The future of digital health interventions and the workplace with Dr. Oliver Harrison

Dr. Oliver Harrison has a lot on his CV. Aside from being a medical doctor, he also worked for McKinsey Health Tech, set up Abu Dhabi’s public health strategy and advises the World Health Organization. UNLEASH was lucky to get 20 minutes of his time to discuss mental health in the workplace among other things. We start with a primer on digital healthcare.

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Jon Kennard: Tell us a bit about what digital healthcare is or how it can help people.

Dr. Oliver Harrison: Pleasure to be here. I qualified as a medical doctor back in the late 90s, and worked for six years total in the NHS in different roles. And I was aware, particularly in mental health care where I was working, that there were two big problems. Firstly, we had nothing like the number of doctors, therapists nurses to go around, which meant that barriers to access were too high. It would take six months, 12 months for people to come and see us as a specialist team. And by the time their GP made the referral, they were already in significant distress, right? So waiting another six months or 12 months is not okay.

But the second thing is that, because of that barrier to access, we were seeing people months or years too late. And if you imagine somebody has a bad life experience, maybe a relationship breakup or lose their job, and that starts a snowball rolling down the mountain, and then they develop clinical symptoms; not sleeping, they’ve been anxious, and then they get a clinical diagnosis. My question was, why couldn’t we start at the beginning at a ‘stitch in time’.

So I became very interested in digital technology to solve both that access challenge reducing our dependency on expensive and scarce human clinicians, but also being able to intervene upstream in people’s everyday lives before those small problems become big problems. And really, over the past 20 years-plus, digital health has reached a new stage of maturity, I would say that the COVID-19 pandemic and the need for social isolation has really delivered 20 years of progress in two years, in terms of the adoption of digital tech.

Even simple things like using Zoom calls for typical consultation, but also the measurements at home of certain physiological measurements, and also the use of digital therapeutics as well to help to manage people. So I think we’re seeing a world that is maturing quickly when it comes to digital tech.

JK: That’s partially answered my next question I was about to ask for some examples about how this worked.

OH: If you imagine somebody who’s living with diabetes, who has a an insulin pump, that is measuring real time, the level of glucose sugar in their blood, and then delivering just the right dose of insulin to be able to normalize that glucose level, the data that’s generated from those devices can be shared obviously, back with the patient, they can tweak the dosing and make sure that it’s on track. But it can also be uploaded either on a memory stick or live to a diabetes nurse who’s supervising that patient. And that can become important for life threatening hypoglycemia, where the blood sugar goes too low, or diabetic ketoacidosis when the blood sugar gets too high.

So that idea of an implantable or wearable device, which is able to share – potentially – life-saving information [in] real time. And a second example is the use in mental health care of digital therapeutics. So I think when most people think about mental health care, they think about speaking to a human person, but we simply don’t have enough clinicians to go around. So the waiting times can be very long. And actually, for some people, it can be a real barrier to go speak to another person about their feelings. And just the very practical thing of having to take an afternoon off work and drive across town, find a parking space, go into your therapy session for 12 weeks in a row, right? If you’ve got children at home, or you’ve got a busy job, can be really hard to fit that in.

But we’ve been able to develop – I mean *humanity* has developed – technology, which allows that therapy experience to be made available to people to use at their convenience using their smartphone or using their laptop. And that’s just a real breakthrough, again, in terms of access. The quality of that is just as good as face-to-face therapy. And it’s really a revolution. And there are lots of clinical trials from telehealth and from others, that shows that actually the quality can be as good if not better than face-to-face treatment.

JK: Sticking with the mental health crisis; I think it’s not exactly that COVID-19 is out of the news, but there are other global issues, sharing the news cycle with it now and it may be to the back of some people’s minds, but it’s certainly very responsible for a decline in mental health in terms of the way people have restructured their lives. A lot of people have done it for the better. But some people, unfortunately, not so much; to tie into business, let’s talk about the importance of preventative care, and do you have anything to say to HR leaders, which may not see this as the right course of action in terms of preserving good mental health within the workplace?

OH: I mean, the statistics are pretty chilling. So NHS Statistics and Office of National Statistics numbers show that in the UK, about 30%, of the adult population, almost one in three, have symptoms that require clinical treatment for depression, anxiety, but also PTSD, OCD, alcohol issues, drug issues, etc. And that’s really just the tip of the iceberg. We’ve then got almost everyone, 85% of the population, experiencing mental health symptoms of some kind, that interfere with their ability to function at work at home, in social situations, and so on.

And what we’ve seen in previous pandemics is there’s two spikes, right? The first one is when people are actually socially isolated, and they’ve had to change their lives. And there’s a whole series of shocks and stresses that come from that. It’s that social isolation and loneliness, the disruption to everyday routine for couples and families being in a small home, together under each other’s feet, missing social contact with family and friends, and even at work.

But also, I think there’s just a profound sense of disruption in society. We’re very used to the idea that in a Western country, if there’s a big problem, if you get our best scientists, best politicians and best thinkers, businesses, working on it in a week or two or a couple of months at worst, it’s solved, right?

And then you find yourself stuck in a second year of pandemic and all of a sudden, the world feels a little bit less safe overall than it has done before. So all of those really combined to make this a huge issue.

And we’re seeing very high rates of turnover of staff. And that relates to the second peak I mentioned. The second peak is when people get back to normal and try to get back on a bus or back in the tube. And after two and a half years of being conditioned around social isolation, being on a busy tube train or busy bus, even seeing your workplace colleagues is an intense experience, right. And that really precipitates a lot of anxiety symptoms, or even depression/burnout symptoms, amongst people who are trying to get back to normal.

So if you as an HR director don’t recognize that the statistics are affecting your population, you will see sky high rates of unwanted turnover of staff, you will see difficulty in recruiting new talent, because a lot of people are looking for mental wellbeing to be taken seriously in the workplace, particularly younger people and Gen Z and millennials, we will also see what’s called presenteeism where people are showing up physically to the office, they’re there in body, but they’re not there in spirit or in mind.

And if you’re a retailer, that means the people who work in checkouts and stocking shelves and not representing your brands the way you want them to, if you’re working in an office or a call center, the productivity levels are not where you want them to be. And overall, this is a huge breaking effects on business performance.

Now, a lot of companies blend into this problem during COVID-19. Some 80% invested in some form of training or a digital asset to improve mental wellbeing in the workplace. But a lot of them found themselves a bit disappointed by the impact of that, because it’s important to have a clear strategy and to cover all the bases. And to go back to the other part of your question. The first thing you need to do in the workplace is stop harming people. So any sense of bias, any sense of bullying, expectations that people will work weekends and evenings, not take their vacation, these are toxic, and these will cause mental health problems. And you’ll see that in the numbers of turnover, burnout, and presenteeism.

But then there’s a whole set of tools that you can put in place around positive factors to go from bad to good with hygiene factors managed and then good to great, and then become a real mental wellbeing workplace, and then you really begin to unlock the human potential, the creativity, the spirit, the productivity of the people that are working on your team.

And that’s got to be good for HR. It’s the HR job, right?

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