David Bowie was right

“The absolute transformation of everything that we ever thought about music will take place within 10 years and nothing is going to be able to stop it,” he said in a 2002 interview. “Music is going to be like running water or electricity.”

There are many parallels that can be drawn between the recent revolution in digital music and the ambitions of digital health, and although perhaps the characters involved aren't quite as flamboyant as Bowie, they’d love to think that an equivalent transformation will take place in the coming five years.

The move from single-channel hard-copy music recordings sold in a huge variety of shops to downloadable or streamed music, distributed only by a couple of vendors, has exploded the availability, accessibility and flexibility of consuming music. Similarly, after years of being kicked about like a political football creating an environment that allowed large multi-national proprietary vendors to create a monopoly, the digital health market could be at an equally explosive point.

At it’s most basic, today’s digital challenge to be addressed is: how do we get a patient’s information to the right place, at the right time, to provide the right service?

Trying to solve the challenge nationally has proven virtually impossible as the NHS National Programme for IT (NPfIT) has proven. Conversely, working on a solely local basis risks duplication of time, effort and money – allowing a thousand flowers to bloom is as big a problem.

Drive down cost while improving patient outcomes...

However, NHS England's Five Year Forward View appears to be the first non-party political mandate that could encourage and support single-channel providers (eg GPs and large hospitals) to deliver multi-channel patient services via an increasing range of digital devices and technology to improve availability, accessibility and flexibility. Ultimately, this will drive down cost while improving patient outcomes.

We’re starting to witness a step change in technical circles within the NHS, locally and nationally. It’s a slow but purposeful move towards community ownership and NHS-held intellectual property. It has open source and open standards at its heart.

The key to success...

In our opinion, this change is most successful where it’s tackling the issues of integration, interoperability and providing interfaces in the NHS. A gold standard for open source integration is forming, and Answer Digital Health is leading the charge with the trusts and partners we’re collaborating with.

The key to success will be doing this on three fronts at the same time: local, regional and national. Having the capability and company structure to work on small digital projects, help a trust with all its architecture and integration requirements, and advise strategically at a national level is a vital trait.

If we get this right, information will flow through systems that are locally configured but nationally hosted, and we’ll enjoy economies of scale. Ultimately, it will contribute to a more financially solvent NHS.

However, as Bowie would have appreciated, the one constant in the economics of health at the moment is change.

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