Carebnb and the law of unintended consequences

Carebnb and the law of unintended consequences

Along with the title: “NHS may rent spare rooms to ease bed crisis” The Guardian ran a story this week, on what it describes as an Airbnb style scheme designed to help alleviate pressure in the NHS, by enabling patients ready to be discharged from hospital to recuperate in a private home. The story, which was first featured in the Health Service Journal, was also covered by Roy Lilley in his regular blog where he raises a host of concerns about CareRooms including safeguarding, exploitation, safety, training and regulation. However, beyond the obvious concerns, he asks the more fundamental and interesting question: “The real issue is not if CareRooms can be made to work safely.  The real issue is why are we even contemplating this? … Austerity is the mother of innovation and here is an innovative solution driven by the mother of all austerity.” On its website, CareRooms offers hosts £50 per room per night, and the promise of up to £1000 a month, for providing a bedroom and three supplied microwave meals for a discharged patient. The website incorporates pictures of hotel style immaculate bedrooms along with a reassuring narrative: “We are working with the local health and care community to provide a safe, comfortable place for people to recuperate from hospital.” Co-founded by a doctor, CareRooms was conceived out of real struggles with shortages in social care, and makes a compelling case to solve what is a well-reported strain on the NHS. It has the support of the NHS clinical entrepreneur programme and I have no doubt it is positively intended. So if the concerns raised...
How can digital innovators give their ideas the best chance of adoption in the NHS?

How can digital innovators give their ideas the best chance of adoption in the NHS?

So you’ve got a fantastic idea for a digital technology or maybe you’ve developed something which you think could add value to the NHS. How do you give your idea the very best chance of adoption in a health service which is still only just beginning to understand the potential value of digital technology as an enabler to better health and care? I recently ran a workshop on this theme at the Yorkshire and Humber Academic Health Science Network Digital Health and Wellbeing Ecosystem meet-up.  With a room full of people who have thought about this tricky question from many different angles I think we made some way towards finding a few answers. So here are 15 tips for starters: 1.Build adoption in from the get-go It may sound obvious but our adoption map made it clear that adoption must be built into the very beginning of your idea development. Considering at the end may only lead to having to go back to the beginning again. 2. Develop your core idea (or understanding of the problem you are trying to solve) before you think about technology Sounds obvious too? But it’s worth noting the technology isn’t always the answer and if it is the answer then you can only know that once you’ve defined the problem well. 3. Identify your *user* *chooser* and *buyer* The person who uses your technology (perhaps a patient) may not be the person who chooses the technology (a health practitioner) who may not be the person who can buy your technology (provider or commissioner). Take them all into account early on and identify benefit...
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...
Is digital technology a technical or adaptive problem in health?

Is digital technology a technical or adaptive problem in health?

Around three years ago I was invited to speak at a consultant psychiatrists committee meeting about social media and digital technology. I was mid way through my PhD and steeped in online ethnographic research about how people accessing mental health services and practitioners were making use of social networks. I had an inkling that I would have a mixed audience and I knew that not everyone would share my (then*) enthusiasm. As such I spent time preparing a range of compelling examples of digital technologies and social media practices, determined as I was to win over any detractors. I arrived a little early and so listened in to the tail end of an exasperated discussion about the various grinding limitations, obstacles and shortcomings of the in-house electronic patient record (EPR). If my audience’s primary experience of technology in health was such a bad one, then this did not bode well for my presentation – I quickly realised I was going to have to recalibrate. How could I be so naive as to think a conversation about the future potential of digital technologies would be welcomed, when the basics of reliable and effective electronic patient records seemed like a pipe dream? This experience came back to me whilst reading The Digital Doctor – Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age (Wachter, 2015) which is dominated by an expansive analysis of the shortcomings of contemporary electronic patient records. Wachter argues that EPRs have brought many a physician ‘to their knees’ with their clunky, confusing and complex systems (73). It is salutary to note that three years on...