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Digital transformation is the only way the NHS will recover

Since co-founding On The Mend in 2017, I have seen countless other health tech start-ups, big tech, and NHS policy initiatives bring with them promise of digital transformation in healthcare. 

Yet, we end 2022 with the NHS on its knees, struggling with a record backlog, chronic staff shortages and now crippling industrial action. 

The global pandemic taught us that without a healthy population we can’t have a strong economy – or much of an economy at all. 

For the UK to have a strong economy, it needs a strong NHS - and this will only be possible after meaningful, effective, and widely adopted digital transformation. 

Wielding an axe when a scalpel will do 

When 319 general practices were surveyed across the UK in 2015, all of them reported no use of video consultations. 

There is no better stat to sum up the shock that COVID-19 had on the NHS. 

The global pandemic pushed digital health into the limelight, with consultations temporarily forced online. 

COVID may have changed the healthcare landscape forever, but the same challenges remain; and these are only getting more critical as the population ages, placing greater pressure on a limited amount of resources. 

As healthcare systems move to a hybrid model of virtual and face-to-face consultations, this creates a new set of challenges for technology solutions that were either built for a pre-COVID world or that worked best during its height. 

A historically low uptake of virtual consultations could not have been due to a lack of secure online chat services (Zoom was founded in 2011). It would have had more to do with how the benefits of such technology were perceived by both patients and healthcare professionals. 

While moving all consultations online during the pandemic might have solved one problem, it created larger, more complex issues elsewhere, especially when hands-on treatment or diagnosis was needed. 

Digital is just one tool in the toolbox 

Digital tools are just that, tools. But the value of any tool is only narrowly defined by the job it is intended to do, not in how it helps to complete the overall task. 

Physical rehabilitation is a good case in point, where exercise compliance among patients is often very low, with as few as 3 out of 10 patients completing their treatment plan. 

This might seem less surprising when you consider that even now in late-2022, it is still not uncommon for a patient to take home stickman drawings on paper to guide them through early rehab once discharged from hospital. 

If you are one of those patients fortunate to have been prescribed exercises digitally, you might be disappointed to find that your Calvin and Hobbes drawing has been replaced by a Calvin Klein commercial as the model on screen is typically someone half your age and, quite often, not even the same gender as you. 

And so the cycle of low exercise compliance continues, with a digital intervention making no difference to the wider problem; patients still keep coming back with disappointing outcomes, placing greater pressure on precious system resources. 

No returns please 

After some years of tinkering, industries such as retail or banking have firmly established a hybrid model that works for both consumers and business owners. 

When you want to buy fruits & veg, you can either go online or visit a supermarket. 

When you need access to banking services, you either go online or visit a branch. 

When you buy clothes, you can either browse online or try it on in the changing room. 

When you want to buy the latest album you can download it on iTunes or wander around your local HMV. 

In each case, it is in the interest of both buyer and seller that at the completion of the transaction, no follow-up visit or helpdesk enquiry takes place. 

This satisfies both customer, who enjoys a quality service with a good outcome, and business, who can spend more time on new customers. 

Accessing healthcare services often leads to a suboptimal outcome for both patients, providers, and payers. 

The patient doesn’t achieve the outcome they wanted, the healthcare professional spends time on unnecessary follow ups, while payers are left footing an excessive and ever-increasing bill. 

Digital tools that do not address the root cause of patient readmission or disappointing outcomes will fail to allow the NHS move towards a hybrid model that works for everyone involved with healthcare. 

Helping the NHS to be On The Mend 

Taking on the challenge of building a sustainable hybrid model of healthcare is at the heart of On The Mend’s mission, which has taken us a lot of time, effort, patience, listening, iterating and experimenting. 

Co-founded by a patient, surgeon and physiotherapist, we have always known the problem in physical rehab affects not just one part of the system, but all of it, with the patient at the centre. 

We understand that while it is in the interest of everyone to discharge a patient as quickly as possible, it is also important to make that patient feel supported, motivated and, critically, engaged with their physical rehab. 

This ensures the patient won’t need to come back to hospital or request unnecessary follow-ups. 

On our platform, the patient’s exercises are recorded on their smart device by their healthcare professional, who can remotely update this prescription as the patient progresses; the patient can set their goals with their healthcare professional, reminding them of what they are working towards; they can even earn financial rewards for sticking with their exercise plan, applying behaviour change techniques with proven health benefits outside of a clinical setting. All the while providing feedback data on how they are getting on to ensure healthcare professionals make better use of their time. 

Our mission is to build the first digital platform to improve the experience and outcomes for everyone involved with physical rehab. 

If we succeed, we will not only have made healthcare work for patients, providers and payers, but we will also have also laid the foundation for a sustainable model of hybrid healthcare. 

This will achieve not just better long-term health for our nation, but also ensure stronger long-term economic growth.

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