holder and decision-maker roles, giving back to my community in meaningful ways that protect what we hold so precious – our health and our healthcare systems, and I will use my learnings from Oxford in order to do so, effectively.  

 

Opinions expressed are those of the author/s and not of the University of Oxford. Readers' comments will be moderated - see our guidelines for further information.

 

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