Creating a digital citizen blueprint

Creating a digital citizen blueprint

One of the many challenges of using digital technology in health and care services is a lack of interoperability – we’re all using a slightly different lego set and the pieces don’t quite connect together. Every time we want to do a particular task we have to swap over to another lego set and start again. This is a well rehearsed and entrenched challenge in the NHS and my home city of Leeds and the wider region has a new initiative to help connect those lego pieces together through common standards and open source technologies. But what about citizens? In a way we have the opposite challenge. We are not standardised lego pieces and never will be. Each of us has differences in our use of digital technologies – these may be influenced by our attitudes, our aptitude, our access and particular barriers that we may experience. There are some commonalities but there are also particular factors that can be easily overlooked. If we don’t understand and pay attention to those differences then we risk designing and deploying digital technologies that entrench the inverse care law – that is, those who already have the most get more and those who have the least lose out further (you can read an excellent BMJ article from Margaret McCartney on this topic here). In Leeds we have a commitment in the Health and Wellbeing Strategy that people who are the poorest improve their health the fastest. This is easy to say but hard to do. This is where the blueprint comes in. At mHabitat we are helping the NHS and council in...
ABCD meets human-centred design – where’s the common ground?

ABCD meets human-centred design – where’s the common ground?

  Asset based community development (ABCD) – a methodology for the sustainable development of communities based on their strengths and potentials. It involves assessing the resources, skills, and experience available in a community; organizing the community around issues that move its members into action; and then determining and taking appropriate action. This method uses the community’s own assets and resources as the basis for development; it empowers the people of the community by encouraging them to utilise what they already possess.   Human-centred design – an approach to interactive systems development that aims to make systems usable and useful by focusing on the users, their needs and requirements, and by applying human factors/ergonomics, usability knowledge, and techniques. This approach enhances effectiveness and efficiency, improves human well-being, user satisfaction, accessibility and sustainability; and counteracts possible adverse effects of use on human health, safety and performance. ISO 9241-210:2010   The health and wellbeing theme of the 2018 Digital Festival was an opportunity to shine a light on the thriving digital health and care sector in Leeds. But whilst the digital sector is a key asset in our city, Leeds is also known for its thriving community sector and neighbourhood networks. The city’s Health and wellbeing strategy aims to build on both individual and community strengths in order to reduce health inequalities in Leeds. There is an opportunity (and a challenge) to align our digital ambitions with our asset based community aspirations to make Leeds a healthy and caring city for everyone. However…. if we don’t consciously and intentionally take steps to locate digital as an enabler to enhance the assets of...
What really counts – keeping humanity at the heart of digital innovation

What really counts – keeping humanity at the heart of digital innovation

Digital innovation is going to save the NHS. We use digital in every other aspect of our lives so why not the NHS? So the hyperbole and the mantra goes. But what if, in our fetishisation of digital, we get too focused on shiny products and forget what really counts? This moving blog post by health economist Dr Chris Gibbons about his family’s interactions with health services, when his dad was very ill, made me pause and reflect on how we keep values of humanity at the heart of efforts to innovate and improve health services. Here is a section of the blog post which emphasises that it was person-centred  and goal-orientated care that made the biggest difference to Chris’ dad: “Innovation has many guises. Innovative ways of thinking about the hospital system. From the point of admission to the successful discharge and rehabilitation of people in a place of their preference then linking up that system seamlessly with health and social care system. We need to emphasise the importance that people doing Neil’s [care worker] job have in linking that all together as a person centred, goal oriented approach to recovery and rehabilitation. That’s where the real value in innovation sits. It doesn’t fit neatly into a Markov model, or have fancy branding and the backing of a pharma company that’ll send you to Honolulu for a conference. But it is the kind of innovation that we should be judging against all the other “innovations” that do” How do we assess what really counts and what is going to make the biggest difference to patients when we have...
20 tips for a successful digital project in health and social care #PDDigital16

20 tips for a successful digital project in health and social care #PDDigital16

What is the absolute best way for a domain expert (health or care practitioner) to collaborate with a digital team (software designers and developers) to realise your goals and create a digital tool that has a chance of seeing the light of day? This is a question we set ourselves at #PDDigital16 after hearing a salutary tale of a practitioner’s nightmare experience whereby a brilliant idea descended into a heap of trouble and a resulted in a failed project. Everything that could go wrong did go wrong and it was a tricky experience for everyone involved. But it doesn’t have to be like that! A group of health and care practitioners and digital experts put our heads together to work out how to collaborate well to get the best results. The 20 tips we came up with are as important for software developers as they are for domain experts. They might make the difference between a wildly successful project and one that maybe isn’t so great. So here goes… 1. Involve end users from the outset (always and always and always) remembering that end users are not just patients (citizens) but often other health and care practitioners and administrators 2. Invest in lots of discovery (early stage research) so you can really understand the problem you are trying to address, the outcomes you want to achieve, and the experience you want to create 3. Check if your idea already exists (review the market) and avoid reinventing the wheel 4. Commission a process rather than a product – this means a collaborative relationship rather than an exhaustive specification – that...
The gap between hyperbole and reality in digital health

The gap between hyperbole and reality in digital health

Looking back at what the mHabitat team have been up to in 2016, I am convinced more than ever that the gap between the hyperbole of digital health and reality in practice remains a yawning chasm. There have been moments in the year when I’ve been quite taken aback by the distance we have yet to travel in utilising even the most basic and ubiquitous of technologies to improve healthcare. Here are three  stories that have stuck in my mind from our co-design work during 2016 to give a sense of what I mean. They aren’t heroic stories of great leadership and transformative change, but rather everyday stories of things not working quite right, and that’s sort of the point. Doing the simple things well (or not) It was during a co-design workshop with a health service that young people described how they value the text messaging reminder service. A good example whereby a ubiquitous technology is used to keep in touch and a solid foundation to build on. However participants were dismayed when a member of staff brought down the box with the office non-smartphone that is brought out daily to send each message individually with each number punched in for every single message that is sent. The staff explained how, to save time, they type the message in one of their (personal) smartphones and then text it to the device and then forward it onto their recipients. They went on to demonstrate how the phone will only hold 50 messages so they have to wipe them each time they want to send out a new set of...

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...