From Socio-Technical Centre, Leeds University Business School
The aim of this workstream was to understand the business and organisational issues in telehealth adoption and to work with health service and industry partners help develop future, innovative business models using scenario planning techniques.
Organisational analyses were completed in each of the four health service sites via qualitative interviews (with operational and strategic managers, commissioners and industry) and scenario planning workshops to provide a whole-systems perspective on local telehealth adoption.
Following this, a series of alternative futures workshops were completed in two research sites and with two groups of national industry and policy stakeholders to identify potential innovative business models for telehealth.
Telehealth stakeholders in health and social care face many difficulties when innovating new business and organisational models. Uncertainties over future funding, technological possibilities and the variety of potential roles within commissioning and Assisted Living Technology market development impact on people’s ability to think about the future in this domain.
The socio-technical systems approach and scenario planning techniques can help NHS sites design new ways of working. Scenario planning reveals that current telehealth service design is entrenched in existing ways of working and operating.
Devising new, innovative, future business and organisational models requires a move beyond examining the constraints of existing services. Seeing telehealth services as one part of a socio-technical work system provides holistic insight into the spectrum of issues that interplay within the delivery of telehealth services.
Four alternative futures were developed to help NHS sites to design their preferred future during ‘Alternate Futures’ workshops. These futures reflect the dilemmas stakeholders faced when designing telehealth service business and organisational models; and were named Hub Central, Thousand Flowers, Navigating Networks and Laissez Faire.
The preferred future is a hybrid predominately based on Hub Central and Navigating Networks; with some element of statutory provision for ALTs provided and organised within a hub structure, yet with a network also being hosted alongside; allowing people to step down from more intensive models of care to more proactive health maintenance and self-monitoring.
Adopting a socio-technical approach can help to align social and technical aspects of the telehealth service during implementation. It is important that there is investment in planning the effective visualisation of the preferred future service model, and ensuring aligned goals, values, infrastructure, processes, support and roles are in place.
It is essential for there to be collaborations and links made between NHS and industry stakeholders when designing new ways of working in Assisted Living Technology markets. Both the business to business, and business to consumer markets will exist in the future, and Assisted Living Technologies will not mainstream from just one market. The futures themselves highlight this dual nature, and the preferred future (hybrid of Hub Central and Navigating Networks) highlights the way in which a network could act as a point between these two markets.