by Saira Arif
Over the years, I’ve worked across multiple digital health projects from grassroots NHS initiatives to national transformation programmes. If there’s one thing I’ve learnt, it’s this: just because something is digital doesn’t mean it’s inclusive and just because a project hits its rollout targets doesn’t mean it’s truly successful.
It’s easy to get caught up in the excitement of new platforms, apps, portals and dashboards. But when we zoom out and really think about who is left out, who’s confused, who doesn’t feel safe to engage, we begin to see the cracks.
Digital doesn’t equal inclusive
There’s a growing assumption in healthcare that “going digital” automatically solves issues of access, equity and efficiency. On paper, the logic makes sense. Digital tools should, in theory, allow more people to engage with services flexibly, conveniently and at their own pace. But in practice, I’ve seen something very different.
I’ve sat in user research sessions where older adults squinted at screens, unsure where to click. I’ve worked with neurodivergent individuals who found some of the so-called “user-friendly” tools deeply overwhelming. I’ve spoken to frontline staff who felt disheartened when the tech designed to “make their lives easier” actually left them feeling unheard and undertrained. This is not a one off problem, it’s a systemic blind spot.
What’s interesting is that this is a topic many people in the digital health space do talk about. We acknowledge the gaps. We mention inclusion in our frameworks. We host events on it. And yet, it’s still an issue.
Because what I still don’t see enough of is people talking about the human side of the tech they’ve delivered. I see countless presentations about how a platform has passed regulations, hit compliance targets or gone live across multiple sites. This is all valuable, of course, but where are the stories about how that tool changed someone’s care journey? Or how it made life easier (or harder) for a clinician or carer? Too often, the user, the actual human being the tech was built for, fades into the background.
Inclusion can’t be an afterthought
Whether we’re rolling out tools for the public or across the workforce, we must stop assuming people will automatically know how to use them. Digital confidence is not the same as digital literacy, and digital literacy doesn’t automatically mean digital comfort or trust.
- Have they been trained on it?
- Do they know why it’s relevant to their role or their life?
- Was it explained in language they understand?
- Were they part of the journey (co-created) or just recipients of the result?
If we want true adoption and lasting impact, education has to be baked into every stage. Not just how to use the tech but why it matters. As consultants, we have a responsibility to challenge this. From the moment a brief lands on our desk, we should be asking:
- Who is being left out here?
- Are we designing for the digitally excluded or just the digitally confident?
- Are we testing with real users or just assuming ease of use?
- Are we considering the emotional, educational and psychological context in which this tech will be received?
It’s not about being critical. It’s about being curious and caring enough to make the solution work for everyone.
From transformation to trust
Here’s the second thing I want to talk about, something that often gets overlooked in digital health: trust. We measure success in user numbers, portal logins, device distribution and pilot timelines. But how often do we ask, “Do people actually trust this enough to use it again?” In my experience, trust is the real success metric.
Without trust, the best tool will gather dust.
Without trust, data won’t be entered honestly.
Without trust, digital becomes just another barrier rather than a bridge.
And trust doesn’t magically appear with a launch date. It’s earned through communication, transparency, co-design and consistency.
The role of the consultant
We’re often brought in as digital consultants to lead innovation and/or manage delivery, but our role is bigger than ticking off tasks on a gantt chart. We are the people who get to ask the questions others are too busy to ask. We hold the space to bring in voices that aren’t usually in the room. We connect the dots between product and people, between ambition and reality.
We must keep asking:
- Does this build or break trust with users?
- Is this tool truly accessible — or just technically delivered?
- Are we designing with lived experience at the centre — or as an afterthought?
- Have we supported the workforce or end user in a meaningful way?
- What role is AI playing in this tool — and is it transparent and explainable to users?
- Is AI here enhancing decision-making, or creating new risks and confusion?
- Have we addressed potential bias in the data or algorithm?
- Would users know when they’re interacting with AI — and do they feel comfortable with that?
We can’t assume that just because something uses AI, it’s automatically intelligent, helpful or trusted. We have to bring critical thinking and compassion into these conversations, especially as AI becomes more embedded in diagnostics, triage and patient pathways.
Digital transformation isn’t just about systems. It’s about stories. Human stories. The anxious patient trying to book an appointment online. The nurse toggling between four logins. The carer who doesn’t know where to find trusted health advice. That’s where real change happens and where our impact, as consultants, can be felt.
If you work in digital health, whether as a designer, policymaker, delivery lead or clinician, I urge you to make space for the human side of technology. Let’s stop assuming that “digital = inclusive.” Let’s stop celebrating success purely in terms of uptake and let’s start focusing on trust, access and belonging…from day one.
When we embed inclusion from the start and build trust as our foundation, we don’t just launch tools. We change lives.
