Twitter is fantastic as a place to have great conversations that wouldn’t be possible without this digital space – I love it – but again today I had another fantastic Tweetup, that is a face-to-face meeting with someone I first met on Twitter. It seems to me that as my twitter relationships evolve I instinctively want to make the effort to meet the person face-to-face. For me, it seems that for the required depth of some of the relationships, digital just isn’t enough. So what happened today was a little bit of face-to-face magic with @smclrk where I learnt so much and started to form a relationship that I hope will endure, that Twitter conversations alone would never have achieved.

This led me to think about some of the debates about using technology to deliver care – is digital enough? Many readers of this blog are likely to have read my earlier blog ‘To Whom it May Concern’ – it’s one of my most popular postings – and are likely to note that I seem to be advocating less face-to-face and more digital. Similarly Roy Lilley’s (@roylilley) blog for the KingsFund ‘It’s crept up on us’ is saying similar things; we need to recognise that in the world we know today surely technology has a greater role and place. I whole heartedly agree but I find the debates that this generates distracting and extremely frustrating.

The trouble is it sometimes feels like we are looking for a silver bullet, or a single direct approach or solution to the complex challenges we face in delivering care in a changing economic and societal landscape – in truth there is no one solution. So why then do commentators persist in saying you can never replace face-to-face with technical solutions, implying that advocates of technology are saying this is the single way? I have never heard any advocate of new ways of using technology or innovation say that this is the case! What they do say is that for some processes (ordering repeat prescriptions for example) or transactions (a query about diabetes control from an experienced patient via email) technology can play a part.

When I went to work at NHS Direct in 1999 I remember being told by other nurses that you can’t care for patients over the telephone. I think this debate is past us now with lots of care being delivered using the telephone; but this is also not without its controversy, if I ever tweet or talk about my personal desire for telephone consultations someone will comment or question to say that I ‘don’t understand’ and that we should always use face-to-face and my heart sinks. I have never said or suggested that we could completely replace face-to-face care. As a person with a long term condition I can say for me that technology can have a role that will improve the quality of my life and (maybe) reduce the cost burden of my multiple hospital visits but equally I need to see my Diabetes Specialist Nurse sometimes for a different sort of conversation that cant be achieved on the phone or via email.

So, is digital enough? I say that it isn’t, and never will be, but it must have a role. Like my experience on Twitter some remote digital relationships are enough but for some, face-to-face is the way to go. My suspicion is that digital will have an increasing role in healthcare but it will never replace the dialogue that we have as human beings who occupy the same room. My plea is can we be balanced in our approach to adoption of new approaches to delivering services using new technologies that may improve the quality of life for some people?