Pros and Cons of Technology in Health Care: The Case of NHS England

Abstract The focus of this study is NHS England, delving on the advantages and disadvantages of technology, specifically mobile technology in healthcare. A systematic review is conducted, using secondary data as a method of data collection. The advantages include improved cost, efficiency, effectiveness, safety, and quality in healthcare, as well as ability to address NHS’ current budget cuts in the midst of several admissions. The study does not find any disadvantages but barriers, including cost, usability, privacy issues, battery power efficiency, low interest in health information and monitoring services, and non-reliance on the available mobile technology. Recommendations include preparing nurses and other medical staff for mobile technology system in NHS England, and pursuing an evaluation study on the efficiency of mobile technology in the organisation. 1. Introduction With the advancement of technology, even the healthcare sector has eventually adopted its benefits towards better patient care. Current studies focus on curing diseases using technology and using mobile phone technology in chronic illness management (e.g. Blake, 2008). In NHS, mobile technology is used in improving the quality of health care services (NHS England).1.1 Aims and ObjectivesThis study aims to discuss the advantages and disadvantages of using mobile technology in healthcare. It also aims to highlight the extent to which NHS England uses mobile technology in care services. The objectives are the following: To conduct a survey of literature on the use of mobile technology in the healthcare practice; To pursue a systematic review in addressing the research question; To identify implications for practice and provide recommendations for future research1.2 Research QuestionThe research question that this study intends to answer is: What are the advantages and disadvantages faced by NHS England in its adoption of mobile technology? 2. Literature Review The review of literature pertains to the survey of various works and studies to find evidence to the study (Oermann and Hays, 2010). Standing and Standing (2009) emphasised that amidst the recognition of the benefits associated with the use of technology in healthcare, its widespread adoption continues to lag. The authors proposed that the major barriers to such adoption pertain to certain basic systemic issues and that its problematic adoption is caused by the fragmented health care system, inappropriate outcome measures, and conflicting incentives. The authors stressed that a systems perspective must be taken vis-a-vis using technology adoption frameworks. No statistical data were tested for hypothesis and only secondary data were used for the discussion, which enabled sufficiency of the discussion. The importance and urgency of adopting technology in healthcare was supported by Avancha et al. (2012) who claimed that the cost, efficiency, and quality of healthcare can be enhanced through information technology. With this in consideration, the authors examined mobile technology privacy requirements that can potentially transform healthcare systems. The use of mobile technology can allow physicians to monitor their patients’ health conditions in a remote manner and likewise enable individuals to also manage their own health. The authors surveyed the literature and developed a conceptual privacy framework for mobile health, which was adequate to generating conclusions. The study of Avanche et al. (2012) was contrary to that of Burley et al. (2011) in their claim of a high failure probability of information technology in healthcare. Nonetheless, they declared seeing an emerging development amongst healthcare professionals who use mobile technology in their profession. The study revealed through content analysis that individual healthcare professionals are the ones mostly making optional innovation decisions. Content analysis as a methodology to draw analysis had been appropriate for this study. Contrary to the study of Burley et al. (2011), that of Boulos et al. (2011) indicated that the overpowering computing technology of the current smartphone generation allows such technology to function as handheld computers. Contributory to this occurrence is the fact that these handheld computers are capable of large memories and application development. The authors cited Apple, Android, Windows, etc. as the available platforms for mobile computing and focused on applications (apps) that target patients and healthcare professionals in a variety of settings, such as health and lifestyle management and public health monitoring. The barriers to adopting apps for healthcare smartphone were identified as cost, usability, privacy issues, and battery power efficiency. These barriers must be taken into account when developing mobile technology in NHS. The study surveyed the literature to come up with the analysis, which had been viable to drawing inferences on the subject. Conversely, a national survey involving around 1,400 Americans demonstrated various concerns on the popularity of mobile healthcare technologies based on radio frequency identification (RFID). Positive association was found between interest in RFID personal medical technology and high trust levels associated with social support. The study revealed overwhelming interest in nascent intervention services but not much in the areas of health information and monitoring (Katz and Rice, 2009). This is contrary to that of Boulos et al. (2011) which highlighted health and lifestyle management and public health monitoring as areas of healthcare mobile technology. The survey was an appropriate methodology for this study to produce the desired outcomes. Similar to Avanche et al. (2012) and Boulos et al. (2011), Brady et al. (2012) stated that mobile phones help in boosting the efficiency of clinical communication and are becoming more progressively involved in healthcare delivery. However, it was found that pathogenic bacteria can reside in healthcare workers’ mobile phones and could further magnify when doctors bring additional communication electronic devices without the necessary guidance on use and decontamination. The study involved 87 mobile phones owned by doctors, sampled for bacterial growth and discovered that 87 percent of doctors knew that such bacteria could in fact reside in their phones but only 8 percent cleaned them on a regular basis. The conclusion suggested simple cleaning remedies to decrease the possibility of cross-contamination from mobile phones. The methodology adopted was appropriate to the generation of expected results. The actor-network theory offers perspectives for understanding people and their interactions with inanimate objects, i.e. mobile technology. Cresswell et al. (2010) argued that being informed by this theory can provide beneficial outcomes to healthcare services research, particularly to complex IT systems. The actor-network theory can enable an understanding of the manner in which social effects are generated as a result of the relationship between various actors within the network. The method used by the authors is descriptive, which is suitable to the contents of the topic. 3. Research Methodology3.1 Research DesignThe research methodology purports to address the research questions and aims and objectives identified in this study. The qualitative research design is pursued in order to properly tackle the advantages and disadvantages of mobile technology in healthcare. This research design focuses on creating meanings in processes and producing inductive analysis (Bryman and Bell, 2003).3.2 Data Collection MethodThe data collection method being utilised in the study is secondary, which indicates the use of secondary sources only, such as books, academic journals, and online resources. Secondary data collection method is defined as the method in which the researcher uses non-original data for a specific purpose not originally intended by the one who has collected it (Grinnell et al., 2012). In this study, all secondary data are intended for the purposes of addressing the research question. The study takes on a desk-based approach as it adopts a systematic review, which is a method used in understanding broad prices of information and contributing to the answers to questions (Jesson et al., 2011).3.3 Inclusion and Exclusion CriteriaThe search for literature is done using inclusion and exclusion criteria. The inclusion criteria for the survey of literature include data published from 2009 up to 2014, discussing mobile technology in healthcare in the UK and other countries. The exclusion criteria are therefore data published in 2008 and older.3.4 Search ApproachThe search engines used are Google, Scholar Google, and Books Google. The search is limited to â€Å"mobile technology in healthcare† and â€Å"mobile technology in NHS.† 4. Research Results Recent news indicates that the National Health Service is utilising smartphone technology to help nurses deal more efficiently with patients and improve the quality of healthcare in the organisation (Watson, 2014). NHS is at the moment facing budget cuts and increasing admissions, making its professionals of all levels to become beleaguered to do more with less resources (See Appendix-A). Increased efficiency, patient care, and reduced cost are anchored on targeted investment in certain identified areas of healthcare settings. The NHS Nursing Technology Fund is one recent initiative in this regard, which provides some hope for NHS and the forefront of health services to improve its overall care delivery (NHS England, 2014). The Prime Minister announced in 2012 that the Nursing Technology Fund will be launched to support nurses and other medical staff toward optimising the use of digital technology in all aspects of care settings in order to realise safer, more efficient, and more ef fective care delivery (NHS England, 2014). Recent information submitted to NHS England also stressed that notwithstanding NHS’ planned paperless healthcare setting by 2018 (See Appendix-B), continued reliance on handwritten notes and hallway conversations to discuss patient condition are still being carried out by majority of nurses and other medical staff in NHS (Watson, 2014). This indicates lack of preparedness and exposure to mobile technology, which by this time must already be carried out amongst healthcare professionals. 5. Findings and Recommendations Watson’s (2014) article about utilising smartphone technology to help nurses toward more efficient care delivery and improved healthcare quality in NHS is congruent to that of Avancha et al. (2012), which emphasised the importance of information technology to improve cost, quality, and efficiency in healthcare. The adoption of mobile technology, given this description by Avancha et al., would enable tackling its current budget cuts in the midst of increasing admissions. This is one advantage of mobile technology system for NHS. The hope for increased quality of care and safer and more effective care delivery through NHS Nursing Technology Fund is also parallel to the studies of Boulos et al. (2011), Avancha et al. (2012), and Brady et al. (2012). However, Watson’s (2014) article on the continued reliance of nurses and other medical staff on handwritten notes and hallway conversations rather than on mobile technology to discuss patient condition are not harmonising wit h the discussions of these authors who highlighted the various advantages that a healthcare setting can draw from mobile technology. It only means that at this stage, NHS is not yet fully utilising the benefits of mobile technology despite the availability of this technology now. The actor-network theory supports NHS’ inclination towards adopting mobile technology in healthcare services with its understanding of the network occupied by humans and their interactions with inanimate objects, i.e. IT systems (Cresswell et al., 2010). The literature did not cite disadvantages to adopting mobile technology in healthcare; instead, it cited certain barriers to ease of adoption, such as that of Boulos et al. (2011) who mentioned cost, usability, privacy issues, and battery power efficiency, as well as Katz and Rice (2009) who suggested lack of interest in health information and monitoring services. In his article for The Guardian, Watson (2014) also indicated that despite the planned paperless organisation by 2018, nurses and other staff at the NHS had not really relied on the already available technology for fundamental patient information. Recommendations for the study include the following: Prepare nurses and other medical staff for mobile technology system in NHS England by implementing a policy on its ultimate use. This policy will enable nurses and medical staff in NHS to be thoroughly accustomed to the system until the full adoption of paperless healthcare setting by 2018. Pursue an evaluation study on the efficiency of mobile technology in NHS. This study will be centered on the extent to which mobile technology system has been effective for NHS. 6. Conclusion This study has centred on the advantages and disadvantages of mobile technology in healthcare, with specific emphasis on NHS England. A systematic review is carried out to fulfill the aims and objectives as well as the research question of the study. The findings identified such advantages as improved health care quality, improvement in the areas of cost and efficiency, being able to tackle NHS’ current budget cuts in the midst of enormous admissions, and safer and more effective care delivery. The study did not identify certain disadvantages to such adoption but cited barriers instead, including cost, usability, privacy issues, and battery power efficiency. Additional barriers include lack of interest in health information and monitoring services as well as non-reliance on the already available technology. Implications for practice include further research toward improved technology innovation in healthcare, and training and expertise in using mobile technology as a fundamental aspect of quality and safe healthcare. References Avancha, S., Baxi, A., and Kotz, D. (2012) Privacy in Mobile Technology for Personal Healthcare. Journal of ACM Computing Surveys, 45 (1). Blake, H. (2008) Mobile Phone Technology in Chronic Disease Management. Nursing Standard, 23 (12), 43-46. Blogger, R. (2011) Cameron is Spending Less on the NHS Than Even Thatcher Would Have. Accessed on 19 November 2014 from http://liberalconspiracy.org/2011/10/31/cameron-is-spending-less-on-the-nhs-than-even-thatcher-would-have/ Boulos, M. N. K., Wheeler, S., Tavares, C., and Jones R. (2011) How Smartphones Are Changing the Face of Mobile and Participatory Healthcare: An Overview with Example from eCAALYX. Biomedical Engineering Online. 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