HANDI – The Healthcare App Network for Development and Innovation

Most of you will know of my involvement with HANDI and new not-for-profit organisation intended to support and encourage the development of health and care apps to transform health and care. www.handihealth.org which I would urge you all to support.

People keep asking “are apps things that run on mobile phones?” and keep talking about “mHealth” as the coming thing.

Well, yes apps run on mobile phones and ubiquitous connectivity changes the world, but there is an underlying “app” paradigm that’s more important so forget the “m” and concentrate on the paradigm.

While it is true that the “app” paradigm comes from the mobile world, the mobility of apps is not the primary thing that makes them a powerful, disruptive technology, rather it is their other characteristics, and these can apply irrespective of the device an app is running on and the modality of its current connection.

My vision for an app is that it is an agile, lightweight and intrinsically connected thing, running on whatever device, from phone to 80 inch digital TV, that happens to be right for the user at any moment, adjusting itself to the form factor of the device it’s currently running on, using mobile connectivity when it’s mobile with a seamless handover of app and data as the user moves from device to device.

Apps are easy to build; at their most powerful when designed do a few things well; are easy to distribute, install and use; and with care can be orchestrated to work together.

Apps are easy to build because they make substantial use of pre-built components in a well defined development framework and can make use of third party data and services, available to them in the cloud, allowing the developer to concentrate on the unique not the generic features of their app.

App stores make it cheap and easy for developers to promote and distribute their app and for users to find and install it

Finally, if they have an appropriate platform, open APIs and a few standards Apps can be orchestrated to work together to meet the broader needs of an individual user.

Together, these thing drive cost down, quality up and enable new ways of working.

Already this new paradigm has produced a flurry of free or low-cost apps in health and care and enabled people who previously could not have got their idea to market to do so. But, this is only the beginning. If we can work together to make it even easier and cheaper to build health and care apps and if we can encourage the development/adoption of open APIs, open platforms and open standards to facilitate the orchestration of apps to support the processes of health and care, we will improve well-being and transform the way health and care are delivered .

This is what HANDI is about. Join us.

NHS Hack Day – Making an Old Man Happy

I’ve been fortunate enough to fall in with some of those young clinicians and developers organising NHS Hack Day (actually two days 26/27 May 2012 in Central London) http://nhshackday.com and I think this is one of the most exciting things to happen in Health IT for many years. It also fit well with my latest not-for-profit venture www.handihealth.org about which more soon.

This free event is now “sold out” (they are trying to get more space at their venue) but you can still participate by joining “nhshackday” at http://groups.google.com/

The energy and enthusiasm of this group reminds me of the early days of GP Computing in the 1980’s and I think they might give a spur in the Acute sector like that of the early pioneers in  UK General Practice.

UK GP Computing was the first widespread application of IT at the point-of-care and retains a position of global leadership. Today over 99% of practices have been fully computerised for more than 10 years, most practices operate” paper light” and most mid-career GPs have never known general practice without a computer.

Progress in the Acute sector has been disappointing, but I think those behind NHS Hack Day are about to change this and I want to encourage them and suggest they take heart and learn lessons from what happen in GP land 30 years ago.

The reason for success in General Practice and the lack of similar progress in the acute sector are many (see: https://woodcote.wordpress.com/2011/11/15/lessons-from-gp-computing/ ) for more. But at the heart of this was the collaboration that emerged between young GPs and techies in the early 1980’s from which all of those companies that have shaped the GP System market emerged.

These young people were fascinated by the power of the early PCs (Apple II, PET, TRS80) and a raft of long forgotten micro-processor based mini-computers which meant a GP practice could afford a computer. They saw opportunities to improve care, build business but above all have some fun. The clinicians learnt a lot about the technology (programming their Sinclair’s, BBC Micros etc – Parallels with apps, open source and the RaspberryPi ?) and the techies developed a deep understanding of primary health care which they lived and breathed with their clinical mates. From the shared understand and respect came some amazing things.

Many of these people are now in positions of leadership in the clinical professions, academia,  industry and the global health informatics community, they haven’t all found out about NHS Hack Day yet, but those that have are much encouraged by what we see what is  (primarily) our children’s generation doing.

As ever, this new generation will need to ignore a lot of our advice in order to make progress (as we did before them) but there are things to be  learnt from our history and there is much we will try and do to support you.

We wish you well and stand ready to try and help.

Cutting off your Nose to Spite Your Face

I’m increasingly using social networking and online collaboration tools for projects in my working life and more and more of my clients are using social networks to promote their interests with their customers, service users and the broader community. Without these tools my efficiency would plummet and my clients ability efficiently pursue their objectives would be much undermined

However, I’m still finding that many behind corporate or NHS firewalls can’t get access to these tools and are thus denied the transformational benefits of making proper use of them. Even though others including many more enlightened  NHS organisations are demonstrating how they can be used efficiently.

Organisations who think they are going to improve corporate productivity by taking a “sledge hammer” approach to Internet abuse and corporate security are dinosaurs and will go the same way, only hopefully a lot quicker.

Sites and services commonly blocked include Facebook, Google Docs, Dropbox, LinkedIn, YouTube, Mikogo, Skype, G+ The list just goes on and on.

The problem is further compounded by overzealous email filtering. Don’t the IT droids understand that there are legitimate business communications in Health and Care dealing with paedophilia, child abuse and rape or that “Dyke”can also be a surname?

Sure there are legitimate concerns with regard to staff making improper use of their employers time and resources and the security of corporate networks, but we don’t try and stop doctors and nursing abusing medicines by saying they can’t have any access to them and in any case where staff are poorly managed and motivated they don’t need technology to help them squander their employers  resources.

I also amazed how people put up with these restrictions, particular in large poorly managed organisations where the IT function is remote, difficult and unresponsive and people feel it is just too much trouble to argue their case and live with the inefficiency or just work round it using their smart phones.

Organisation have to understand  that survival will increasingly dependent on having a workforce who know about and understand how they can use web 2.0 tools like social networks, crowd sourcing and cloud based collaboration. Cutting of their access to such things in the workplace is surely cutting of your nose to spite your face and an abrogation of managements responsibility to ensure staff are trained and  motivated to use these tools appropriately. IT departments also have to step up to their responsibilities to protect corporate security and resources in way that don’t interfere with the business and realise that they can’t get away with blunt sledge hammer approaches.

Finally,  those face with in appropriate block on access, should tell their employers to get their act together. But, don’t blame me if you get fired.