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 Leeds develop a citizen blueprint that surfaces differences so that people making decisions about digital technologies can take them into account. We started this process at a Leeds Digital Festival event entitled ABCD meets Human Centred Design which I blogged about here and through which we identified a number of approaches and actions we could take to be citizen-focused:
- Intentionality – be aware of where power is located and actively seek to understand what matters to people, what their strengths are, and how to build on them
- Mutual inquiry – buddy up decision makers and digital innovators with community activists so they can learn from each other
- Reciprocity – share tools and techniques from both disciplines
- Asset mapping – map assets within communities (nb. organisations should think about how they can be an asset to local communities)
- Scout – find out what is happening elsewhere and learn.
In response to those challenges, we have started doing a few things:
- Partnering with the community-led organisation LS14 Trust to share tools and techniques and learn how we might help communities build their own innovation capacity
- Scouting for people who are further down the road from us in order to learn from them and have found Peter Julius who talks about his work with Kent Surrey Sussex AHSN here. We are also looking to the great work being done in Sheffield led by the Good Things Foundation amongst others, and which you can find more about here.
We have been working with a range of groups over the last six months to develop a library of personas that highlight different attitudes, aptitude and access to technology. This has involved spending time with community groups such as Moor Allerton Elderly Care and the Migrant Access Project to share stories and create a set of personas that exemplify the experiences of each group in relation to digital technologies.
Through our conversations with older people we found a strong fear of being left behind in an increasingly digital world, alongside many physical barriers to using smartphones. However, these fears and barriers were tempered with stories of older people relying on their smartphones to call for help when falling in the home or using maps when they have got lost.
Through our conversations with migrant communities we got to understand worries about the roll out of universal credit and concerns that a two hour slot on a library computer would not be enough to complete the associated online forms. There was great fear that people would be penalised if they didn’t keep up with email communication as a result of not having their own computer or smartphone.
Alongside this persona library we will produce a set of design standards that help the city design, develop and implement digital technologies that are citizen-centred.
We are edging our way forwards bit by bit, learning as we go, no doubt making mistakes along the way. If you have experience of blending asset based community development process with digital design or anything similar then we’d love to hear from you. We are keen to collaborate and learn and share as we go.