What can policymakers do to design out exclusion?
A digital inclusion policy, strategy, and governance structure is needed within Integrated Care Boards (ICBs), and providers, to ensure that all programmes consider and mitigate digital exclusion and help to reduce associated health inequalities. This should include:
Developing a digital health and care communication strategy and information resources (national, regional, local, population level).
Embedding a digital inclusion assessment in other equality impact assessments.
Ensuring a robust system to monitor complaints, safety data, and outcomes in digital health and care.
Developing data sets that enable identification of those most at risk of digital exclusion, those not engaging in digital health and care, health inequalities associated with digital health and care, patient insights and experience and clinical outcomes of digital health and care.
The health and care system needs to better design and commission service/pathway/technologies that are as easy to access and interact with as possible for all health and care service users, and the health and care workforce. This includes:
Reviewing accessibility and usability requirements and processes (e.g., DTAC) and embed standardized process for ensuring digital health and care technologies are fit for required population, including highest need populations.
Ensuring that digital health and care services/pathways/technologies can be accessed by basic digital literacy skills.
Ensuring all the public facing service/pathway/technology information is accessible, written in plain language, and is translatable.
Reducing specification requirements for digital health and care technologies - and that they are fully useable on all devices our population may have access to.
Ensuring the digital health and care pathway/technology is interoperable with assistive technologies and other health and care pathways/digital products.
Moving towards single sign-on (SSO) where users are asked to enter their login credentials one time to access all health and care related applications.
Commissioning formal support to enable access to digital health and care where there is a known/unavoidable skills gap.
Commission a library of trusted, accessible, useable, digital health and care services/pathways/technologies to aid people accessing these independently.
Provide technology and connection for the highest health and care need populations to enable them to access and interact with digital health and care e.g. ‘prescribing’ appropriate technology and removing data charges for an individual’s essential health-related services (e.g., NHS app)
Ensure people accessing digital health and care have the same (or improved) access to personalized, accessible and useable health and care information and support as if they were accessing non digital health and care.
Consider workforce needs alongside the service user- the digital exclusion issues are the same.
Use Digital Inclusion Framework and implementation tools to:
assess the inclusivity of current digital health and care pathways, services and technologies,
design new inclusive pathways, services and technologies, and
inform digital inclusion policy, strategy, programmes and pathways.
THE CORE VERSION OF THE FRAMEWORK provides an overview of the enablers and facilitators of digital inclusion on every stage of the digital health service user journey.
THE EXTENDED AND INTERACTIVE VERSION of the framework includes the recommendations for mitigating against each digital inclusion barrier.
THE ASSESSMENT TOOL supports the practical application of digital inclusion framework in the context of designing and reviewing digital services and pathways.