Damian Roland on #NHSChangeDay

bannerEarlier today I had the privilege of chatting to Damian Roland, NIHR Doctoral Research Fellow in Paediatric Emergency Medicine at Leicester University, about NHS Change Day.  Damian is one of the key individuals who has driven forward the NHS Change Day initiative and he kindly agreed to share how the idea emerged and give some examples of pledges and tips on running events to help us at the University of Dundee as we get going with our plans to get involved in this year’s Change Day on 3 March.

We recorded our conversation in a Google Hangout but my video stream was completely out of sync and Damian’s was a bit out in places too resulting in a video that’s a bit strange so I’m posting the audio track of our conversation.

We chatted for about 12 minutes so it’s not too long to listen to.  Damian is really inspiring and I hope some of that inspiration rubs off as you hear him and we can get the word about Change Day locally in Tayside but also across the rest of Scotland.

To keep up with NHS Change Day in Scotland join our Google+ Community and follow @NHSCDScotland on Twitter.

Web 2.0 & Social Media – Access in the NHS

I’ve blogged previously about connectivity issues in the NHS and the problems with accessing Web 2.0 and social media sites that can support teaching and learning. In one of these posts I mentioned the work that the NHS-HE Forum Connectivity Best Practice Working Group, which I’m a member of.  This group has been pulling together and sharing case studies of good and best practice around IT connectivity in the NHS, which locally have certainly helped us make progress in Tayside.  My contribution to the working group has been to write a paper on Web 2.0 and social media in relation to education and research and this was published last week following the most recent NHS-HE Foum meeting held in London on 14th May 2013.

I had originally hoped to have the paper finalised before Christmas, however the delay perhaps has been quite timely given the Department of Health publishing its new digital strategy just before Christmas.  The DoH strategy “sets out how the Department of Health will give its staff the knowledge, skills, tools and confidence to embrace digital opportunities to deliver better health, better care and better value for all.”

At the moment for staff wanting to engage in digital opportunities to support learning and collaborative research there are still barriers with access to many Web 2.0 and social media tools being blocked.

The paper I’ve written highlights the emerging benefits of Web 2.0 technologies and, whilst taking account of potential risks, outlines some recommendations concerning their access.  I’m grateful to my colleagues from both the NHS and HE on the NHS-HE Forum Connectivity Best Practice Working Group for their feedback on the various drafts on the paper and their input into the final version of the document. We hope this document will prove helpful to various groups within the NHS as they seek to raise issues around the accessibility of web-based technologies.

I hope the paper will be of some use to those wanting to start a dialogue with NHS organisations about access to Web 2.0 and social media sites in the NHS to support learning and research.  I’m also hoping that we can start to gather case studies that can demonstrate ways that these technologies can be used to maximise their benefits for education and research particualrly given the growing interest in #FOAMed. I’m also planning to do some follow-up work to this paper which I hope to share over the next month or so.

If you’d like to contribute a case study on good practice or are interested in connecting around these issues please do leave a comment.


An opportunity to vote for Eduroam in the NHS

The Department of Health is currently developing it’s Interoperability Toolkit (IKT). Following a call for suggestions of themes that should be added to the Toolkit they are now available to view and it’s great to see that one of the potential themes addded is to deliver secure, open access to the Internet at any NHS site.

The aim of this theme would be to

Provide “free” internet access for workers / visitors involved in academia / research, enabling access to relevant information sources to support users whilst on an NHS site (and vice versa).

and would support this scenario:

Whilst visiting an NHS Trust, an academic data consumer requires internet access to retrieve information concerning research and  education.  He is enrolled to eduroam at is home University and fortunately, the university he is visiting is also an eduroam site.  As a consequence, he has automatic access to the internet at the site he is visiting.  His access is authenticated through his home site.  It would be useful if similar access could be made available when visiting an NHS Trust.

Eduroam is  used across many academic sites internationally and this the proposal would be to extend Eduroam to include NHS Trusts.  The proposal has been supported by cases studies prepared by the NHS-HE Forum IT connectivity best practice working group, which I’m a member of.

The NHS are now inviting individuals to vote for the 5 themes they think will deliver the grestest benefits.  Voting is open until close of business on 27 February.  If you work in medical education or research in the NHS then you might want to vote for this as a priority.

NOTE – eduroam is towards the bottom of the list in Technology Enhancements described as “ Deliver secure, open access to the internet at any NHS site”

Isn’t it time that Higher Education went agile?

Andrea Provaglio: Beyond Agile @ WebExpo by evalottchen, on Flickr

A few weeks ago I read a piece on Inside Higher Ed titled Blackboard’s Challenge.  It talked about the change in ownership of Blackboard and the challenges faced moving forward and it included this statement:

A healthy Blackboard is important to our higher ed community because the presence of Blackboard drives competition and innovation in the LMS market, and because many schools will continue to be Blackboard clients in the foreseeable future.

Is that right? Is a healthy Blackboard important to the higher education community? As this piece by TechCrunch highlights, Blackboard is not exactly universally liked as a company or as a VLE/LMS and this comment may chime with many:

Personally, I’ve never met someone who gushed about the Blackboard user experience, which was handicapped by feature creep, while, over the course of your four years at college, the speed, agility and core user experience stayed the same.

This poor user experience and sense of loathing isn’t something that’s exclusive to Blackboard, others have similar critical views about Moodle and Desire to Learn.  It’s also not a view that’s limited to VLEs, you can hear similar frustrations about administration and other IT systems in higher education.  It’s the same in the NHS, there are complaints about systems that are slow and clunky and the NHS ePortfolio also comes in for lots of stick.  Where is the evidence that these commerical and institutional systems drive innovation in the way that users want to see innovation?

Using technology is pretty much a condition of work and education these days and for many it’s a headache, when it should be the opposite.  Universities spend large amounts of money licensing proprietary systems to support student management and learning.  These systems are adopted to support efficiency and avoid duplication of effort, yet many systems don’t speak to each other, so there is still duplication and departments still rely on endless spreadsheets and Access databases to manage their own unique requirements.  Systems that get procured are generally ‘market leaders’ but being a market leader doesn’t necessarily mean being the best.  Every institution has its own quirks and using off the shelf solutions don’t always make for a good fit.  Further investment is often needed to support customisation or the development of building blocks that help provide useful bits of functionality.  In the case of VLEs it can sometimes feel like you’re trying to fit a square peg into a round hole, particularly for courses like medicine that don’t fit the typical modular degree programme.  Then we have the issues of usability.  Some of these systems are bewildering, there’s no evidence of user experience or interaction design or the realities of day to day workflows being taken into account in their development.  There are browser issues and not much evidence of responsive design to support use on different devices.  It’s little wonder that staff and students aren’t just bringing their own devices to work but also using open technologies to support them in their work and studies.

So is a healthy Blackboard important to Higher Education?  I don’t think so.

With technology changing so rapidly isn’t it more important that HE begins to change its culture around technology and becomes less reliant on commerical technology solutions?  Is it time for HE to start adopting a much more agile approach to its use of technology and a culture of involving end users as it develops and implements IT solutions that are truly transformative?

The Agile approach to IT development has been adopted by the Cabinet Office as it has revamped GOV.UK, the gateway to government information and services. They’ve opted for agile, chosing to use open technologies and inhouse development teams that engage with real users. The UK Government’s digital strategy is detailed on their Cabinet Office website.  It’s worth having a read of. There’s a bit from Appendix 3, which outlines the proposed digital by default (transactional) service standard that states:


Redesigned transactional services will be:

  • simple and intuitive enough for users to succeed first time, unaided
  • designed for inclusion, so all who could use it do use it
  • make use of common design and user experience tools, so once people have done something once, they will be able to do it elsewhere
  • redesigned using feedback received from a private or public alpha phase, and a public beta phase

Development and technology

Redesigned transactional services should be:

  • developed using agile, iterative, user-centric digital development methodologies, using open source code by default
  • make use of common cross-government technology platforms
  • make use of and meet open standards
  • offer high-quality APIs, enabling reliable reuse by third parties and integration with other government services
  • capable of working on all common browsers and a wide range of web-enabled devices, including mobile phones
  • impartially, robustly and regularly tested throughout the design and lifetime of the service.

What kind of systems would we have in HE if we adopted this digital design approach?  How much money would we save?  So much money has also been wasted on big NHS IT projects, could an agile approach help make some real progress here too?

There’s much said about lack of engagement with educational technologies by teaching staff in HE.  Part of the problem could be that we’re too focussed on a particular technology like an off the shelf  VLE rather than how lecturers want to teach.  If we worked with teachers as the starting point and included students would the typical VLE look quite different? If it was designed and redesigned using data from feedback, would we be using something that had any resemblance to the current incarnation of Blackboard or Moodle?

VLEs were the topic for discussion on last week’s #UKmeded Twitter chat at the suggestion of Jess Palmer aka Minty Green Medic, who shared some frustrations with her institutional VLE.  Following the chat Aspirant Medic (Christopher McCann) blogged about bringing technology to medical education and how he’d like to see a new open learning environment emerge for medical education, an idea that was discussed during the chat.  Similarly in medical education the NHS eportfolio also causes frustration, you can frequently see tweets about this and there’s also discussion on the NHS Portfolio Revolution blog.  Recent NHS Hack days have looked at developments around the Portfolio. Matt Pendeleton has also shared some thoughts on engaging clinicians in the development of clinical systems based on his experience on recent clinical attachments.

Technology is generally becoming more accessible and we’re engaging with growing numbers of apps and websites to support different aspects of our work and play.  The user experience of these technologies is generally positive which is why there’s so much heart sinking when using many institutional IT systems. There’s been many a time when I’ve been using an app on my iPad or using some Web 2.0 tool and I’ve thought why can’t I have that functionality in the tools I have to use for work (eg learning repositories). I’m not alone here,  Jess, Chris and Matt have ideas and hundreds of others do too, students, staff, doctors, patients and adminstrators.  With an agile approach these individuals would be able to help contribute to developing solutions that really work.

So how do we get HE and the NHS to see the light about agile development in the way that the Cabinet Office has?  There needs to be a fundamental change in culture around IT projects, one that focuses on relationships and communities and that is inclusive.  It’s also likely that business and procurement strategies may need to change.  It’s been interesting to look at recent tweets about some of the issues around the NHS ePortfolio servers and to see that a simple and logical solution can’t be implemented because of finanical procedures.  There needs to be a realisation that infromation management touches every department and it can’t be looked at in individual silos but rather needs to be seen as a whole across the whole organisation.  It’s an area where we need to see strong strategic and creative leadership, a leadership that engages with stakeholders at all levels.

A few days ago Seth Godin wrote that “When everyone has access to the same tools

…then having a tool isn’t much of an advantage.

The industrial age, the age of scarcity, depended in part on the advantages that came with owning tools others didn’t own.

Time for a new advantage. It might be your network, the connections that trust you. And it might be your expertise. But most of all, I’m betting it’s your attitude.

There’s a lot of talk about competition in HE,  is our attitude to IT something which can help to give us an advantage?  How do we change the attitude and the culture around IT in HE?  How do we encourage our instituions to become agile so that UK HE can be responsive in an ever changing climate.  Maybe I’m just barking up the wrong tree!

I’d like to know what the catalyst for change was at the Cabinet Office.  If you know I’d welcome hearing from you.


Starter for 10: What online tools & social media should be accessible in the NHS?

I’ve written previously about the problems of accessing elearning in the NHS and how this affects teaching and learning.  Back in November my colleague Andrew Howe and I gave a presentation to the NHS-HE Forum on accessing University teaching and learning from the NHS.  Our presentattion  gave an overview of some of the problems our clinical teachers and students face accessing University resources on their NHS PCs.  We also highlighted the frustrations concerning the inability

  • to access the growing amount of open learning content available  on sites such as YouTube, Vimeo and blogs and
  • to make use  of Web 2.0 and social media tools.

These sites, tools and technologies  make it easier for teachers to produce and remix online learning content.  They also offer many opportunities to support collaborative work, research and to share information with patients and colleagues. The reality, however, for those involved in teaching in the NHS and for our students on clinical placements is that access to many of these sites and tools are blocked by NHS firewalls. In some cases health boards have made them accessible but only to those clinical staff using them for research.

The outcome of our presentation and the following discussion at the November NHS-HE Forum meeting is that a short life working group has been set up to look at NHS-HE connectivity best practice.  The group includes IT managers, librarians, medical educators with responsibility for elearning and  we’ll be putting together our work plan when we meet later this week.

One of the things I’ve been tasked with doing is coming up with a starter for 10 list of tools/sites that should be accessible from the NHS.  I know the sorts of sites that my colleagues are keen to be able to access for example

  • YouTube
  • Vimeo
  • WordPress sites
  • Blogspot sites
  • Posterous
  • Social bookmarking sites like Delicious and Diigo
  • Google docs
  • Slideshare
  • Ning
  • Twitter

I’m also interested to hear what the wider NHS community involved in teaching and research would like to access.  Which tools would you like to access that are currently blocked in your health board or trust and why would you like to have access them, what benefits would they bring to your work?

Accessing e-learning resources in the NHS

Yesterday I was contributing to a staff development session for ST (specialty training) doctors and my stint was about e-learning.  I talked about content that’s available on the web that can be reused and remixed under a creative commons licence and touching on the tools that support personalising learning and networked learning.  Then I had to say they probbaly wouldn’t be able to access a lot of these sites for on the job teaching because the NHS denies access.  At the end of the session frustrations with the NHS IT infrastructure were raised, issues with old web browsers (IE6) old operating systems (pre XP) and the inability to access useful online resources.  These are all common complaints across different NHS Trusts and it’s why many doctors are keen to have a University PC/Mac on their desk.

The problem of accessing e-learning resources is covered in a short commentary in the latest edition of Medical Education by Prince, Cass and Klaber from King’s College Hospital, London (Medical Education 44 (5) p 436-7). Prince et al highlight the wealth of excellent resources that are being developed and made available but that there is a danger that enthusiastic learners will be unable to access them.  They pick up on a paper published in the same edition looking at accessibility issues in African medical schools due to infrastructure and resourcing issues but go on to draw attention to the significant access problems faced by postgraduate trainees in the NHS.

Prince and his colleagues surveyed doctors across 37 English NHS Trusts in April 2009 to assess the accessibility of online resources to postgraduate trainees.  Unfortunately I can’t see the table with the results referred to in the online version but the paper indicates that many experience blanket ‘internet denial’ leaving them unable to access important clinical resources and download PowerPoint presentation or pdfs of journal articles.  Only 32% could access the The UK Department of Health ‘E-learning for Healthcare’ programme modules.  YouTube is identified as huge source of medical video content which is blocked and likewise there is no access to iTunesU.  The authors go on to say,

Whereas in Africa limited infrastructure is producing an information bottleneck, access in the UK is restricted by ‘denial of service’ restrictions placed upon a competent and fast modern system. Emerging Web 2.0 applications, such as wikis and blogs, provide creative and interactive learning environments within which all learners can contribute and interact, provided they are given ‘write-access’. Shouldn’t we be managing the risks more effectively in order to allow learners the freedom to use IT resources to better effect?

This question is how do we go about managing the risks more effectively to allow NHS staff to access online learning resources and tools which many of us take for granted.  There are understandable concerns about the security of patient information and quite rightly so, I don’t think any of us would disagree that the NHS needs to diligent about this.  It’s also essential that clinical systems take priority in terms of bandwidth, which is the reason sites with streaming video like YouTube and Vimeo are blocked in the NHS.  All of this said individuals working in the health professions are called to be lifelong learners and need access to educational resources which are being increasingly delivered and freely available online.

Is there any dialogue going on at a national level that is seeking to address these issues?  IT projects and the NHS don’t have a good track record, but are there are steps that can be taken to separate  access to educational resources and tools from the clinical and management IT systems.  I agree with Prince and his colleagues who end their short commentary by saying,

There is an urgent need for commissioners, providers and users of e-learning materials to be jointly involved in planning how, when and where resources will be used. Without such a partnership, there is a significant risk that ‘disconnection’ will severely compromise what could be one of our most valuable learning tools.

How do we make this happen?