Digitalisation of Health Care Services

Full title: Digitalisation of health and social care services for older adults: what can we learn from the COVID-19 pandemic?

For at least a decade, the World Health Organization (WHO) has been encouraging use of digital technology to improve health and social care services.

There is a growing role for digital technologies in society, but concerns that older adults are being disadvantaged and excluded with the growth of use of these technologies.

The COVID-19 pandemic led the UK government to mandate lockdowns and social restrictions. This was accompanied by rapid implementation of many digital services both in the UK and internationally.

We aim to produce an initial piece of work: a scoping review to identify what we can learn from the recent at pace innovations in UK. This will be a first step to a longer-term ambition to advance our understanding of how health and care services have been digitalised, and the policy implications of this change. Further work will include data analysis of the digitalisation of services and also an exploration of user views and experiences of older adults from South Asian and African Caribbean descent.

Aims

  • To advance our understanding of how health and care services have been digitalised during the COVID-19 pandemic.
  • To learn what has worked well and what has not, with a specific lens on the digital divide and health inequalities.
  • To provide evidence for future policymaking.

Research methods

Initial mapping review

An initial review will be used to map the extent and quality of published literature around digitalised services during the pandemic, and guide subsequent stages of the work by highlighting the areas to focus on.

Objectives and review questions

This review aims to map the evidence on the impact of digitalisation of health and social care services for older adults since the start of the COVID-19 pandemic in January 2020. To meet these aims the review will initially answer the following question:

1. What types of evidence are available / currently being sought on the digitalisation of health and social care services/digital delivery of interventions or practice for older adults during the COVID-19 pandemic?

This will allow us to map an overview of the current evidence and guide development of a subsequent deeper evidence synthesis to answer a second set of questions, if appropriate:

2. What are the outcomes and impacts for older adults of digitalisation of health and care services/digital delivery during the COVID-19 pandemic? What barriers, facilitators, and limitations regarding digitalisation of these services/digital delivery for older adults have been identified? What (if any) theoretical interpretations are there of these barriers, facilitators, or limitations?

Evidence will be sought from: 

  1. Evidence reviews (both systematic and narrative; published or in progress)
  2. Primary studies (quantitative and qualitative; published or in progress)
  3. Grey literature

Initial sense-checking on the review will be done by consulting our public and patient involvement (PPI) panels and DHSC stakeholders.

Based on findings from this review, we will more fully develop the work described below in conjunction with DHSC colleagues and other stakeholders.

Further stages

The follow on stages of this work is as described: 

Data analysis

We will carry out data analysis of the digitalisation of GP services and health inequalities.

The following questions will be examined, specifically related to older people (aged 65+):

i. How has the mode of GP consultation varied for older people (65+ years and compared to younger groups) over the pre-pandemic period (pre- Jan 2020) pandemic period (Jan 2020 – Feb 2022) and since the main pandemic?
ii. Are there differences in number of consultations for different age, socio-economic and ethnic groups related to digitalisation?
iii. Is there a relationship between digitalisation of GP consultations and health inequalities among older adults?

Understanding experiences and views of older people from minority ethnic groups

We will host a series of focus groups to explore the experiences and views of older adults from two ethnic minority groups (South Asian and Black African or Caribbean backgrounds) about digitalisation of primary care services. The following questions will be examined:

i. What is it like accessing/using digitalised primary care services as an older adult from a South Asian or a Black African or Caribbean background?
ii. How do older adults from these groups describe their views regarding digitalised primary care services?
iii. What are the expectations of older adults from these groups regarding future digital primary care services?

Policy relevance

The review will consider how digitalisation of services has progressed and the evidence base upon which such digitalisation has been based.

This review will inform development of policy and practice for the digitalisation of health and care services.

Potential future work would permit identification of good practice (what works), the views of older people, how digitalisation relates to health inequalities (does it exacerbate them or can it mitigate them?), and vital information for policymakers regarding digitalisation of services.

Delivery timeline

Review stage: Spring 2023

Further work: Summer 2023

 

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