100% digital – shining a light on digital health and care in Leeds #LDF19

100% digital – shining a light on digital health and care in Leeds #LDF19

Each spring, the Leeds Digital Festival corrals the digital community to put on its Sunday best and parade our northern finery to the world. With a thriving digital health and care sector in the city, we are super proud at mHabitat to curate this theme of the festival on behalf of the NHS and local authority, in partnership with a whole range of local and national bodies. You can find our programme of events here. Digital and the inverse care law With technology woven throughout the NHS Long Term Plan there has never been more of a focus on the role of digital in enabling transformation of health and care services. However, in stark contrast, barely a day goes by where we don’t encounter the most basic barriers to uptake of  technology, not only in services but in people’s everyday lives. Whether it be community nurses whose laptops either take forever to boot up, or young people in excluded communities confused about how to navigate the web, we need to think critically about both infrastructure and human factors. If we fail to do this then we run the risk of exacerbating the inverse care law and worsening health inequalities. One way to understand how we balance the promise of digital technology with the realities of health and care services, and the lived experience of patients and citizens, is to bring people together from a wide range of disciplines to deliberate. Our events endeavour to blend a variety of perspectives and expertise – academics with clinicians; citizens with philosophers, ethicists with industry – and so on. Our 100% Digital Leeds...
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...
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...
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...
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...