Frameworks, lyrics and non-adoption of technology

Frameworks, lyrics and non-adoption of technology

You know that feeling when a piece of music (or a book or film) resonates so strongly that it helps you understand something about your life? In my late teens it was The Smiths who did just that. I suspect that teenage hormones may have been a factor, but every lyric from Morrissey’s pen seemed to speak to me directly. Fast forward to 2018, and minus the heady mix of adolescent intensity and the tunes, I had a not altogether dissimilar sensation reading Beyond Adoption: A New Framework for Theorizing and Evaluating Nonadoption, Abandonment, and Challenges to the Scale-Up, Spread, and Sustainability of Health and Care Technologies by Trisha Greenhalgh et al (2017). This paper felt like reliving the first four years of my journey into the digital health technology sphere – every challenge, mistake, obstacle we have encountered is captured in this compelling paper on why technology doesn’t get adopted in the NHS. It felt a bit like the life story of mHabitat but minus the highs… NASSS is an evidence based and theory informed framework that endeavours to set out the interrelated factors that influence the non-adoption abandonment, scale-up, spread or sustainability of technology. It aims to be a tool that can easily be used in practice. The rich blend of research methods comprising case studies with qualitative interviews and ethnography, along with a review of the literature, elicited the seven framework themes (see the diagram above). Our tacit experience of non-adoption could have easily have been one of these case studies – everything from poor clarity of the problem the technology is meant to solve; poor...
Digital resilience: how health and care practitioners can help teens with mental health difficulties

Digital resilience: how health and care practitioners can help teens with mental health difficulties

I’ve recently written a blog post and report for NHS Digital’s Widening Digital Participation Programme based on a review of the evidence along with interviews and focus groups with young people. The report focuses on digital resilience of teens with mental health difficulties. You can find the blog post here and the full report...
Towards a manifesto for digital health #socialjustice

Towards a manifesto for digital health #socialjustice

What would a manifesto for digital technologies grounded in social justice look like? In other words, the development of digital technologies in health and care that enable an equitable distribution of wealth, opportunities, and privileges within society and which balance the interests of individuals, communities and institutions. After all the NHS is a collective endeavour – each of us contributing so that we all have access to health and care free at the point of demand. A few weeks ago I co-facilitated the first of mHabitat’s three Digital Humanities in Health and Care seminars along with Dr Helen Thornham from the School of Media and Communications at the University of Leeds. Along with a group of practitioners, technologists and academics, we considered the role of ethics and justice in respect of the inexorable rise of digital technologies in health and care. Mark Brown, one of our speakers, talked about the contested notion of social good in sphere of digital health: “Delivering public services is a political act. The shape of public services and how they feel are defined by political and historical realities. The decision of who pays tax, what taxes they pay, upon whom those taxes are spent and who it is that does the work is political. The ‘social good’ is not an uncontested idea. The culture of Silicon Valley is increasing looking, in the American phraseology, like a dumpster fire. Libertarian ideas run riot, with the very ideas that our public services in the UK are founded upon are seen as a deadly infringement of the rights of the individual to choice. Low tax, low regulation...
15 top tips for co-design in digital health

15 top tips for co-design in digital health

The mHabitat team are currently running a Digital Development Lab on behalf of NHS England for a small group of innovators who have developed promising digital innovations for young people’s mental health. We are helping them travel the journey from development through to adoption within the NHS. We recently brought our lovely band of innovators together for a couple of days of shared learning on a number of hot topics. I’m going to be writing a short post on each topic and first up is the fundamental importance of co-design in digital health. Helping us think about this topic was Andy Mayer of Yoomee fame, Matt Edgar of many things including Global Service Jam, and our regular collaborator Mark Brown from Social Spider. Whilst they shared their wisdom I furiously scribbled down a collection of top tips. Follow these simple rules and you won’t go far wrong: Should we even do it? – rather than start with ‘can it be built?’ begin the conversation with ‘should it be built?’ The answer to the first is usually ‘yes’ and the answer to the latter is often ‘no’ What don’t we know? – be honest with yourselves about what you do and don’t know – test your hypotheses and ask questions as you go Find your fans – start with your prospective users from the get-go and create a fan base – a community of people who are really up for collaborating with you It’s all about context – understand what tasks your prospective users are trying to accomplish in their context (not just who they are) so your innovation is...

What has frugal innovation got to offer the NHS, social care and wider public sector? This is a question we will be debating at our People Drive Digital #PDDigital16 festival on the evening of 28 November at the Open Data Institute in Leeds. One of our debaters is Jaideep Prabhu who is professor of Indian Business and Enterprise at the Cambridge Judge Business School within the University of Cambridge. Jaideep has written extensively on the topic of frugal innovation both in emerging markets and in the Western world. You can watch him share his thoughts about what the West can learn from frugal innovation here: So what is frugal innovation and how is it relevant to people driving digital innovation in health and care? Nesta define frugal innovation as follows: Frugal innovation responds to limitations in resources, whether financial, material or institutional, and using a range of methods, turns these constraints into an advantage. You can read a Nesta report on frugal innovation here. The report highlights many examples of frugal innovation and I particularly liked the story of the Kerala neighbourhood network in palliative care. In contrast to a doctor led hierarchical model of care, volunteers from the local community are trained to identify problems of people who chronically ill in their area and to intervene. 70 percent of the Kerala population have access to palliative care in contrast to only 1 percent at a national level. The neighbourhood network consists of more than 4,000 volunteers, with 36 doctors and 60 nurses providing expert support and advice to enable care for 5000 patients at any one time. Frugal...

People centred participation – thinking forward to #kfdigital16

What are the conversations we need to be having about digital in health and care? Who needs to be part of those conversations? And what do we hope to achieve by having them?  These are questions I was left with after two days at the King’s Fund 2015 Digital Health and Care Congress which took the form of plenary sessions and breakout workshops alongside a public meeting of the National Information Board (NIB). Never mind the apps, what about the fundamentals? Many digital health events seems to orientate around a mix of policy issues and showcasing of apps and digital services. Whilst these are interesting and useful I believe there are more fundamental conversations we need to have about the role of digital in health. There are knotty problems and challenges that everyone is grappling with but which are not easily surfaced without a dedicated focus and a more deliberative participatory approach. These sorts of conversations did surface on Twitter during the Congress but the event itself did not facilitate their discussion in depth. Here are a few examples of fascinating conundrums we all should be thinking about in the sphere of digital innovation: Wondering how much #kfdigital15 debated will be about potential of digital to challenge, rather than accept, existing NHS power structures @jamesfm55 My concern is that focus on ‘apps’ will distract from what could really be done to improve population health #kfdigital15 @amcunningham I’m troubled a little by the idea of ‘taking responsibility for your own health’ filtering into #kfdigital15. Hope someone unpacks that idea @markoneinfour I’d like to attend #kfdigital16 where these sorts of thematic...