By Rachel Royall
Modern medicine and healthcare relies on modern technology and communication. So in the evolving world of digital, how is the public and patient interface in healthcare changing and what are the implications for public relations practitioners for the future?
• About changing habits in how the public are seeking and accessing healthcare
• Why dedicated and professional communication is required to build public understanding and trust as the digital transformation of the NHS takes place
• How communicators have the access and the influence to champion the role of patient and public centred design and services
A digital transformation
In our everyday lives we embrace technology from shopping online and sending photos and messages to friends via various apps, to using voice recognition to tell us the weather.
We’ve embraced and adopted technology throughout our lives with what seems like relative ease.
Of course, we all know people who have been slower to buy the latest smartphone, or who still choose to pop into the local Sainsbury’s rather than order online, but overall technology has pervaded every aspect of our lives.
In healthcare though there is something of a dichotomy. Computers were first used in the NHS for administrative purposes in the 1960s. Since then we’ve come a long way with advancements in robotics, artificial intelligence and precision surgery.
So why is the NHS still the biggest procurer of fax machines? Why are we still spending so much on post as opposed to embracing email for patient communication?
On the one hand the patient interface with the NHS is nothing short of miraculous as new technologies are used to treat and cure illness and disease, transforming the dynamic between patient and care giver, yet on the other hand we are slow to adopt technology for patient communication, (apps, text, email), even though it has been widely used in other sectors for the last decade.
Digital transformation has the potential to completely change the way the public engages with healthcare.
In the UK technology has changed the way individuals access health services. For example, the original concept of 111 was telephone advice by a remote health care professional and this is now evolving to an online channel that will enable an online consultation. People will be able to receive advice, guidance and potentially manage their journey to a GP, pharmacist or even a hospital via the internet or on a smartphone.
The patient and public interface with health professionals is becoming more informal. In some areas, people no longer have to wait for a fixed appointment to ask a doctor a question and can send a secure message via their health record to their GP, or skype our doctors so they are able to offer diagnoses or treatment via phone or computer.
The digital revolution not only impacts on how we access services, it also impacts on how we obtain information about our health and manage our care. On Google one in five internet searches are healthcare related.
More than 1.5 million people access NHS Choices every day to seek advice about healthcare. As patients and the public become more knowledgeable and more informed and they increase their access to digital services, it is inevitable that the ways that patients and the public access the NHS will continue to change.
The implications for public relations practitioners
There are challenges and opportunities for public relations practitioners in embracing the digital revolution in healthcare; digital transformation is mission critical, public trust is essential and the dynamic of power between professionals and patients is changing.
The population is growing and changing, putting additional demands on the NHS and social care. The Office of National Statistics has projected that the UK population is set to pass 70 million before the end of the next decade.
It also highlighted the ageing nature of the UK population. In 2016 there were 1.6 million people aged 85 and over and by mid-2041 this is projected to double to 3.2 million.
Technology can help deal with demands in healthcare, as societal change embraces the fact that many things, but not all, can be done without direct face-to-face interaction.
Targeting the dissemination of health information to the right audiences at the right time to encourage self-care can help to reduce demand.
Using digital technology well can free up more time for care givers to spend face-to-face with the patients who need that care. It’s all about giving people the right care, in the right way, at the right time.
Embracing digital across the health and care sector isn’t optional, it’s business critical and the PR community is well placed to amplify this message, to encourage adoption and also to support leadership teams to understand the changing environment.
To use the words of Robert Watcher: “The one thing that NHS cannot afford to do is to remain a largely non-digital system. It is time to get on with IT.” 
The simple reality facing us is that without public understanding and professional engagement to build trust, we won’t deliver the potential of digital technology in healthcare.
The NHS is one of the most trusted brands in the world with 98 percent recognition. However, the Edelman Trust Barometer shows us all that public trust in institutions is declining. Not only that but alongside immigration one of the issues that Britons are most fearful of is the pace of technological change.
Against a constant backdrop of media crisis, the public relations profession has a key role to play in helping to build public trust in the use of digital technology for healthcare, both in terms of technology for patient care and moving information around the system and using it to improve things.
Tactically we can help build trust by being proactive about communicating the benefits of using healthcare data for research, by encouraging the adoption of digital technology that is already in place and by explaining how we keep personal information and systems safe. We also need to be transparent when things go wrong and be open about progress and challenges.
All of this is essential to building public trust. And whilst trust in politicians is at an all-time low, there is a huge opportunity for the NHS workforce to be advocates as trust in doctors and nurses is still high at over 90 percent.
To truly benefit from the opportunities that digital can bring, we need the support of public relations professionals to bring doctors, nurses and all other healthcare workers with us.
There is a piece of work here to truly engage those managing and designing healthcare systems and those delivering care, as well as to understand and respond to any concerns and to support them to see how embracing technology could transform their practice and free up more time at the patient bedside.
Improved access to information and technology in healthcare shifts the dynamic of power between healthcare professionals and the patient – it increasingly puts patients in the driving seat, as they have more access to their own information.
There is also a tension between care and technology, some systems feel clunky for nurses and doctors – they get in the way of the human relationship. The language and tone can sometimes feel inaccessible, using systems sometimes doesn’t feel human.
Above any other profession, PRs have the access and the influence to champion the role of patient and public centred design and services, improving them for the patient and healthcare professional alike.
PRs can help leaders listen to the public, access insight and develop technologies that meet public expectations. Also once patients understand the benefits to their care they can be a catalyst for change.
The digital revolution in healthcare will continue apace over the next thirty years and will be unrecognisable to those of us who get to celebrate the 100th birthday of the NHS. However, it is a huge opportunity and communication is at the heart of it.
The collision of information, technology and communications will continue to impact on the public and patient interface with the NHS. The technology in some ways is the easy bit, as the technology develops, the communications and PR profession needs to take its rightful role in the leadership of the digital agenda.
The digital transformation is not only business critical in medical innovation but also in communication innovation.
Only through professional and ethical PR can we build public trust and only through helping our organisations listen and understand the needs of NHS staff, patients and the public will we develop services that meet their future needs.
 P.6 Watcher Review: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/550866/Watcher_Review_Accessible.pdf
Rachel Royall is an experienced Board level communications and engagement director and is currently the Director of Communication for NHS Digital, the government arms-length body responsible for implementing digital transformation across the NHS and health care in the UK. Rachel has held senior level communication roles across the public sector, including the NHS, HM Revenue and Customs, Cabinet Office and Department of Health. Graduating from Kings College London with a degree in Theology, Rachel has an MA in Public Communication, a Diploma in Strategic Communication and is a member of the Chartered Institute of Public Relations and the Institute of Internal Communications.