Despite being in a digital age, the NHS is firmly stuck in the past it comes to interacting with patients and the public, say Bob Hudson and Dave Hudson

There is a paradox in the way the NHS seeks to engage with patients and the public. Tranches of social, political and economic life are increasingly moving online, and more people expect to interact with government and its agencies in the same way as they do with companies, banks and each other.

But engagement in the NHS is stuck with a pre-digital mindset where information arrives in the post and people phone up to confirm attendance at meetings. This has to change.

‘Giving citizens an active place in the flow and content of information both democratises and legitimises initiatives’

Resistance to digital engagement is often based upon the belief that this will disadvantage older people who are less likely to be digitally connected.

Figures for the first quarter of 2013, compiled by the Office for National Statistics, show that while 99 per cent of 16-24 year olds are accessing the internet, the figure is 34 per cent for the over-75s.

However while the group most likely to participate in engagment with the health service (older people) is the least digitally engaged, the largest “harder to reach” category (younger people and those with families) is the most digitally engaged. Moreover it is clear that the generation coming through to old age (the “baby boomers”) are often extremely digitally literate.

Feedback at the touch of a button

In the digital age, information is power, and giving citizens an active place in the flow and content of information both democratises and legitimises initiatives.

First wave technology such as email is now commonplace but even this is probably still used sparingly as a PPE tool. By collecting emails from patients and seeking permission to communicate non-confidential information to them electronically, a virtual feedback group with huge membership can be created – literally – at the touch of a button.

‘Healthcare organisations can use app technology to orchestrate conversations and engage in wider, more engaging and cost effective ways’

The simplest new technological opportunity, but one that needs to be sophisticated in application, is Twitter. A multitude of conversations is already taking place between innovative patients, staff and professionals. About 70 clinical commissioning groups and many provider organisations are already online, as our some of the best CEOs and other senior staff across the NHS. Twitter is about dialogue but for each respondent there will be many more listeners, so the reach of a conversation can be very wide indeed.

Twitter can be used for a variety of purposes − to inform, listen, share, debate and engage − but unless it is interesting and responsive it will be largely ignored.

But perhaps the bigger prize is developing a mobile app. Mobile internet use is set to overtake desktop by 2014. Unlike first wave technology, mobile devices are always on, internet connected, location aware and can be content managed through scalable “cloud” technology.

While social networks have turned traditional marketing and communication on its head, smartphones and tablets by their very nature provide the opportunity to harness it.

Adding value

By embracing both mobile and social at an early stage and understanding that conversations are happening on social media regardless, healthcare organisations can use app technology to orchestrate conversations and engage with the public and patients in wider, more engaging and cost effective ways. Some initial ideas of areas where a mobile app may add value include:

Membership system. NHS foundation trusts already have public membership schemes and a number of innovative CCGs are developing their own versions. Apps, through their ability to login via social networks such as Twitter, Facebook and LinkedIn (or to simply create a user account in the cloud) mean organisations can easily build relationships and start to communicate digitally. With the capacity to ‘join’ so simple, membership could snowball very quickly.

Push notifications. Traditional membership systems are communicating via hard copy or email, but a mobile app provides a more targeted method of communication called push notifications. When users open the app for the first time they can be asked if they would like to receive push notifications. Messages communicating an issue or promoting an event (including the ability to book a place within the app) can then be sent to the device, whether the app is open or not.

Additionally, push notifications can also be broken down into channels that allows for a much finer grain of communication. Users could sign up for a range of push notification channels within the app that relate just to a specific area, for example cancer, mental health, neurology − a digital citizen’s panel.

Events. Mobile apps are ideal for promoting events, making it easy to maintain an up to date list of events along with a real time user location enabled map for directions to the venue. Other features could be event check-ins, event ratings and feedback.

The cost of an app would not be exorbitant − a basic model for about £10,000, more for an all singing and dancing model – and the development costs could be shared with neighbouring organisations. The innovation element would be huge and the investment would reap massive future dividends.

It’s a question of when to do it, not whether to do it.

Bob Hudson is professor at the school of applied social sciences, Durham University. Dave Hudson is a mobile consultant specialist at Applification