"Start with the problem": Interview with Liz Ashall-Payne, Part 2

Could you describe the average patient who is seeking information on digital health to improve their life?

I do think it’s absolutely women aged 30-40, but it’s not just that demographic. We recently did a survey with North West London CCG that involved 1,000 people. We asked them what motivated them or what would activate them to use a digital health app. A lot of people were already using digital health and almost 100% said that, if they were recommended a product by their GP or other clinician, they would have a look at it.

The big thing that they struggled with was knowing where to go for products and knowing that their practice offered these solutions. There’s a real disconnect between what we can do as healthcare providers and what the patient receives.

The average patient that’s actively seeking solutions is probably different from the community that we could activate if we provided this service to them in a way that targeted them from a marketing perspective. There’s a huge gap there.

Just as the design and development of different apps and software is about innovation and making something different from existing products, private GPs and other doctors do need to distinguish themselves from others to get patients. What would you say to private GPs, especially those who are a bit older or less IT-aware, who are looking to take advantage of digital health?

My first piece of advice is not to be scared. There’s a lot of fear in this space and I’ve found that they’re not trained to know about this side of the world. I’m not technical either, but I’m embracing it. Be brave and have a look what’s out there. The other thing is to start asking questions. If you’ve got those fears, voice them. Ask people how you might be able to use digital health.

The third point is to be clear about who you want to target with a product.

If you’re a doctor and you’re seeing a lot of young people coming to you and saying that they’re stressed and anxious, start with that problem. If you’ve got people who are drinking too much alcohol, start with the problem and go and have a look at what’s available for that challenge.

The fourth thing to remember is that one size will never fit everybody. Even if you find a range of products to support a problem area, you’re going to find at least some people who say it isn’t for them, and that’s okay. One product will not fit everyone in your community and that’s a massive myth that has spread cynicism.

People will say this is THE diabetes app, and that’s the worst thing you can say because it will support a certain demographic, population, age range or stage of condition, but it won’t support everybody. From that perspective, my advice is to remember that you wouldn’t prescribe just one drug for everybody who came in, so let’s think about digital health in the same way.

My final point is to be brave. We have to embrace this new technology, and we have to have some space while we do so.

You’re clearly an advocate for digital solutions that are genuinely great for dealing with current and future healthcare issues. It’s good to see that patients and doctors are being encouraged to use only the very best tools. At present, how prevalent would you say digital health solutions in the average primary care setting? Have you noticed any trends as time has gone on?

That’s a really good question. I think we’re really early on as it was only 8 years ago that the smartphone came into our lives. We are very early on in this journey, but the best way to describe the current landscape is as a normal distribution curve. This is at the cutting edge, and you won’t currently be seeing the majority of doctors using healthcare apps.

You’ll see champions of the system wanting to use healthcare apps and digital solutions, and they are using them. However,

Where it’s not happening, the reason is because there’s no infrastructure to facilitate making an informed choice and governing what products go to whom. The barriers that exist haven’t necessarily been overcome.

In terms of trends, we definitely see more going on. It’s a perfect storm as GPs are under a massive amount of pressure as populations are growing. We know the story well – we’re growing older and suffering more long-term conditions, so our patient populations are not just growing, but becoming more complicated.

When we go and speak to primary care colleagues, of course there are lots of questions and quite rightly so. More often now, we have people saying, “Yes, let’s do this”.

We’re seeing a change in our population, but also recognising the absolute need to do something different.

To be continued.