Shifting from IT to situated technology in healthcare

Tomorrow, there will be roughly 1000 preventable healthcare deaths in the US and Europe combined. And it’ll happen in modern hospitals staffed by some of the best and equipped with the latest…

…We have to stop thinking IT as in “information technology”, it’s not enough just to handle the information – like the [Electronic Health Record]. It’s the combined and seamless flow of patients, information and work that offers the only solution – and for that we need “flow technology”, in short healthcare needs FT. Information is merely a natural ingredient in the flows and not vice versa.

This is a real problem, but simply moving from transactional IT systems to what Sig calls “Flow Technology” is only part of the solution in healthcare. How information systems are situated into healthcare is critical – after all healthcare is about dealing with people, not sitting in front of computers.

We’ve seen examples in community services, such as the LIFE Programme in the UK where social workers were spending most of their time on paperwork. Research into emergency department design has also highlighted the importance of communication to dealing with violent and disruptive patients.

I’m with Sig that the right flow-based information systems can help, but never in isolation to the whole service design.


Lessons from designing mobile digital public services

Designing a mobile application that lets mental health service users register their mood and activity daily proved a long and challenging road. Adil Abrar shares five important lessons

Five lessons from the experience of designing the “Buddy” app are:

  1. Find the right part of the health system to work with; 
  2. Focus on creating a minimum viable product; 
  3. Embrace ‘agile’ development fully to get the most out of bringing designers, developers and strategist to create the solution; 
  4. Even when designing apps for health consumers, remember that managers and clinicians are also the customer as well; and 
  5. Don’t trip over Internet Explorer 6 when demonstrating to public sector stakeholders!

Also see this nice prezi presentation about the project and lessons learnt.

Patient Opinion Australia

Patient Opinion was founded in the UK in 2005 and since then has grown to be the UK’s leading independent non-profit feedback platform for health services. Patient Opinion Australia (POA) was established in 2012 and, similar to its UK counterpart, is registered as an independent not-for-profit charitable institution. Patient Opinion is about honest and meaningful conversations between patients and health services. We believe that your story can help make health services better. How it works:

  • Share your story of using a health service
  • We send your story to staff so that they can learn from it
  • You might get a response

Your story might help staff to change services Share your story and help make our health service better!

I’ve frequently shared the story of the original Patient Opinion with the Australian Gov 2.0 community, so I’m really excited to see Patient Opinion Australia (POA) finally launch. Its going to be interesting to watch how Australian health consumers and institutions respond to the idea.


Looking around at the small amount of coverage POA has received in the media and social media, it looks like we’ll have to work through the same concerns they experienced in the UK:

Nurse for Nurses blog:

I have a concern with the anonymity of the process. Our existing government complaints process is also anonymous and this has led to organisations being put under the microscope because disgruntled people have used the process to mischief make.

I am also concerned that this website will encourage people to circumvent existing complaints management systems and use this website as their first port of call rather than giving the organisation an opportunity to address their concerns.

ABC Radio National:

Norman Swan: So what do you do about the fact that some people in the health care system who have some of the most difficult circumstances have the least access to online sites such as yours? So that you’re going to get the middle class complaining but not people who have three kids, single parents and out of work?

Michael Greco: Well, again experience in the UK has shown that that’s not quite the case. There were some concerns about for example, that elderly people don’t use the internet. Well they’ve disproven that.

However, they have received more positive coverage on the Australian Ageing Agenda (also provides a lot more background on the project in Australia).

Don’t confuse ‘MySchool’ for healthcare as innovation through open data

Professor Braithwaite says he doesn’t oppose the system outright but he says the Government needs to give a much better explanation of how it would operate.

JEFFREY BRAITHWAITE: Is the data really reflecting performance of hospitals and services or is it a reflection of the different idiosyncrasies within the system and the complications within the system?

So it really does require a lot of smart thinking to present data in an effective way.

TIMOTHY MCDONALD: Do you suspect that when all is said and done a system of this nature simply might not be worth the money?

JEFFREY BRAITHWAITE: Well that’s the big $64 question. No-one really knows.

You set up an authority, you hire staff, you have a lot of activity within the health system to gather data in accordance with the information system’s requirements. You get a lot of people not only gathering the data but using it.

Do you get commensurate benefits in terms of health systems improvement? No-one really knows.

I wasn’t particularly impressed by the MySchool effort and I wasn’t impressed by the MyHosptials site when I heard about it late last year. However, lets not get confused about actionable and useful open data with publishing meaningless facts and figures, that are only likely to distort management priorities. I’m still waiting for a genuine Government 2.0 approach and innovative thinking in the public sector to be applied to this particular problem. And its not like there aren’t models they can copy. I wonder what’s stopping them?

MyHospitals (again) – is health care a journey or a transaction?

We are not providing real time information on how many parking lots are available or the current length of elective surgery waiting lists. For such information, they should contact the hospital or their doctor respectively,

I commented on MyHospitals the other day, but only just came across this related coverage.

My immediate thought in response to this quote from Alison Verhoeven, Senior Executive at Australian Institute of Health and Welfare (AIHW), is: but why not?

Don’t factors like access to parking also affect the patient and the patient’s carers, friends and family as they move through the health system? It leaves me wondering exactly who the ‘My’ in MyHospitals is.

How stories from real people can give us insight into why things happen

James is a Senior Business and Technology Consultant with Headshift Social Business Consultancy. Headshift is a leading international social business consultancy which helps organisations use smarter, simpler, social technologies to improve business performance, communication and customer engagement.

Both James and Professor Hasan gave examples of using IT in the health sector not just to collect vast amounts of statistical information to tell us what is happening but stories of real people that can give insight into why things happen.

James described the UK website ‘Patient Opinion’ where patient stories, the majority of which are positive are guiding new directions for the health system.

Follow up media release to my presentation at the University of Wollongong’s SInet event. I was asked to focus on health care, so as well as Patient Opinion I also shared some Australian examples of how the Web is being used to help people with mental health issues to share their stories:

I also talked about some work that Headshift is involved with working with an organisation that is trying to improve how community services are being delivered to families, which also has an impact on their overall health and well-being. I explained how user-centred design can be complementary to the social innovation process.

Better Health IT can save lives, but can we actually build these better IT systems?

AN estimated 5000 deaths, two million GP and outpatient visits and 310,000 hospital admissions could be prevented every year if an effective IT system were rolled out – saving up to $7.6 billion in health costs annually, according to an analysis for release today.

I’m always a little cynical about this kind of number of crunching. I’m all for saving lives, but remain unconvinced that we can actually build the better IT systems they call for – the health industry doesn’t have a great track record here after all.

However, listening to a news report on the radio today about a community protesting about the reduction of services at their rural hospital here in NSW today, I couldn’t help thinking that we don’t just need better technology, but better ways of managing complex systems like the public health system. We need global systems that allow local solutions, not one big homogeneous business process engine for health care.

This is because not everything in health (and other community service areas too) can be boiled down to a transaction, like medication or lab tests. Even if we can achieve it, improving health transactions with IT will only take us so far in improving patient outcomes (and ultimately saving tax payers money).