Supporting & Empowering Scotlands Citizens: National Action Plan for Technology Enabled Care

Actions & Deliverables

Whilst our existing eHealth Strategy ^[12] will continue to drive forward the infrastructure & technological requirements underpinning activity, the actions outlined below will enable us to make the necessary step changes to enable our citizens to be able to access and use technology to better support their health & wellbeing whilst at home and in their communities. This will inform the work being progressed on a Digital Health and Care Strategy for Scotland from 2017/18.

TEC Development Programme

1. We will work with Alzheimer Scotland to ensure that the Technology Charter for People Living with Dementia becomes fully embedded across all health & care providers in Scotland, and inform the next dementia strategy (see example 4).

2. We will continue to invest in 'at scale' developments through the TEC Development Programme, ensuring more of our citizens are empowered to remain at home through the use of technology enabled care. This includes supporting service redesign to integrate new ways of working into mainstream service provision and pathways, building on initiatives such as the Living It Up service for people living with long term conditions, and the expansion of video enabled care services to care homes in Scotland.

3. We will work with our national procurement agencies to review and ensure our procurement approaches & frameworks are fit for the future.

4. In partnership with SCTT we will set out milestones to inform a shift from analogue to digital telecare services.

5. We will publish our National Model for Home & Mobile Health Monitoring, which will facilitate flexible solutions that support the [self] management of disease and improve wellbeing. This builds on the work carried out in the United4Health Programme, and will enable us to rapidly scale solutions for a number of long term conditions.

Example 6 - Home & Mobile Health Monitoring

Lanarkshire's Rapid Improvement Study: Hypertension Monitoring in General Practice demonstrated that within 3 months 115 patients self monitored their Blood Pressure with result of saving 415 practice nurse / GP appointments. They concluded that for this population of patients in Lanarkshire;

• Home & mobile health monitoring ( HMHM) of blood pressure improves efficiency
• HMHM of blood pressure for about two to three weeks avoids an average of four to five GP or Practice Nurse appointments. This saves clinic time for clinicians, reduces telephone contact time (using texts instead) and prevents patients having to travel to the surgery for routine monitoring.
• HMHM of blood pressure supports clinical decision-making
• GPs/Practice Nurses report that HMHM of blood pressure enables faster decision-making and provides optimum readings. This resolves issues around 'white coat syndrome' (it did so for one third of this cohort) and allows a diagnosis of hypertension to be either confirmed or ruled out.
• People mostly find it easy to monitor their own blood pressure and report results by text
• People found the BP monitor and Flo text messaging system easy to use, felt it helped them monitor their BP, and would use it again in future, if they needed to.

A larger scale version of this, using the FLO telehealth system, is currently being rolled out across Lothian as part of the development of home and mobile health monitoring in Scotland, with full evaluation by the Edinburgh University (with funding from the Chief Scientist Office). As of 2016, there are over 100 GP practices engaged in HMHM initiatives and numbers continue to expand.

6. We will commission a feasibility scoping report on the merit in extending access to proven preventative technologies for all over 75s and those with a diagnosis of dementia and, pending outcome of this, set out an implementation plan.

7. Local delivery organisations (including Health Boards, Integration Authorities and third and independent sector organisations) will work to embed TEC into their strategic plans for service delivery.

8. Supported by NHS24, we will commence the national roll out of computerised cognitive behavioural therapy ( cCBT), building on the EU-funded MasterMind ^[13] programme, resulting in a 'Once for Scotland' approach to treating mild to moderate depression.

Innovation Programme

9. We will work with our Enterprise Agencies to set out the strategic context for securing continuing investment in digital health & care innovation, positioning Scotland as a world leader in this field, and ensure a pipeline of 'next generation' technological developments for the benefit of our citizens and our economy.

10. In partnership with the DHI, we will develop our approach to allow for new technologies and approaches to be safely tested in a number of care settings, both physically and technically.

11. We will inform and consider our approach to the use of apps and mHealth more generally, including the use of wearable devices and user-generated health & wellbeing data.

12. Aligned with the Open Innovation programme, we will set a number of strategic challenges facing health & social care provision, and look for digital health and care options and solutions.

International Engagement

13. We will publish an International Engagement Strategy, setting out how Scotland can maximise the opportunities to engage with global experts, and leverage additional funding in the field of digital health & care.

14. We will continue to work with Scottish Enterprise, Highlands & Islands Enterprise, Scotland Europa and Scotland Development International to support inward investment, growth and export opportunities in digital health & care, to fully realise economic benefit for Scotland.

Cross Cutting Enablers

15. We will commission a think piece on the role of TEC within future care, to inform our next strategy. Whilst there have been many recent publications setting out the 'art of the possible', to date none of these have set possible developments in the context of Scotland's integrated health & care system.

16. We will work with NES and SSSC to ensure our workforce are supported to use technology effectively and engage with patients/service users through digital means.

17. We will facilitate continued knowledge exchange throughout Scotland, including making it easier to access relevant materials and resources by rationalising our web presence.

18. We will build and further develop our strategic partnerships with a broad range of organisations and interests to ensure that all new services and developments are co-created with those who use them.

19. We will work with the housing sector and the third sector to progress the use of digital to support people in their own homes, working with the Housing Partners for Health and Wellbeing, Care & Repair, Scottish Council for Voluntary Organisations ( SCVO), the Coalition of Care Providers Scotland ( CCPS), the Health & Social Care Alliance Scotland, Carers Scotland and others.

20. As we move towards a 'digital first' approach to health & social care, we will work to raise awareness across the general population on the benefits of TEC.

21. We will continue to work with ISD Scotland ^[14] in order to embed routine use of measurement and evaluation for continuous improvement and service planning.

22. We will work with the Care Inspectorate to ensure that the new national Care Standards take into account the increasing contribution of technology in the delivery of safe and effective care.

Whilst these are concrete actions for us over the short term, taking these actions now mean that by 2020 health & care delivery in the community should be routinely supported by digital technology, where this aids delivery and improves outcomes.