Tag Archives: User

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!

Acronym Soup: RCP, JRCPTB, WPBA, SLE, AoP, AoMRC ATDG

The Royal College of Physicians

This week I met with the Royal College of Physicians in London to discuss the NHS ePortfolio. After the many discussions I have had with trainees and trainers on this blog, on Twitter and in person I felt well prepared. I was sure the RCP should be taking a keen interest in the ePortfolio and it’s place in the wider context of Postgraduate Education, and through some brief email conversations I felt we were likely to have common ground. But as I walked through the falling leaves of Regent’s Park, I wondered what they would make of me and my graffiti-decorated blog…

It would have been unrealistic to expect to leave the meetings with all the answers, but I truly believe we have taken the first step towards a better solution. There are lots of details to work out, and I found myself discussing things like commissioning and procurement – yet another new language to learn! What was so positive was that there was an acknowledgement that trainees (and trainers) are dissatisfied with the ePortfolio, and that the concerns being raised are not idle complaining, but are educationally valid.

This is an important issue because it affects thousands of doctors, and because it relates to other areas of Postgraduate Training. The RCP wants to support trainees in their professional development and acknowledge that the ePortfolio is part of this process. There is also a realisation that technology has moved on, that the ePortfolio was not future-proofed, and that it is important to take stock and think about how to move forward. Financial contraints will impact on these plans and we need to be both realistic and imaginative in our decision making. The fact that the new RCP revalidation tools for Consultants have no interface or link with the trainee ePortfolio is another example of a lack of joined up thinking which we must avoid in future.

I was happy to hear that the RCP have almost finalised the details of the new ePortfolio User Reference group, which will have several trainee representatives. Hopefully this will not only impact on decision making, but also improve communication, so that we don’t in future have changes appear with no warning. It was also encouraging to hear more about the research being done on WPBAs/ SLEs. The RCP are putting considerable time and resources into reviewing the use and utility of WPBAs and the results of this research is likely to have a significant impact on the assessment systems for all medical specialties and shape training for the next 10 years. This is a great opportunity to engage with the College and have a real impact on Postgraduate Training.

There are many questions that do not yet have answers, in particular the question of funding and commissioning ePortfolio systems in the future. All doctors have a core set of common needs and I believe it is essential that we define these together and press for collaboration across Colleges, and open-ness in every part of the process.  The Trainee Roadmap is a first attempt at this, and I encourage you to contribute. The RCP seem to truly be putting trainees’ needs at the heart of what they do, and are (slowly) responding to the concerns of the thousands of you who have visited this site. But the structures of these organisations are complex and my attempts to find a way through the committees and funding streams of the RCP, the JRCPTB and others is already bringing on a headache.

We need to make sure this stays at the top of the agenda for the College, and I look forward to follow-up meetings in the future. I hope the other Colleges are watching, and are considering their own strategies. Otherwise they may find their trainees asking questions they can’t answer….

The Academy of Medical Royal Colleges Trainee Doctor Group

Coincidentally, in the same week I also went to give a presentation at the AoMRC ATDG (seriously, the number of acronyms in the world of medical education is mind-boggling).

There were many nods of assent as I described my frustrations with the current ePortfolio, and the demands placed on trainees and trainers to complete activities with little educational value. The representatives at the ATDG come from a wide spectrum of specialities including O&G, General Surgery, Anaesthetics and Intensive Care, Emergency Medicine, Pathology, General Practice, Ophthalmology, Psychiatry, Radiology and Medicine. Various ePortfolio systems are used by these trainees and some, such as the Haematologists, have to use two systems which, of course, do not talk to each other.

There was also great enthusiasm for sharing information, and for collaboration across Colleges. There was agreement that there are common needs for tools that support learning and professional development, capture workplace learning, log assessments, and provide evidence for appraisal. These needs are shared by doctors of all specialities and span the start of FY1 to retirement (in fact, since four UK medical schools use the NHS ePortfolio, these needs span Undergraduate as well as Postgraduate training). Technical aspects were touched on, and some absolutes were identified: such as a single sign on for all systems; a set of core standards for any ePortfolio used by doctors; and the need for flexibility for Colleges/Specialities and individuals. There was enthusiasm and hope for a future in which there is a simple but flexible ePortfolio system, with mobile support, that truly supports learning, and that makes people smile not scream when they login!

This committee is unique in bringing together trainees across specialities. It’s also full of lovely and enthusiastic people. The representatives are going back to their respective College trainee groups to gather information on what systems are used, and what trainees think of them. I hope we can then finalise a Trainee Roadmap and Core Requirements document, that will help us move forward.

Watch this space!

My 15 mins of fame

I am having some brilliant and highly productive meetings about the ePortfolio this week, which I will write about as soon as I can.

In the meantime, you can see my 15mins of fame in the NHS Hackday video:

NHS Hackday 2012: Geeks who love the NHS

“It’s an amazing atmosphere when you can come with a problem as a physician and say ‘I know nothing about any of this stuff, but I know what I want to be able to do.’ And then to have a room full of people who have the know-how and the enthusiasm to go ‘we can do that.'”

I love @wai2k‘s quote, which really sums up the weekend and the project: “with collaboration between the people who create the software and the people who use the software you can potentially create something quite magical.”

The ePortfolio needs exactly this. We are getting there.

Tell NES what you want: what you really, really want

It seems the powers that be are listening! This blog has always tried to encourage communication and collaboration with all interested groups, and the managers and developers at NES (the group who run the NHS ePortfolio) have been great, engaging with users on Twitter and here.

Now they want to meet you in person. On their latest post they say:

 [NES] is holding a series of user group meetings across the UK in late November 2012, open to all users of the ePortfolio but with a special interest in hearing from clinical staff.

The open meetings will serve a number of objectives including:

  • Disseminating the future plans for ePortfolio and building them in conjunction with feedback from all users
  • Providing an opportunity for users to speak their minds and share their ideas to improve the system
  • Giving users a chance to meet members of the ePortfolio team (technical, training and managerial) directly and informally
  • Offering a forum for users to present to peers and the ePortfolio team about their experience using the system

The meetings are in London, York and Edinburgh and are soon:

  • York: 19th Nov 10am-2pm
  • London: 20th Nov 10am-2pm
  • Edinburgh: 27th Nov 10am-2pm

Unfortunately the times set for the meetings will severely limit the number of people who can attend. I can’t go as I have prior work commitments. And I’m not even in a Clinical job this year! I really hope that anyone on shifts or with a day off makes an effort to go and give your feedback. I have emailed to suggest an evening meeting (with wine) would be better attended.

When people offer to listen, we need to make sure they hear us. Or we’ll be stuck with the system as it is forever. If you can, sign up to a user group meeting near you here:

http://guide.nhseportfolios.org/Resources/ePortfolioUserGroupApplication.aspx

PS. Apologies for the 90s Spice Girls reference in the title…

What would you ask?

As a result of this blog, and “a little help from my friends” I have a meeting next week at the Royal College of Physicians to discuss the NHS ePortfolio. I hope to articulate the discussions on this blog, and those that I have had over email, twitter and in person with many of you.

I hope to communicate the frustration felt by trainees and others about the NHS ePortfolio, along with the hope that it could be something so much better: a true educational and professional development tool to support lifelong learning. I hope to gain a better understanding of the views of the Colleges, in particular the view of the governance structures, the funding streams, and the future vision.

Broad areas I hope to discuss include:

  • lack of user input on any decisions about the ePortfolio and proposals to change this
  • poor communication of the rationale for, and timing of changes (personally, I had no warning about the change to formative and summative DOPS) and the effect this has on demoralised trainees
  • technical limitations – such as speed, which increase frustration and decrease utility
  • design limitations – such as lack of flexibility, poor organisation and visualisation of content so that it is hidden away and can’t effectively inform PDPs. These design limitations have an adverse effect on the educational utility of the ePortfolio
  • educational limitations due to lack of an app, meaning delays between a workplace-based assessment being observed, and completed online (therefore feedback becomes meaningless)
  • other limitations – lack of ability to share content with anyone other than supervisors, lack of interoperability and exportability of data for more creative uses
  • what does the College believe is the answer to the question “who owns the data in the ePortfolio?”
  • is there scope for greater collaboration between JRCPTB, RCPCH, The Foundation Programme and other groups who commission their ePortfolios through NES, to invest jointly for change – an app would be a perfect opportunity for this. The users of these systems share many basic needs, and could have individual specifics built in
  • what is the future of the ePortfolio, in technical, and educational terms, and how will this be decided?
  • how is the ePortfolio funded and commissioned? What are the plans for the future? How can we improve the process and increase transparency?
  • the concept of an ePortfolio has great potential but is not delivering what is needed. Investment is essential. User input is essential. There is a great opportunity to get this right and improve both the perception and reality of postgraduate training. Who will lead this change? Will it be the RCP?

I am very grateful to the RCP for taking the time to meet with me, and hope it will be a very constructive and positive conversation. Please let me know what else you feel is essential for me to communicate, as we begin to get closer to a process for change.

What would you ask? Please let me know by commenting below. You can also still edit the ePortfolio Trainee Roadmap

An ePortfolio wish list – created by an NHS ePortfolio NES developer

There have been lots of great suggestions on this site as to features that would make the NHS ePortfolio better. There has also been some insightful debate on the model that we should propose for the future, from aesthetics to functionality to commissioning. When I find a free hour I will make a summary page, as the debate has extended far beyond my initial expectations, and on arriving to the site it may now be difficult to see a coherent narrative. Some ideas for improvements are summarised in the tech improvement shopping list, others are amongst the comments on various posts.

A new development is that an NHS ePortfolio NES developer @ben555 has started a wish list where you can suggest improvements and vote them up or down the list.

Make a (NHS ePortfolio-related) wish

Whilst debate over longer term issues  continues, this is a great way to gather momentum for change. I have voted for an app – this is urgent!

Make your suggestion and cast your vote now…