Prevention is better than cure
One of the aims identified of engaging people more closely in their personal health and well-being is to increase the number of quality of life years they experience; preventing illness and prolonging life. The shift within the NHS in focus from sickness and cure to wellness and prevention reflects the fact that the management of long term medical conditions and other issues relating to old age are of increasing concern. These trends are discussed in greater detail in the Wanless reports which also outline that a more engaged public with higher levels of well-being will assist in relieving the financial pressure of such situations by remaining healthier for longer. However, an international comparison study by the Picker Institute found that;
“Despite the strong official commitment to developing a patient-led service, our results suggest the UK is not performing well when it comes to involving patients in their care Technologies alone cannot substitute for a strong culture of and commitment to involvement in practice of preventative health and wellness. However, they can supplement such practice and make support more responsive for individuals who are making their own self-care or lifestyle choices. Encouragement can be provided remotely to people via technological means, from informational text messaging services to online interaction in forums or via web conferencing. The increased scope for personalised information provision in a wellness context that web and mobile phone technology brings with it is also important in getting wellness and lifestyle messages across in a more targeted way - to the right people in their preferred mode of access.
The provision of effective support to those who take up the use of technology when they require human interaction must be emphasised as an essential part of the process to be included from the planning stages of implementation. Yet technology can provide tools to promote health literacy and to reach groups which may not otherwise be easily targeted - there is a need for balance and consideration when considering which tools to use, and what level of human support may also be required behind that interface.
The other main purpose of supporting this shift in emphasis from curative to preventative healthcare is the substantial projected cost benefit as outlined in the final Wanless report. Armchair Involvement tools could contribute by enabling people to find information, to make more informed choices, and to communicate more effectively with the NHS in a cost effective way, making greater use of the internet. This could contribute to a reduction of demand on the NHS in line with the ‘fully engaged’ scenario as outlined in the interim Wanless report.
“Fully engaged – levels of public engagement in relation to their health are high: life expectancy increases go beyond current forecasts, health status improves dramatically and people are confident in the health system, and demand high quality care. The health service is responsive with high rates of technology uptake, particularly in relation to disease prevention. Use of resources is more efficient.”