Tag Archives: Hackday

NHS Hackday and the oPortfol.io

This weekend I was at NHS Hackday. Doctors, other healthcare workers, students, patients, organisations and software developers came together in their free time to make stuff that could make the NHS better.

Thanks to @londonlime

Thanks to @londonlime

I was astounded by the last Hackday. I didn’t think my expectations could be surpassed. They were.

The projects were diverse, aiming to solve everyday problems at all levels of the NHS. You can see the list on the Google doc and they’ll be on the wiki soon. The highly deserved winner was OpenHeart. The team used the amazing open source electronic health record at Moorfields Hospital, Open Eyes, and adapted it for use in Cardiology. The end result was stunning. It will save hours of doctors’ time, will create patient records that are much more understandable for patients themselves and for GPs, and will improve communication and therefore the quality of care.

Another favourite was Dementia scrapbook, an app to allow family and friends to contribute to a virtual scrapbook of memories and reminders. It has an easy to use touch interface that can be used by carers or people with dementia themselves. Dementia is common and this takes a very patient-centred approach to solving problems many of us may face in the future. I hope to see it available soon on the app store.

Cellcountr, initially hacked at the Liverpool hackday, was built on with additional features such as data visualisation and a customisable keyboard. It will be launched in the next month at a Pathology conference, and will then make a real difference to doctors, and their ability to accurately diagnosis patients with haematological conditions.

So what did we do? We created oPortfolio, an open API which allows trainee doctors to record learning events online, offline and on the go. It includes a webapp, a mobile-friendly site, an iPhone app, and an android app that all synch data. From nothing to all this in 36 hours! The team were incredible: full of talent, patience, and creativity.

Oportfolio

What does it do?

It solves an immediate need to log learning events on the go (see examples below). It lays the foundation for a more complex system to log assessments and meetings. With (quite a bit) more work it could be a simple open portfolio that doctors who are not currently in a training programme (eg LATs, people doing fellow jobs in between F2 and speciality training) could use to track their professional development. The funding model would have to be clarified as development and hosting is not free! It could also be an arena to experiment with and showcase new ways of organising a professional portfolio that could usefully feed into the debate on what and who a portfolio is for. It could highlight how different systems talking to each other and 3rd party apps and plug-ins have the potential to improve a core product. Another fabulous creation was Quicklog, an app to log personal development in performing procedures on the go. They built in data visualisation to encourage reflection and chart progress. It would be fantastic if the data from Quicklog could be integrated into a portfolio system. Anyone who is interested (and understands it!)  should look at the code on github for oPortfolio and Quicklog!

Screen Shot 2013-01-28 at 11.55.34

What does it not do?

It is not a replacement for the current ePortfolio system(s). The NES ePortfolio and others (eg surgical portfolio) are complex structures build up over years, with thousands and thousands of pounds of investment. Many have questioned whether they are value for money and I can’t answer that but good software does cost. Existing systems have  layers of access rights and methods of data extraction since these were priorities for the bodies who paid for them. They have cloud hosting and data security. People have spent years making them do what they do and it would be crazy to think they could be replicated in a weekend. They have their problems and must be improved but they are here to stay until a better alternative exists.

The focus of building a model Oportfolio was the user experience. If it was developed further it could fulfil a need for trainees who are not in a current training programme, who currently use various cobbled together documents on Evernote, phone notes apps, word documents and paper to record their learning and showcase their achievements when applying for jobs. With regular end-user input it could be beautiful, and a joy to use!

I am sure that our exploits this weekend will appear highly challenging and controversial to some. But I am not controversial. I have always highlighted the frustrations felt by trainees (which are well known) but advocated for engagement with all interested parties: individual trainees, trainers/educational supervisors, LETBs, Trusts, Royal Colleges, current ePortfolio provider NES, the GMC and HEE. We need to get our heads together and think about what the future of training will look like, what tools are needed to enhance learning, and how they will be funded.

The NHS can’t keep putting up with unintuitive, inflexible IT that doesn’t match the realities of practice. As demonstrated at NHS Hackday; intelligence, enthusiasm, creativity, a few humous sandwiches and some coffee can create magic. But that magic needs support and investment to make it sustainable. Muir Gray says change in the NHS will come from the bottom up. He is one of a few inspirational people at the top supporting projects in which frontline staff make a difference. We could do with a few more like him….

The perfect ePortfolio

Thanks to @londonlime

Thanks to @londonlime

This weekend I am at NHS Hackday in Oxford. I have written about hackdays before. I am a huge enthusiast. It is amazing to see doctors, other healthcare workers, patients, organisations and software developers coming together in their free time to make stuff that could make the NHS better. A hackday IS agile software development, speeded up, with people motivated not by profit but by intellectual curiosity and a desire to make the world a little bit better.

There are some amazing people coming to NHS Hackday Oxford. Some of them are interested in rethinking a professional ePortfolio. The one we have currently is competent. It does a job. The creators at NES are great, but they are constrained by their history and location. In my opinion an IT project that supports thousands of healthcare professionals’ development should not be run by project managers in a Scottish NHS health board. Their customers are Royal Colleges, not ePortfolio users. However great NES are at their job are they really the best people to make the perfect ePortfolio?

As trainees we want more. In relation to the software we want seamless functionality, we want flexibility, we want personalisation, we want visualisation of data, we want speed, we want interoperability, we want openness and APIs, we want mobile offline data entry, we want intuitive navigation, we want reliability, we want to be encouraged and inspired, we want beauty.

Too much to ask? I hope not. 

I need to form these vague statements into some specifics between now and tomorrow. Wish me luck!

NHS Hackday and the ePortfolio Data Liberation Front

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?

What next

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.