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...
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...
What does new power mean for the NHS?
What do shifting societal trends towards a sharing economy mean for the NHS? Understanding New Power (Heimans & Timms, December 2014) sets out a framework to conceptualise shifts in power which are enabled by digital technologies in contemporary society: Old power works like a currency. It is held by few. Once gained, it is jealously guarded, and the powerful have a substantial store of it to spend. It is closed, inaccessible, and leader-driven. It downloads, and it captures. New power operates differently, like a current. It is made by many. It is open, participatory, and peer-driven. It uploads, and it distributes. Like water or electricity, it’s most forceful when it surges. The goal with new power is not to hoard it but to channel it. The authors conceptualise a participation scale from consumption to co-owning, from old power models exemplified by Britannica to new power models such as Wikipedia. You can find out more about their framework in a fascinating Ted Talk given by Heiman here: Despite this being a contemporary framework, informed and enabled by digital technologies, it resonates with Shirley Arnstein’s Ladder of Participation which was published all the way back in 1969 and remains common currency in the field of NHS patient participation. Arnstein conceptualised an eight rung ladder of participation in decision making from manipulation and tokenism at the bottom to citizen control at the top. Heiman and Timm’s framework is like Arstein’s ladder, with the rocket fuel of technology as an enabler of new power possibilities for those of us who have access to the digital tools and literacy to take advantage of them. ...
Dignity in a digital world
It’s easy to love or hate technology, to blame it for social ills or to imagine that it will fix what people cannot. But technology is made by people. In a society. And it has a tendency to mirror and magnify the issues that affect everyday life. The good, bad, and ugly. Danah Boyd Digital innovation is routinely heralded as the panacea for modern health and social care – creating more efficient and effective services, enabling patients to take more control of their health, and citizens to manage their transactions with government online. Personalised Health and Care 2020 (November 2015) sets out a framework for digital technologies with a bold ambition: One of the greatest opportunities of the 21st century is the potential to safely harness the power of the technology revolution, which has transformed our society, to meet the challenges of improving health and providing better, safer, sustainable care for all. To date the health and care system has only begun to exploit the potential of using data and technology at a national or local level. Our ambition is for a health and care system that enables people to make healthier choices, to be more resilient, to deal more effectively with illness and disability when it arises, and to have happier, longer lives in old age; a health and care system where technology can help tackle inequalities and improve access to services for the vulnerable. But in our rush to embrace digital technologies, are we paying proper attention to the implications for all of us as patients and citizens? What does digitally transformed health and care mean for...
How can directors of informatics support people driven digital? #NYHDFpeople
How can NHS directors of informatics support and enable people driven digital innovation? This is a question Sue Sibbald and I will be speaking to when we present to the Northern, Yorkshire and Humberside Directors of Informatics Forum this Friday. In our work at mHabitat we have found the top five practical barriers to digital innovation that fall within the domain of informatics directors are: Staff equipped with mobile devices Sufficient bandwidth to access the web Public wifi in all health and care settings A permissive approach to social media (not blocking channels such as YouTube) Access to online patient held records and interoperability with third party apps. The other big barrier we have found is the variable confidence of health and care staff to make use of digital tools and the Internet in their day to day front line work and professional development – the above list will provide the right backdrop but culture and confidence is mostly an organisational development issue. Here is our draft presentation which features feedback from #PdDigital15: Sue and I are keen to crowdsource your priorities for directors of informatics in enabling people driven digital. Whether you’re someone who accesses health and care services, a practitioner, or simply someone with an interest in the topic, we’d love to hear your views. Please comment on this blog or tweet us using the hashtag #NYHDIFpeople. We’ll adapt our presentation to incorporate your feedback...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
