I spent this weekend in Liverpool at NHS Hackday. I had no idea what to expect. I had never met anyone there before and only knew a few names from twitter and google groups conversations in the weeks running up to the Hackday. I wasn’t completely sure I knew what a Hackday was.
I was astounded.
I spend a lot of my life getting frustrated by the slow pace of change and the massive inefficiencies in the way that we work. I want to be freed up to spend time teaching, learning, writing, thinking, talking to patients and providing care. I hate unnecessary paperwork and bureaucracy. I hate meetings that don’t achieve anything.
NHS Hackday was a breath of fresh air. A diverse group of people with totally different backgrounds, most of whom had never met, got together, discussed problems and solved them. In a weekend!
I will describe here what happened at the Hackday, what our project “The NHS ePortfolio Data Liberation Front” achieved and why it won 2nd place. There is far more info about how it is run, by who, and why on the NHS Hackday site. You can also see an interview with Carl (from OpenHealthcare) on Youtube:
What follows are my personal impressions.
The HACKDAY CoNCEPT
On Saturday morning, whilst people were registering and getting coffee all those with ideas for projects wrote them on a board. Everyone gathered in the main hall and each idea had 2minutes to pitch. After all the pitches, people gathered around signs indicating each idea, and people formed groups. Then the work began. Groups discussed their vision, their proposed solution, and thrashed out conceptual and technical details. Fuelled by enthusiasm, tea, coffee and wotsits, software developers created things out of thin air (OK, out of data and code, blood, sweat and tears). Health professionals like me, who couldn’t code, were on hand to give context to the projects and point out real-world hurdles, which could then be worked around.
The NHS ePortfolio Data Liberation Front
Our group consisted of me (full of ideas, no understanding of code), Nicolas Tollervy, a developer (a genius with lots of patience and an incredible ability to work round every problem the project presented him with) and Marcus Baw, (a GP who can code a bit and is a RCGP Health Informatics Group member, who was a great bridge and font of knowledge on NHS informatics issues).
We discussed some of the problems with the current NHS ePortfolio and possible workarounds. Since the code is not open and there is no API this was no simple problem.
We discussed the urgent need for an app to make trainees and trainers lives easier, and make WPBAs educationally valid. Any app would have to be able to get data into the ePortfolio so that a WPBA showed up not just in the personal library section as any random document, but in the WPBA section. With no code and no API this would be a great challenge.
We decided to focus on the fact that my data is locked in a vault in my ePortfolio. Whilst it is in there I can do nothing with it.
I want to liberate it, as I could then do anything I want with it! Ideas include:
- visualise my achievements and progression
- present the data in a way that my supervisor can see, understand and give feedback on
- present the data in a way that makes it clear I have achieved all the competencies required by the JRCPTB for ARCPs and CCT
- integrate the data into my CV, my online CV, an alternative ePortfolio (mahara, Googlios etc), use it for job applications
- allow me to take the data with me into another role (progression or change of career path) eg Foundation Trainee –> Emergency medicine ACCS trainee –> GP trainee –> GP (all use different ePortfolio systems)
Not only is there a practical need for this, but the more we talked about it the more I realised that this is bigger than practicalities. It’s a philosophical argument. It’s my data. About me. I want it liberated. I can already download a PDF so clearly no-one disputes the fact that the data is mine and I have a right to it, but a PDF is useless.
@ntoll worked incredibly hard (with breaks for coffee, sandwiches, a trip to the pub and a curry house), came up against many problems and found ways around them all. We modified our plan as we went along, and decided that the best use of our time would be to do a ‘proof of concept’ and focus on a particular data set within the ePortfolio (there’s a lot of data in there, and it’s not organised as logically as you might imagine!). By the time we reached the submission deadline of 12.00 on Sunday we had something to show for our efforts. @ntoll made some finishing touches and we put together a brief presentation.
All 15 projects that had been selected from the pitches presented (a strict 5min and 1min for questions) to a panel of judges including: @MarkPriceDavies (chair), Ian Gilmore, Dr Farath Arshad, Zeinab Abdi, Francis Irving @frabcus, Dan Lynch @MethodDan, and Lilian Wiles. They deliberated and at 17.00 announced the winners.
The Other Projects
You can see more details of the projects on the NHS Hackday site, and get all the code through the wiki and on github, since all projects are open and shared. There were lots of fantastic projects but those that particularly caught my attention were:
- AskIt (a general purpose question asking android app for any questionnaire you need – Waterlow, MUST score, falls assessment etc. Simple, effective, important!)
- Making sense of patient comments (data visualisation from sources such as NHS Choices – massive potential applications)
- CoIncidence Gate: a Conflict of Interest tool (scraped data from conflict of interest statements on Pubmed – something like 480,000 papers analysed!! Again, follow the link for more discussion on the massive potential applications of this project)
- BleepBleep (making in-hospital communication better. An end to having to call switchboard. An end to the bleep! I trialled this, and am keen to help get it into hospitals now! Stop wasting time on hold)
- GAAG: Guidelines at a Glance (there are well-studied barriers to doctors using guidelines, meaning patients don’t get best care. GAAG provides quick access to personalised most-used bits of guidelines on an app. Lots of potential for social add-ons, highlighting when guidelines change, seeing what peers use, rating bits of guidelines. See presentation for more info. Can’t wait to use it!)
- Bloodcount (haematologists sit at very advanced microscopes counting different normal/abnormal cell types using very un-advanced technology = clicker and pen and paper. Bloodcount is a desktop system of a counter with keyboard shortcuts, reference normal and abnormal cells, report generation and learning function. Hard to describe to do it justice. A worthy winner!)
- wtfdoc (an NHS jargon buster for patients and relatives as an app. Has a database, and if a term is unknown it will crowdsource answer through twitter and other sources. V clever!)
Why I think We Won a Prize
Our project won the First Scraperwiki prize for scraping, and came joint second overall on the day. I think the reasons we won are multiple:
- @ntoll achieved amazing things writing novel code to scrape data out of a closed system and generate a .json file of hierarchical data that could then be used. In just a day and a half this was some achievement!
- our pitch was powerful as this is an issue for all doctors of all specialities at all levels, especially with revalidation now a reality. Facilitating learning for healthcare professionals is in all our interests as a society
- the concept of data liberation goes beyond this project. Who owns the data in public databases? Who owns the data in the NHS? What right does an individual have to their own data? What right does an institution have to keep it from them?
I owe a huge thank you to the organisers, supporters, volunteers and participants at NHS Hackday Liverpool 2012. And a special thanks to Scraperwiki for providing prizes including my beautiful new Google Nexus 7! This weekend I saw innovation in action, providing real, practical solutions to the day-to-day problems facing those who work in and use the NHS. Some of these solutions are now in use – today! Others will be worked on outside the Hackdays or at the next one. I have had my mind opened to new ways of working and have returned to work today full of enthusiasm and inspiration.
There’s no going back now. I’m a doctor who loves geeks who love the NHS, and I have the T-shirt to prove it.