Vicky Sargent's Blog Watch 7: coding & the NHS; hackdays.
A month or so ago, NHS National Director for Patients and Information Tim Kelsey tweeted that the NHS planned to ‘help health workers and others learn how to programme’.
Follow up interviews confirmed that the reference to ‘health workers’ includes doctors, nurses and other front-line staff. So yes, the Code4Health initiative does include teaching clinicians to code, and yes, this has provoked a wide range of reaction within a sector where IT is notoriously dysfunctional.
Leaving the NHS on one side for a moment, the ‘everyone should learn to code’ issue is itself not uncontroversial, as the much-quoted Please Don't Learn to Code post from Berkley-based software developer Jeff Atwood attests.
So far the discussion about the NHS and Code4health seems to be contained within the sector - although I do wonder for how long. Neil Pettinger is a former NHS information manager and now training consultant who was quick to respond.
His post Is Code4Health a good idea? looks at both upsides and downsides, and starts with the observation that NHS analysts often debate the benefits of educating managers and clinicians in the ways of data, so they have the necessary understanding to ask more intelligent questions of those with specialist expertise.
He then quotes a couple of authorities on why being able to code is empowering for all sorts of reasons, concluding 'there are good reasons to support Kelsey's initiative. I want to support it. It kind of feels right’ before coming to the ‘buts’:
‘First, let's face it, NHS staff don't have the time. It takes ages—and no small amount of tenacity—to learn how to code.’’ (The developers in our office would agree with this one).
His second point is that the NHS staff who'll sign up for Code4health will be the ‘usual suspects’. What’s really needed, he says, is dialogue and conversation, preferably face-to-face. ‘The black box information people need to get out more’ he says ‘They need to engage with the business’.
But it takes two to tango, and if doctors don’t need to code, even Jeff Atwood would support ‘learning a tiny bit about programming just so you can recognize what code is, and when code might be an appropriate way to approach a problem you have’.
But first things first, he says. ‘Being able to get around on the Internet is becoming a basic life skill, and we should be worried about fixing that first and most of all, before we start jumping all the way into code.’
Of course there is no reason why a doctor, nurse, or health service manager can’t be a bit of an IT geek as well, and you’ll meet a few of them by following the links in this piece. Not to mention the growing numbers of doctors and other healthcare professionals who are ‘digital natives’ and intensely frustrated with the IT tools provided at work.
The NHS hackday movement is tapping into the enthusiasm of these individuals, which has also been boosted by the scrapping, around a year ago, of the NHS’s heavy-handed, top down National Programme for IT.
A recent NHS hack weekend in Liverpool prompted a flurry of blogs, including Hacking the National Health Service from ScraperWiki, developers of the online tool for screen scraping and data mining.
As they point out, in this age of easy to use consumer software, health workers are still having to cross hospitals to reboot computers needed to retrieve vital data, or to keep patient records on Excel, which can’t be easily handed over to the next shift.
The blog describes two of the outputs from the weekend, one identifying academic papers that have a registered conflict of interest with particular drugs companies, and the other about making the NHS ePortfolio fit for purpose.
This second project is described in some detail by Nicholas H.Tollervey in his post A Deadly Equation of Acronyms: NHS+IT=FUBAR (Fucked Up Beyond All Recognition, since you’re asking).
As ntoll describes it ,‘ePortfolio is loathed by its users [they] complain that it's unintuitive, disorganised, ugly to look at and, at times of peak usage, slow.’ With his hackday team-mates ntoll ‘quickly came to the conclusion that helping trainees to get to their data was a fundamental issue. Unfortunately, there appears to be a conflict ….if a trainee can easily download their data (after all, who else's data is it?) in a widely used and open format then there's nothing to stop them from taking their data to a different service. This is obviously bad news for ePortfolio who are sitting pretty as a mandatory monopoly.’
The project described was clearly a happy bringing together of coder and medics. ‘Working with such a smart, motivated and jolly couple of doctors was the highlight of the weekend’ says ntoll. ‘They understand technology and care passionately that it becomes a force for good’. ‘Obviously’, he concludes, ‘people like them should be in charge of making IT procurement decisions.’
Turning to hackdays in other sectors, the Smarthack weekend held in Birmingham a couple of weeks ago was one of the topics covered in Rick Robinson’s post Tea, trust, and hacking – how Birmingham is getting Smarter .
Rick works for IBM supporting a number of Smarter City initiatives, including those in Sunderland and Birmingham, and helped fund facilities and catering for the Smarthack. His post describes how early discussions produced the ideas, including one about an “app” that might be created to connect charities that distribute food, to catering services with ‘leftovers’ to offer.
As someone who has previously blogged about the importance of dealing with wastage and efficiency in urban food systems, Rick was pleased with the Smarthack outcome: ‘the idea the team created was carefully formulated as a way to reduce food wastage that would be compliant with food safety and hygiene legislation….10 or so coders subsequently spent Saturday and Sunday building an app based on the idea, fuelled by beer and pizza – and by their own willingness to contribute to their city.’
The events I’ve described provide a very positive picture of hackdays and the creativity and innovation that can be unleashed. But it is worth noting that with hackdays it is not always so. In the wrong hands, hackdays can be exploitative, as Thayer Prime explains in When hackdays just *aren’t* cool – some PR advice - a post that has become pretty much required reading for anyone thinking of organising one of these events.
Vicky Sargent’s Blog Watch is published on Mondays, covering blogs on government, digital technology, the public sector, health & social care and a few random things. Recommend a blog for Vicky to follow or take part in the conversation using the comments function below. Vicky Sargent (@vickysargent) is a director of Boilerhouse Media.