Digital health has great potential to improve health and healthcare.

It could allow:

• Genuinely coordinated care via a shared record, reducing unplanned admissions and getting people out of hospital faster.

• Better self care, giving patients the information, resources and contacts they need to take charge of their care.

• Real time data via wearables and sensors, providing timely and proactive interventions, rather than treating what comes through the door.

• And, in coming decades, innovative AI approaches that will lead to increasingly precise and personalised treatment plans, and freeing up consultant time for the most complex patients.

The UK should be a great place to be a digital health entrepreneur. We have the skills, a history of medical innovation, a sophisticated investor community, and the NHS - a coordinated system, with common standards, which should be able to make strategic investments. However, this is not the case in practice.

The NHS has earned a reputation as a very difficult customer for digital innovators.

The number of digital entrepreneurs that have successfully built a business at scale with the NHS as a core customer, can be counted on one’s fingers

This looks like a huge missed opportunity from the perspective of patients, clinicians, taxpayers and UK plc. It is exactly what a digital strategy that focuses on making the UK the best place to start and grow a digital business, unlocking the power of data in the UK economy and improving public confidence in its use, should see as a measure of its success.

Based on many conversations with digital innovators, three areas stand out as being most in need of reform:

• Open digital architecture

Digital entrepreneurs will struggle to make their products easy to use if they cannot plug into the existing digital architecture of the NHS. This is long promised, clearly articulated in various policy documents, and has some top notch people working on the issue. However, the devil here is in the detail - previous examples, such as GPSoC, have not delivered what was hoped for. This needs continued pressure from the top, to deliver the goals that have been set out.

• Regulation and evidence

​We need clarity about pathways to approval, and to strike an effective balance between the costs and timescale necessary to generate evidence and the returns available. There are a number of ways to do this well, but few people are content with what we have at present. Reform is happening here, but is somewhat slow and remains unclear to many people in the space.

• Procurement 

Digital entrepreneurs cannot live with sales cycles measured in years. They must be able to work in partnership with NHS providers to evolve their product and its implementation, rather than work via arms length contracting arrangements. Our exit from the European Union, and its cumbersome procurement regulations, represents an opportunity to create a more effective way of working with entrepreneurs.

There is light at the end of the tunnel. Our impression working alongside NHS staff is that clinicians and managers are much more comfortable with the idea of implementing technology than they were even a few years ago, and the products they are being offered are increasingly mature and well evidenced.

The issues outlined above are well known and have some smart people working on them. However, the practical challenges remain much as they have been for some time, and continued pressure from the top will be vital to realise the potential of digital health.

We've got some great speakers looking at this topic, among many others, at our upcoming conference on the 9 May - The Future of People Powered Health - Watch a live stream of the event here, or browse the full programme.

John Loder, Head of Strategy, Nesta Health Lab, will be chairing a discussion 'How can innovative digital technology get to scale?' at 10.20am on 9 May