Digital training ‘should be embedded in clinical curricula’

Digital training should be “embedded” into clinical curricula rather than being “bolted on”, the chief executive of ORCHA has said.

Liz Ashall-Payne said more needed to be done to ensure appropriate digital training for clinicians or risk a “knowledge gap” forming between current and future staff.

“Broadly speaking across the workforce there is low awareness and education and so trust in digital health, especially with no governance in the market,” she told Digital Health News.

“To avoid a knowledge gap forming, alongside looking at our future workforce, we should also look to the current front-line staff. Here digital health should be part of staff mandatory training.

“Digital shouldn’t be bolted onto the curriculum but embedded throughout. But being pragmatic, to start with, there should be at least one digital health module in every pre-qualifica tion curriculum.”

Dr Sandeep Bansal, chief executive of Medic Creations and mentor on the Royal College of GPs innovation mentorship programme, echoed calls for digital training to be incorporated in the medical school curriculum.

“It is not just digital adoption that is difficult, all change is tough to deliver and takes considerable time, as clinical staff don’t have the time to upskill and all for change. This is why we need dedicated protected learning time,” he said.

“Your organisation is only as strong as lowest digitally mature staff member. It is all very well educating our tech-savvy junior doctors, but we must make sure those less au fait with digital advancements are not left behind.

“That is where patient safety could be put at risk. After all the main purpose of digital innovation is to enhance our ability to care for patients, by enabling more effective, efficient and precise clinical practice.”

Various degrees of digital training are already delivered in trusts, clinical commissioning groups, integrated care systems and other organisations.

But the solution isn’t as straightforward as providing digital training, according to Patrick Mitchell, director of innovation and transformation at Health Education England (HEE).

“We do know that there are new and emerging technologies, the rate and scale of digital change is significant and requires our healthcare professionals to have digital capabilities to take advantage of these technologies for quality patient care that offers choice,” he said.

“We cannot be prescriptive about how these skills should be taught, what we can do is to support the system with frameworks, guidance and tools to facilitate training provision.”

The Building a Digital Ready Workforce (BDRW) programme at HEE is looking at how to digitally prepare clinicians through a number of workstreams including professionalism, digital literacy, leadership and the Digital Academy.

“These workstreams and the tools, programmes or training being developed, tested or delivered will support individuals and organisations to be digitally ready; which is to be willing and able to take advantage of digital technologies,” Mitchell added.

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Digital GP provider LIVI released a report on 24 October which found nearly 80% of GPs had not received any digital training.

The report, Care Records, also found that digital expectations are high, highlighting a clear need to help prepare GPs in “webside manner”.

With a well-publicised GP workforce crisis, digital healthcare has a key role to play through building a more sustainable workforce for the future, it said.

Some 80% of GPs think video consultations would make it easier to work from home and 65% of GPs think video consultations would make it easier to work more flexibly.

Despite this, 77% of GPs have yet to receive any training on delivering care via video consultation and 78% see poor technology, such as inefficient hardware and Wi-Fi, as a barrier to digital practice.

Dr Harriet Bradley, medical director at LIVI, said: “The potential for digital healthcare is significant, allowing patients to access care whenever and wherever they need it.

“But for this to happen, there is much to be done to get our tech infrastructure ready.

“Aside from these necessary upgrades, GPs are calling for more support and training. We believe ‘webside manner’ should be an available training module for both experienced GPs and GPs in training – we want GPs to be empowered to embrace the digital healthcare revolution.”

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ORCHA, a health app evaluation organisation, conducts reviews for NHS England and NHS Digital to help accelerate the uptake of technology across the country.

Recent research from the organisation found only 15% of healthcare apps meet minimum safety standards, highlighting a need for a proper review process to protect patient safety.

Ashall-Payne said currently clinicians don’t know if health apps are “good, bad or ugly” when patients present the data they’ve collected on them.

“Clinicians are trained in medicine and so are confident and competent, but as clinicians aren’t yet trained in digital health they are naturally nervous. Why should we expect them to prescribe digital health without this [training]?,” she said.

Clive Flashman, chief digital officer of charity Patient Safety Learning, agreed with the need for clinicians to receive digital training but with a focus on how to quickly evaluate an apps.

“What is essential is that all clinicians, not just GPs, have access to advice, tools and support to enable them to prescribe and monitor the effectiveness of apps and digital therapies,” he told Digital Health News.

In December last year the National Institute for Health and Care Excellence (NICE) published standards for developing digital health technologies, which were later updated in March 2019.

It’s “vital” clinicians are made aware of standards like this and the NICE clinical assurance framework as part of their training, Flashman added.