From online social networks to codesign in digital health

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?

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 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.  ...
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 all NHS premises provide free access to wi-fi

Should all NHS premises provide free access to wi-fi

Below is my argument for free access to wi-fi in NHS settings that I made in a recent ‘head to head’ article in the British Medical Journal. You can find the full article, including the ‘no’ argument made by GP Grant Ingrams here. Aspirations for digital technology to transform health and care systems are high. The UK government’s reportPersonalised Health and Care 2020 sets out a framework for digital technology to improve patients’ experience and outcomes with more efficient services.1 Citizens will have full access to their care records, an expanding set of NHS accredited health and care apps, and digital information services. We will transact with health services by accessing diagnostic results, ordering prescriptions, and contributing patient generated information to our care record. This bold ambition can be realised only with digitally engaged citizens and the removal of barriers such as lack of access to public wi-fi in healthcare settings. The health divide will widen unless action is taken to ensure that people who are digitally less confident have access to their health information and can make sense of it.2 Digital ubiquity Digital technologies are increasingly widespread in day to day life, but healthcare seems to lag behind other sectors and the expectations of citizens.1 The telecommunications regulator Ofcom says that 93% of UK adults have a mobile phone and 61% have a smartphone.3 The 2013 Oxford Survey of Internet Cultures, which included around 2600 UK adults, indicated a trend for people to use their mobile handset to access the internet and a growth in “next generation users,” who use multiple devices on the move.4 We have seen substantial increases...