Continuing on my Disney theme, the recent news that Scarlett Johansson is suing Disney over the streaming of the ‘Black Widow’ movie caught my attention and reminded me of an important issue related to digital health in the NHS – how technology is paid for.
So, what happened? Disney streamed the new movie at the same time as it was released in the cinemas. After setting a box office record, grossing £157m in its first weekend, box office sales dropped sharply (and with it, Scarlett’s earnings).
According to the Verge, the contract was structured along conventional means of aligning actor’s pay checks to box office results. It further highlights that the contract was negotiated in 2017, before plans for Disney Plus had been announced and of course before the Covid pandemic imposed restrictions on movement and changed people’s entertainment viewing habits.

Non-withstanding any legal technicalities that apply to this particular instance (and I am not picking sides), customer (and patient) expectations are changing (and some things are just getting more into focus) post Covid, and service providers must evolve accordingly.
An important part of this is to identify the most effective and fair ways to compensate and incentivise innovators and technology providers.
Three things for the NHS to consider:
- Funding frameworks (and approach) – get rid of organisational and even departmental barriers to funding solutions that benefit ‘others’ (the solution will reduce burden on community providers so why should the acute hospital pay?). A variation of this issue is around taking a short term view and always seeking ROI within the same financial year). Integrated Care Systems (ICS) and population based approaches to funding are an opportunity to address these issue
- Applying pragmatism where needed – considering ‘Workflow costs’ and resource implementations. Yes, we should offer online consultations and triage, but does that actually increase resource requirements in certain circumstances? If so, how should that be funded and how should providers of these online services be supported to deploy and develop the workforce required?
- Is it finally time to think about outcome based incentives for digital health solutions? No point paying £ per use / license if it doesn’t help achieve the health and wellbeing outcome. From an innovator perspective, this may need to be balanced with upfront ‘incentives’ that puts the risk-benefit balance into a favourable part of the spectrum to encourage healthy competition
Very happy to hear your comments below or feel free to email me to share ideas – janak@usehealthdata.com