Joel Bailey looks at how NHS organisations are incorporating information technology into service design to improve patient experience and outcomes

Service design often involves taking an existing service and working with patients, staff and commissioners to reshape the “ecology” that sits around it to make it better. It is not only about clinical care: the ecology covers the entire patient experience - from the information they receive to the environment in which care is delivered.

The role of technology in this process is becoming increasingly important - both as a tool for engaging people in the design process and as a platform for delivering information and services, with 24 hour instant access, in a way that meets their individual needs.

Technology enables people to find services (for example, through NHS Choices), which tallies neatly with the government’s choice agenda. It also allows people to share their experiences and comment on them, comparing and contrasting different healthcare options.

Technology is a facilitator to effective service delivery. One of the most common complaints about NHS services is that they take place away from home, but digital tools take healthcare to where patients are rather than vice versa. If a service is available online or can be downloaded, users don’t have to come into the clinic to get information.

Technology also allows services to be marketed where the patients are. Rather than forcing users to come to a particular NHS website, information can be promoted via social networks such as Twitter or Facebook.

The role of digital services has recently been thrown into sharp relief by swine flu and the demand for online information. This has helped us reassess the potential of technology in healthcare: while it is not problem free, there are many opportunities available. Importantly, it shouldn’t be used as a driving force of its own but instead as an enabler for improvements elsewhere.

However, the public are demanding a more technology based approach in all their services - public and private sector alike. It should therefore be an integral component of any service redesign carried out in healthcare.

How to do it

Organisation planning to incorporate technology into their service design should consider the following:

  • Lead from your service strategy Ask how your users want to engage with you, rather than how you want to engage with them.
  • Develop for users Co-design workshops allow users to fit your service innovations into their daily lives and ensure you pitch the appropriate level of technology into the mix.
  • Develop with staff Your employees are most likely to understand the daily challenges faced by service users.
  • Feedback loop How is existing technology used? What are your users struggling with every day? Evaluate the impact of past projects and identify areas for investment.
  • Channel shift Look for routine offline transactions that can be resolved online. But be careful - map where they occur and ensure you have offline support routes in place.
  • Digital engagement Social networks such as Facebook and Twitter are more than simple marketing routes - they are opportunities for continuous open dialogue. Identify how they can help staff and service users and establish what you will and won’t discuss through these online channels.

Case study: pregnancy desktop

Gary Ashby, programme director at NHS Choices, comments: “Pregnancy information is a crowded market, with dozens of competing providers and often conflicting advice. The NHS has always been seen as a trustworthy source, but we needed a clear, concise way of getting all our disparate information across to expectant parents.”

The result was the Pregnancy Care Planner, a free service on NHS Choices that contains everything a parent needs to know to have a healthy and happy pregnancy.

But there was also the opportunity to build something innovative. Communications agency The Team designed an application that expectant mothers could download directly to their desktops. Users log in their due date and Pregnancy Desktop loads automatically every time they turn on their PC. It then provides articles, imagery and information suitable to that week’s stage of pregnancy, enticing them to look at the application every day.

The results were startling. Visits to the NHS Choices pregnancy pages shot up 38 per cent and Pregnancy Desktop soon became one of the site’s most popular downloads. More than 2,300 people download it every month.

At a tactical level, Pregnancy Desktop effectively reaches a narrow audience (expectant mothers) with specific, targeted information. Strategically, it provides NHS Choices with a growing database of mothers who, with consent, could be targeted with other healthcare information. It allowed the NHS to build a more personalised relationship with the key decision-maker for family health matters: the mum of the house.”