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...
People Drive Digital #PDDigital at NHS Expo 2015

People Drive Digital #PDDigital at NHS Expo 2015

People driven digital emerged out of conversations towards the end of 2014 about wanting to put people firmly at the centre of digital innovation in health and care. These conversations took us to our #PDDigital event in May, followed by the publication of the People Driven Digital White Paper which we launched at King’s Fund Digital Health and Care Congress session in June, and then the inaugural People Driven Digital unAwards in July. We took a breather, did a bit of reflecting, and are now taking our learning to share with others at this year’s Health and Care Innovation Expo on 2 and 3 September 2015, where Mark Brown, Anne Cooper and myself will be running a session at the pop-up university. Our White Paper gives some clues and some challenges as to how a collaborative approach to digital innovation, as promoted in Personalised Care 2020 can be realised. We argue that the potential for people driving digital innovation from the ground up should be recognised, understood and supported at a strategic level. Health and care need to enable this to happen but it should be led by people not by institutions. We believe that it is only by people driving digital innovation that a step change can be achieved and outcomes in health and care transformed. So what next for people driving digital innovation in health and care? If you’d like to contribute to the conversation, please come along to our session, tweet using the hashtag #PDDigital or comment on this blog – the more we have people accessing and working in health and care services involved in...
Should social care staff friend people they support on Facebook?

Should social care staff friend people they support on Facebook?

Should social care staff ever friend people they support on Facebook? According to this great paper by Peter Bates, Sam Smith and Robert Nisbet, the default view of social care staff and organisations is a resounding no. This stance is echoed in the proliferation of social media guidelines for health care practitioners that you can find curated here. The authors make a case for a more nuanced response to this question as explored through the lens of support for learning disabled people. They argue that the multi-faceted nature of people’s lives resists the reductive notion of linear personal/professional boundaries implicit within social media guidelines. I have previously blogged about the positive affordances of boundary violation between the personal and professional on online social networking sites.  The authors point to the value of digital inclusion and potential of social media for accessing information and peer support. These ideas are beautifully captured in the context of mental health in a guest post by @positivitysmile. I concur with the authors’ stance that a thoughtful approach to social media is required for health as well as social care practitioners. Use and ethics of social media are not routinely incorporated within practitioner training and in my view this should be integrated throughout the curriculum rather than either ignored or sidelined as a stand-alone session or module. As our online and offline lives become ever more intertwined, health and social care staff will benefit from a sharpened understanding of online social networking both for themselves and people they support. Facebook is not a neutral space I would like to add a few additional thoughts to those...