China cups and therapy dogs with a dash of teal
What do china cups, therapy dogs and self-managing teams have in common? Well, quite a bit it turns out… It all began at an Improvement Academy Fellows event some months back where consultant physician Dr Rod Kersh and I had a serendipitous conversation about self-managing teams in healthcare based on a model known as Teal. In his presentation humanity above bureaucracy you can watch Jos de Blok describe how in 2007 he set up a new model of nursing in the Netherlands led by practitioners and co-produced with patients: Back in Doncaster, Rod and his team run a ward for older people with acute medical needs and dementia type illnesses. Their practice is informed by the principles of Teal and grounded in compassion and empathy. On his ward it’s the small thing that count – such as the this is me information sheets that are part of the medical record, and the photos of staff on the wall accompanied by a this is what people like about me mini-biography. But sometimes it’s the apparently small stuff that can be the toughest to resolve. Rod has been engaged in a valiant battle to replace standard hospital issue plastic cups with china tea cups on his ward. You can read his blog about it here in which he describes the importance of the everyday in engendering humanity: “Person-centred care, where we remember that the patient is a person and, that person is the reason for the existence of the hospital, and our work, where we need to sometimes check ourselves when we slip into modes of process and performance; here the cups...
The next Uber for healthcare
‘This app is basically the next Uber for healthcare’ A web search for the phrase uber for healthcare yields around 11,100,000 hits along with a plethora of suggested related searches. Uber has become shorthand for customer convenience and the disruption of established markets. It seems many people are looking for the lucrative uber for healthcare model and it’s a phrase with currency at many digital health events and in numerous articles. This recent Kevin.MD blog post argues that an uber for healthcare will be ‘super convenient, quick and easy, and inexpensive’. A recent commissioned article in the weighty British Medical Journal, entitled Uber for Healthcare asks: Is it time to reinvent the home visit? … app happy entrepreneurs backed by venture capitalists believe that they can turn back the clock (Hawkes, N. 12 February, 2016). The idea of a quick and convenient healthcare system that we can access with a swipe of our app while we go about our busy lives is seductive. But should we be questioning more deeply whether we want app happy entrepreneurs backed by venture capitalists disrupting the NHS with uber-style models of healthcare? Relationships or transactions An uberised model of healthcare prioritises transactions over relationships – it elevates convenience, efficiency and accessibility. But arguably healthcare is much more complex than an A to B taxi journey for all but the most simple of ailments. What happens to an uberised model when referrals along a multi-provider care pathway are required or ongoing support to help someone manage multiple long term health conditions? An uber style healthcare model may benefit the generally fit and...
From online social networks to codesign in digital health
I set this blog up just over four years ago in January 2012 both to record my online ethnographic PhD research and with the hope of having conversations that would help inform my thinking and enable me to share my learning along the way. After four years of working full time, compressing five days into four and doing research on the extra day I’d squeezed out of the week, I finally had my viva on Friday. I passed the assessors’ grilling with four minor corrections and am basking in a profound sense of relief and delight in equal measure. My research was about online social networks and mental health with a heavy focus on the now departed The World of Mentalists blog and ecosystem around it. I have many people to be grateful to for in helping me think about this topic over the last four years. In particular I’d like to thank all my interviewees for sharing their time and expertise (you know who you are) and to everyone who welcomed me into the madosphere. I’d also like to thank Phil, Mark, Sue, James and Kat for many a Skype, phone call, meet up and often conference podium where we shared our thinking about mental health and online social networks with various audiences. During those four years my interests have developed beyond online social networks to digital technologies in health, with a particular focus on co-design and ethics. I’ve clocked up 133 posts on this blog and recently changed its title to reflect those broader interests. A few years ago I set up mHabitat which comprises an ever...
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...
Young people, social media and the ethics gap
“Adults ruined Facebook. Don’t do the same with Instagram. And don’t you DARE go anywhere near Snapchat!” This was the anguished cry of my teenager during a treasured moment of increasingly elusive mother/daughter conversation. Her plea reflects a wider shift in online teenager behaviour away from more public social networks towards more private ones such as Snapchat. As Facebook becomes more domesticated amongst adults, it appears that teenagers are heading to their own more private and separate spaces. The very idea that I might set up a Snapchat account was enough to fill my teenager with abject horror. So back to our conversation. I was secretly keen to check out ideas considered in Disconnected – Youth, New Media and the Ethics Gap (Carrie James, 2014) which I have just finished reading. The author considers how young people address ethical issues and moral dilemmas relating to privacy, property and participation online. Based on numerous interviews with young people aged 10 to 25 she found positive examples of highly ethical behaviour that evinced a ‘play nice’ mindset and which respected the privacy of others. However, she also found thoughtless, dismissive and occasionally callous behaviours towards others. Not surprisingly for young people who are still developing their sense of identity, attitudes were often highly individualistic and tended to focus predominantly on consequences of antisocial behaviour for the self rather than for others: Self-centred stances are not surprising given that egocentrism often characterises the adolescent and emerging adult phases of development. However, the dominance of egocentric thinking is problematic online, given the deeply social nature of the Internet and the qualities and opportunities...about.me
Victoria Betton
victoria betton
director mHabitat | NHS | social media & mental health doctorate | interested in digital inclusion | parma violets fiend | http://codesigndigitalhealth.co.uk
