Saturday, May 31, 2008

Armchair involvement for using technology to engage people in health service improvement.

The NHS Institute for Innovation and Improvement has recently launched a new web site called "Armchair involvement" which aims to provide a practical guide to using technology to engage people in health service improvement.

The site will provide:

* descriptions of different types of technology
* interactive examples of where technology has been used to involve and engage people in health
* the benefits and potential pitfalls of using technology to engage people.

Comments on the various pages are invited with opportunities to share your own examples of where you have used technology to engage staff, patients, carers, service users and the public - although there seem to be very few comments yet, and I don't know what evel of moderation will be employed.

In developing this work some of the key thinkers and leading experts from health, information, television, multimedia, horizon-scanning, telecommunications and service design have come together to discuss what technologies are available today and what tomorrow’s world may look like. It is claimed that there is a great deal of enthusiasm across the NHS for using these tools to reach people, to better understand their opinions and to encourage involvement in service improvement.

It will be interesting to see the level of usage - and whether the ideas, examples and opinions expressed lead to changes in the ways the technologies are used by the NHS.

The research report on which it is based aims to offer key inputs into the role of technology in shaping of the NHS’ future relationship with staff, patients, carers and the public.

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Saturday, May 24, 2008

Canadian Medical Association launches online health consultations

The Canadian Medical Association has launched a health portal with a direct and secure link for patients to share the data they input with their doctor in online consultations.

The portal uses secure messaging, an application that offers a private channel of communication between doctors and patients, as a safer alternative to email. Patients and doctors can communicate online about matters such as monitoring chronic disease, follow-ups after appointments, and prescription renewals.

Friday, May 23, 2008


The latest (25(2) June 2008) edition of Health Information and Libraries Journal has just been made available at:

It contains several interesting papers (but I might be biased as I was the lead author on one of them!

Editorial - Information, immunization and the information professional Kate McIntosh

Original articles

The attitudes of health care staff to information technology: a comprehensive review of the research literature Rod Ward, Christine Stevens, Philip Brentnall, Jason Briddon

Online anatomy and physiology: piloting the use of an anatomy and physiology e-book-VLE hybrid in pre-registration and post-qualifying nursing programmes at the University of Salford Michael Raynor, Helen Iggulden

Job hunting in the UK using the Internet: finding your next information professional role in the health care sector and the skills employers require Karen Davies

The Journal of Ayub Medical College: a 10-year bibliometric study Midrar Ullah, Idrees Farooq Butt, Muhammad Haroon

Scottish toolkit for knowledge management Lynn Caldwell, Sandra Davies, Fiona Stewart, Annette Thain, Ann Wales

Informationist programme in support of biomedical research: a programme description and preliminary findings of an evaluation Susan C. Whitmore, Suzanne F. Grefsheim, Jocelyn A. Rankin

Regular features

Korean medical libraries and professional associations: changing services and roles Jeong-Wook Seo, Jeong Hee Park, Heajin Ki, Jin Young Park, Mi-Jeong Park, Hye-Yang Kim

Promoting reflective information literacy practice through Facilitating Information Literacy Education (FILE) Susie Andretta

Implementing EBLIP: if it works in Edmonton will it work in Newcastle?
Andrew Booth

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Wednesday, May 21, 2008

Wetpaint wiki on social networking in the NHS

Following last weeks meeting on Social Networking in the NHS a wetpaint wiki entitled May Masterclass - social networking
has been set up to ensure that everyone can contribute to the final event report and discussion paper. All contributors need is a passion for utilising the full potential of Social Networking tools in the NHS.

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Tuesday, May 20, 2008

How People Learn - Dr Betsy Weiner Presenting

Went to Dr. Weiner's presentation at Vanderbilt Nursing School today and it was WONDERFUL! Remarkable use of Second Life as a Web 2.0 teaching tool! It focused on Disaster Preparedness training, but was a subset of talking about various methods of how people learn (what domains).

Besides the How People Learn Powerpoint, there are two demonstrations I will do today in class: (online example of the use of How People Learn in the Online modules for Emergency Preparedness) (a virtual reality example of Emergency Preparedness using the Second Life format)

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Saturday, May 17, 2008

Comment on the social networking masterclass

I thought this was a really good workshop and thanks to all organisers and speakers. I had to leave to get a train and so missed the final discussion but wished to make the following point.

Rob Ward had listed as one of the possible perils of social networking ‘undue weight given to minority views’. I agree with his conclusion. Although the world of blogs, wikis, and social networks gives an opportunity for alternative views, which in some cases the ‘establishment’ may have wished to suppress (and Rod gave us some interesting examples from WikiLeak) we also should be concerned about the decline of the scientific approach and the use of evidence in healthcare. Helen Nicol had two points in her presentation, the implications of which I would dispute. She referred to ‘the wisdom of the masses’ and ‘more brains more information’. Quite often the masses do not have wisdom but follow prejudice, hearsay, and urban mythology. How often do we see public opinion radically influenced by the tabloid press, for the story to change a few weeks later? The tabloid press and tabloid TV use the case of Uncle Norman or sister Mary to tell one person’s story. That story may be true but if we are to take a rational approach, for example, to our understanding of the cost effectiveness of a particular treatment we need to consider evidence gathered on representative populations. Similarly, the phrase ‘more brains more information’ may apply in a limited range but if we were to ask 1000 or even a million people to work together would they have come up with Einstein’s theories? More information may just mean more noise rather than more intelligence.

What can we do to ensure that in the new (and exciting and productive) opportunities for collaborative working and more open debate we do not lose our science. The obvious and immediate response is to say we need both health and information literacy but my impression (and I admit that I have no hard evidence to back this up) is that society is going backwards in information and scientific literacy. Is there something that we can do on the Web to encourage the scientific approach

Thursday, May 15, 2008

Masterclass Event - Social Networking in the NHS

Today (Thurs 15th May) I'm attending a NHS Faculty of Health Informatics Masterclass Event - The Power and the Perils of Social Networking Tools in the NHS

The day is being held at the British Library was to be chaired by Bev Ellis (Vice Chair – NHS Faculty of Health Informatics and Head of Health Informatics – University of Central Lancashire) but she was on a train with delays at Bletchley. Therefore Bruce Elliot took over those duties, and started with an intro to the NHS Faculty of Health Informatics, and set out the aims for the day and dealt with practical issues.

The first presentation by Rowan Purdy ( ex Head of Knowledge Services – Care Service Improvement Partnership and now Senior consultant, Surepoint) covered "An overview of current Social Networking tools and predictions for the future". He started with hands up on a roller coaster for who had IT & used it to social networking (at work). He gave the definition of social networking from Wikipedia and talked about some of the ways in which people use the characteristic tools. He talked about the bottom up v top down approaches both online and off line. He looked at feeling oppressed by their email & advocated RSS readers as a way to manage this. He moved on to talk about blogs as personal and corporate voices, and then moved on to instant messaging for immediacy and emotion. He talked about Skype and video conferencing tools. He then gave an overview of wikis for collaborative editing for agenda, papers etc. and how house style and peer review emerges. He mentioned clear forest which tries to extract meaning from content and talked about how the various tools link together. Social tagging as a way of adding labels & keywords to create tag clouds and social bookmarking eg delicious was presented as another social networking tool. Social libraries eg librarious and Youtube and other media sharing eg flikr were discussed along with MySpace, Facebook & LinkedIn (I gave trying to link to them all live at this point).

He then talked to tools for social networking in the NHS eg NHS networks, Knowledge community, & CISP developments. He then talked about how some of these tools could be used within NHS organisations to produce a layer of loosely connected social tools. He highlighted the importance of the culture and passion rather than technology & mentioned the importance of leadership & behaviours. He got out his crystal ball to look at the future Web2.0 & Web3.0 providing more power to people to reuse content eg Yahoopies, QEDwiki, adding the personal touch & customisation eg BBC site. Second Life & its application to real work looked at potential applications for the future. The cabinet office was given as a potential example iterative policy documents. His final points were that technology is not key but that people being willing to take risks are the way to take small steps to help each other move forward. His gave the attribution for his photos etc and encouraged others to do the same otherwise people will stop sharing. The Q&A started with discussion of inclusion, IT literacy, access etc etc. Rowan suggested that some social tools eg Flikr are a way for getting those with less IT skills switched on to IT use, through the element of fun. The risk of the multiplicity of tools can reduce communication rather than improve it came up as a question & this raise issues of "smartness" & "interoperability" & building onto & connecting with others. The generational issues were also highlighted - and in came the words "control" by the organisation.

The power and the potential of the patient’s voice in transforming Health services – the experience of Patient Opinion – Paul Hodgkin (GP and Chief Executive – Patient Opinion) He started by highlighting the importance of recognising the things that are importance for individuals. He looked at what is driving social networking
*Economics of voice
*Economics of collaboration
*Economics of reputation

He used examples of photos from Flikr clearly describing patients experiences and rateMDs and similar sites. The freedom of speech issues and payment by advertising were seen as increasing the rankourous nature. He also talked about patient opinion & how they are checked & 5% edited & add tags. He also highlighted how the comments can be used to change practice. Collectivised wisdom as a social benefit and the importance in getting the tone right in web based responses - so it doesn't look like a whitewash. The issues of access and IT use in the elderly were addressed with phone and paper alternatives described. The profile of responders was discussed but not claimed to be representative but covers all almost all NHS services. He talk about how postings can be directed to the right managers and other key interested players via email alerts. The comments are rated so that you can filer the types of comments you want to see, and various reports are generated. It was funded by the DoH & is now funded by small subscriptions from Trusts etc & the benefits of this were highlighted. He moved on to talk about NHS choices - Your thoughts & the importance of independence and the value base and the similarities and differences between the different approaches. He talked about the advantages & disadvantages of surveys, user groups etc and the underlying business models. He described some of the lessons learned from the Patient Opinion experience and the advantages and highlighted some of the difficulties to achieve adaptation and use by public services - its about conversation not about data - not representative but useful. He took a Q&A session about Patient opinion which discussed identities, & how the data could inform reviews of the NHS & links to public health depts. Looking at the Return on Investment in terms of improvements compared to investment & whether this data was available + getting subscriptions out of hospitals and PCTs, SHAs, DoH etc.

A break was them negotiated, before Paul continued to talk about the cost of collaboration based on Clay Shirky's book. Examples given included pledgebank, and suggested how this can be used to recruit people for campaigns etc at low cost for people who feel isolated which can be benign or malign. He looked at the public policy on choice based on exit or voice & how exit has been the main way in which choice has been expressed - but how we are likely to move towards voice. He moved on to the economics of reputation and gift economies. value no longer resides in scarcity in the digital economy and non financial incentives. Work satisfaction is related to autonomy - linked to NHS culture. He suggested using the sort of things that ebay does to rank sellers could be used to rate GPs, outpatients depts & consultants, based on end user satisfaction not process. Q&A discussed issues around doctors being willing to rate each other, and the tensions between localness and general access. Also discussion were raised around private v public comments. Patientslikeme was discussed as a possible way forward.

The next presentation was about Experiences in the power and the perils of the use of Social Networking tools by Healthcare Staff and in Higher Education by me. The presentation will be added here later.

A summary of research on the power of Staff, Patient and other blogs et al in influencing change in Health and across the Public Sector was to have been given by – Steve Moore (Director and Co-founder of Policy Unplugged) but he was unable to attend.

Using shared experiences: the future of social networking in the NHS Helen Nicol (Programme Manager – Capability & Capacity – NHS Connecting for Health and author of the "The Business of Knowing" blog). She described herself as interested in the way technology can enable learning and the interface between online and face to face. She talked about the conversational web and how the wisdom of the mases has a lot to offer in knowledge generation. She drew a parallel between the power of computer networks and networks of people. Her presentation was in two parts, one from the consumer perspective and the other from the organisational. She emphasised the points made earlier about people trusting user generated rather than professional advice and the useful "anonymity" of the web to investigate personal issues. The move to niche sites and applications for people with particular diseases or conditions was discussed, along with attitudes to institutions and conformity. The need for a recognition that there is more gray than black and white was highlighted. The expert patient approach and the qualitative components of interactions were seen as being key. Helen discussed espace and some of the issues which surround the "institution" and peoples willingness to "open up". The facebook group "Escape from NHS Connecting for Health" even got a mention, before moving on to look at appropriate business models. Helen then moved on from patients to the organisation and learning from experience. She raised questions about whether "communities of practice" can be engineered. Sermo was given as an example of the doctors lounge personified. Information arbitrage was then discussed as the model for pharmaceutical companies to gather data from communities of experts. The difficulties of creating communities either online or off line was explored with examples from espace. The demise of NHSnetworks was given as an example of the difficulties and OpenID and similar systems to integrate the disparate systems well suggested as the way of the future, and some suggestions for the NHS were put forward. Q&A touched on espace & whether it has a clear purpose.

The new report from Demos – "The Talking Cure: Why Conversation is the Future of Healthcare" was suggested as good reading.

The general discussion "What should be done in order to maximise the power and potential of Social Networking tools within the NHS and minimise risks?" was later than planned and occurred with final tea & coffee. The elephant in the room of "can you create a social network" was raised & the possible need for a "manager" was also raised. The importance of sharing between the different countries in the UK was highlighted.

Key messages were about trying things out and if its not working try something else. Support the mavericks & don't let them leave.

The place and ownership of social networking in the NHS raised problems & will be included in the final report which is being created as a wiki led by Rowan & the link to it will be placed here when available.

Delegates left for journeys home - with potential problems if they are getting trains up the west coast main line.

Members of eSpace and the NHS Faculty of Health Informatics can view copies of the presentations at:

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Tuesday, May 13, 2008

NPR and Social Media Presentation

This came from another group here at Vanderbilt Uuniversity ("Spiders"). Think those interested in the topic will enjoy the presentation (it's an online web presentation what are being called Web 2.0 social media issues).

From: on behalf of Melanie Moran
Sent: Tue 5/13/2008 1:45 PM
To: Vanderbilt Webspiders
Subject: Good presentation on social networking and education

Hi Spiders,

I wanted to share this presentation I saw at a conference last month in Baltimore by Andy Carvin, who is heading up NPR's social media efforts. Good general discussion and some nice historical references as well.


Web 2.0 has come up as a potential meeting topic for Spiders - please send 2.0 topics / ideas that you are particularly interested or have unique experience with and I will line up some speakers (maybe you!)

Melanie Moran
Assistant Director
Vanderbilt News Service
(615) 322-7970 office

Watch Vanderbilt:

NHS-HE Forum Meeting

Today (Weds 14th May) I'm attending a meeting of the NHS-HE Forum, which aims to "Co-ordinate and support network connectivity between the NHS and Universities involved with education and research in medicine, nursing and professions allied to medicine", at the Royal Society of Arts in London. Having cracked into the wireless network here I will try to give a flavour of the meetingas it goes along.

The meeting is being chaired by Professor Roland Rosner (Director, Education & Information Support Division (EISD) at UCL) who founded the forum in 2001.

The first speaker is Brian Derry (Leeds Teaching Hospitals NHS Trust & also chair of ASSIST) discussing the Swindells Health Informatics Review
Tricky position related to what he could share as now working on implementing the review - some speculation, some reasoning - but no inside knowledge. He described the current policy context of the Darzi review, free choice & informed patient, plurality & multi-provider etc. The NHS operating framework, including emergency preparedness as a guide to current priorities was highlighted - performance indicators, now being vital signs (about 120) with gaps between inputs and outputs. He highlighted the importance of information as adding value and the risks of measuring the wrong things. Quote - "ad hoc data collection produces ad hoc data quality" - linked to quality of information for payments & the importance of data assurance and audit. NHS systems are out of date & need to be patient centered rather than organisation centered. He moved on to look at the care records service (underpinned by ruthless standards) and accessible by patients, with some of the security and confidentiality issues and standardisation. He then moved on to the tensions between policy and IT. The comfort of clinicians with IT is a safety issue. He argued that complying with patient requests not to store patient information was unsafe. He then moved on to talk about the secondary uses service (a sophisticated bucket) with issues not of scope creep but of scope gallop. "Quote information as a weapon". He used part of the advert for the Chief Information Officer to highlight the importance of information in the future NHS and the importance of professionalism in Information Management, and joining up the different agencies. The capacity & capability issues, CPD & HI workforce development strategy were highlighted as future issues. He believes this will change the landscape when the report is published "in the next couple of months". The Q&A included a comparison with the last few years & the need for clinically based information. The potential for different systems in different places and the effect on staff. The differences between primary care and secondary care (& other settings) and the human interface & the lack of "logical" processes in the patient interaction were described as challenges in bringing hospital systems up to the current level of primary care.

The next presentation is about the Connecting for Health Research Capability Programme by Prof Sir Alex Markham. This new NHS Connecting for Health programme aims to develop the capability of NHS IT Systems to enable research and analysis aimed at improving the quality and safety of care. It is taking forward the recommendations of a report by the UK Clinical Research Collaboration (UKCRC) Advisory Group to NHS Connecting for Health. He talked about the difficulties of achieving things in the complex environment previously described. He talked about the policy context for research around NIHR etc all of which recognised the importance of information and the drivers for the NPfIT & CfH in the research landscape. He wants to change the names of "Secondary Uses Service" (SUS)/ Information Centre (research is not secondary), "Honest Broker" (rest is "dishonest"), "safe havens" (rest unsafe) etc...
The aims are to provide access to data for research with all the issues around annonymisation, developing data sources & dissemination. Demands from pharmaceutical companies & clinical trials etc - highlighted issues around "consent to consent" & patient confidence in clinicians and researchers. Post marketing surveillance through data systems may enable earlier licencing.
The "enabling phase" finishes in June 2008 & he outlined the key deliverables under 6 work streams. He is hoping for sign off so that it can be sent to the treasury for funding for next year. He highlighted further challenges & asked for evryone interested to "engage". Q&A discussed effects of "data losses" on the work. He avoided questions about commercial involvement eg DR Foster & SUS, but said he was not opposed in principle to commercial involvement. The dissemination of knowledge & inclusion of other databases - led to the questioner being volunteered to address some of the work.

Bob Day from JANET, UK is next up with an update on the N3 - JANET Gateway with Marshall Dozier, from the University of Edinburgh talking about their early adopter work, which has now been running for 6 months. Issues of information governance in the NHS are being addressed and more time is needed for further trails and needs to be widened from England to the rest of the UK. Public Sector Networks may provide a better approach that JANET being a customer of N3. Malcolm Teague described the national context and the need for a strategic solution which is better than the Internet, providing a 100Mbps interconnection through the firewall. The Statement of Compliance (SoC) approach was seen as being better that the old Code of Connection limitations. The technical infrastructure and initial partners were described along with some of the "coming soon" developments including video conferencing. Questions about encrypting mail to & from the NHS caused discussion & a future agenda item. Marshall Dozier talked about the Edinburgh early adopter - as an embryo inside an egg - chipping away in the background. They are working on improving access to VLEs (including WebCT), video conferencing & access to other resources eg library resources, ejournals, ebooks & data sources. Astonishing number of IP addresses, proxy server & firewall issues. The Athens - Shibbolith debate caused some delays but helped to think in a more scaleable way - and will hopefully help staff in NHS settings who are also students in HE, better access to resources. Questions were about how the learning from the gateway early adopters could be shared more widely. Future issues around Academic Health Care Centres were also raised.

An Update from Northern Ireland by Helen Jenkins, of Queens University Belfast was moved before lunch. She dsecribed the context with a unified health and social care (HSC) system. The university library is also contracted to provide services to the HSC staff. She described issues around delivery via the internet of resources, elearning, teaching & research. The ICT structure wasn't up to the task with very few internet access points & low bandwidth & poor resiliance. The restrictive policies limited access to many useful resources & IT services didn't think used for work & a bit paranoid. Each trust had different It architectures & policies - therefore formed a forum to try to address the issues around the infrastructure & skills & need for strategic emphasis. User needs were unquantified. More recent developments have led to a ICT strategy & better communication between the parties, even if that didn't overcome the funding issues.

Supporting e-learning for the NHS is the subject for the after lunch presentation by Phil Candy, (Director of ETD, Connecting for Health. ) He suggested two key propositions. 1) sucess of NPfIT depends on users learning what the applications do. 2) ETD inCfH is a key player. The context includes the dti, hefce, EU, SCIE, dfes policy etc Modernising Healthcare Training in the NHS & ETD Discussion paper for a national Learning Management System. He outlined the CfH ETD vision & highlighted some of the issues. He highlighted some of the redundancy and duplication of effort in elearning materials. The match of just in time learning might function with just in time learning. He presented a (well worn) rationale for the use of elearning. Some specific projects were described the national repository (see NHS and Social Care E-learning Resources Database), and the TRAMS project which has 5 % of the live environment with fake pateinst & issues integrating this with the frnt ends that users will be seeing. The integration of the national learning management system with the Electronic Staff Record (ESR) (DH not CfH) (Oracle Learning Management (OLM) platform & another solution for those outside the ESR. He also mentioned the move from ECDL (taken by 225,000 & completed by 30,000) to ELITE (Elearning IT Essentials). The discussed the different "levels of maturity" for elearning amongst NHS Trusts & SHAs. In the meantime he advocated the ICCA Toolkit. He suggested we are on an interesting journey & that there are interesting times ahead. Q&A addressed interoperability, the move from ECDL to ELITE.

A quick update by Angie Clark, on behalf of Peter Hill, on the National Review of NHS Library Services. She highlighted some of the headlines & how the work is to be taken into account in the Darzi Report & getting knowledge & Library services into the core of the NHS. Suggestions are that Chief Knowledge Officers should be identified in SHAs & Trusts. More discussion is neede between the role of Cheif Information Officer and Chief Knowledge Office. There are also proposals for "team knowledge officers". Training to get the evidence into the practice agenda was also seen as a vital step for the future. The challenge of changing the culture of all NHS staff was key.

This was followed by a talk on NHS Library Services and the UK Access Management Federation with a talk by Ian McKinnell, of the National Library for Health. The current situation with Eduserve/Athens which NHS England has a 5 year contract with to manage access authentication with local managers. The last tender rejected proposals to use CfH authentication systems and stayed with Athens while work continues to arrive at an Open Standrads solution. The national content eligability contract was described with now includes health students in HE. Future work to open standards was highlighted to achieve one agreement across HE & the NHS.

The final talk on the agenda is an Update on Content Issues by Betsy Anagnostelis, Royal Free/UCL on behalf of Dr Paul Ayris. It described the work of the NHS/HE content group for joint procurement which have so far failed over lack of agreement over content & payment & differences in financial years. They are considering a licence which embraces both NHS & HE was a deliverable. Other work is around open access repositories for funded research eg UKPubMedCentral. The work is informed by the SHERPA project. There is high interest in looking at the copyright issues between NHS & HE for the same individuals. The NHS CLA licence is being renegotiated and may address some of the issues, alongside the JISC model agreement which may help provide reciprocal resources between the NHS & HE. The results of the Peter Hill review of NHS Library services will influence future work. Questions were about alternative (Scottish) models and the justification (Value for Money) for joint agreements.

The day finished with thanks to Professor Roland Rosner who is retiring from his post as Director, Education & Information Support Division (EISD) at UCL, but it is hoped he will find a way to continue his leadership of the forum.

Overall it was an interesting day with a busy and varied agenda and general discussions showed the wealth of expertise and experience in the audience, who were willing to share their knowledge and ideas to improve the situation for thousands of users.

The powerpoint presentations from this meeting are now available at the NHS-HE Forum 14th May.

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Free healthcare information by mobile phone

This is a link to an article about a project in Africa on using mobile
phones for toll-free health information and medical emergency calls. Here
is the link:

New book on the history of UK Health Computing

A new book has been published this week about the history of health computing in the UK.

UK Health Computing: Recollections and Reflections edited by Glyn Hayes and Denise Barnett has been published by the British Computer Society to bring together information on some of the key people and events over the last forty plus years.

It is published at £29.95 with a five pind dscount for BCS members.

The book is available from Amazon.

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Monday, May 12, 2008

Contagious Media

My purpose in writing this is to promote I believe could be an arm of Nurse Informatics expertise in the near future: social and contagious media. Up front I'd like to ask those in the positions of leadership to consider a conference part, or in whole, dedicated to exploring this.

I was very pleased to see that many others promoted "The Wisdom of Patients: Health Care Meets Online Social Media" (, as it has been an area I've been most interested in for a long time now. It has been my hope in going into Nursing Informatics to promote the value of it in patient education and support. [Note: I joined, a social network, to connect to Jane Sarasohn-Kahn regularly. It's one venue for learning about the medium and connecting to others "socially" and professionally.]

My most recent readings have focused on online support groups, investigating their characteristics, requirements, qualities, and overall value. The number one thing I've learned is that patients will turn away from providers without adequate support, and rely instead on poor information from their peers. To address that, Nursing Informaticists could have an expanded or niche role in providing online education and support to healthcare consumers. Education is in the nursing domain.

Consider watching the following viral video. While watching it, please consider what age group is most likely to benefit from it? What age group is most likely to forward it to friends? What group is most affected by the issues in the video? Finally, what group would benefit from "contagiously" sharing this video, based on the lure of age-specific, apparently crude humor with their friends? Think of the power of the internet in that millions of people across various avenues have forward this video in one format or another to each other and, ultimately, gotten the healthcare message.

I apologize in advance if it offends anyone, but I hope you'll see the potential in other areas, and get the idea of how to mold contagious media to other health education endeavors. (It comes with a click to say you're over 18 disclaimer to watch.) (Note: This website is one of many social networks spreading this video.)

Having watched it, think of what other diseases and treatments and health issues you could come up with videos for. What age-appropriate material could you see causing someone to want to forward such a video? As Nurses, education is within our domain, and this technology could really be a specialty for us as NIs, and one might consider it a "professional responsibility."

For my undergrad in IT, I did my senior thesis on a facet of social networks: contagious media, which is a subset of viral networks. The final version took over 50 megs and included videos and such. It was a fun, contagious product itself!

Thanks for listening, and considering. I hope I haven't been gauche and that you'll see the value in these tools, and potential in NI to develop their for the betterment of our patients.

Richard Aries, BS, RN

Student, Master of Science in Nursing (Nursing Informatics)
School of Nursing, Vanderbilt University

For more information about the Vanderbilt University School of Nursing MSN-Nursing Informatics curriculum, please visit:

Tuesday, May 06, 2008

Report of Evaluation of Summary Care Record Early Adopter Programme

An interesting report has been published today into the evaluation of the Summary Care Record (SCR) Early Adopter Programme. It highlights many of the difficulties which have been encountered and makes recommendations to improve for the future.

The evaluation team led by Trisha Greenhalgh at University College London discusses criticisms of the programme focusing on "implementing a technology rather than a broader and more developmental focus on socio-technical change". They also make comment about the ethical and moral considerations inherent in the "current ‘hybrid’ consent model for the SCR, which is widely seen as overly complex and unworkable (and which many GPs and Caldicott Guardians see as unethical), and consider alternative models, notably ‘consent to view’, that have been shown to be acceptable and successful in comparable programmes" in Scotland and Wales. This was despite the fact that few of the patients in the pilot area reported strong feelings about whether they had a SCR and low levels of "opt out".

The report also criticises an "outdated model of change – centrally driven, project oriented, rationalistic, with a focus on documentation and reporting, and oriented to predefined, inflexible goals", and argues for "more contemporary models of change (which are programme-oriented and built around theories of sensemaking, co-evolution and knowledge creation) include soft systems methodology, technology use mediation and situated action".

The full (138 page) report is available from, and although I've only read the executive summary so far I think it should be compulsory reading for anyone involved in electronic health records.

Further commentary and discussion is taking place on the E-Health Insider site under Urgent review of SCR consent model recommended and elsewhere. It will be interesting to see if the lessons learned will be put into practice.

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New Directions in Health Informatics Education

Special Issue of UKHIT - New Directions in Health Informatics Education

The latest issue of UKHIT (UK Health Informatics today) is now available online (Spring 2008. No 56)

This 20 page issue deals with the challenges, opportunities and risks associated with elearning. There are articles describing the philosophy and curriculum of programmes in the UK and the USA.

Jeannette Murphy

Friday, May 02, 2008

Trust Driving People to Web Social Networks for Health Info

Recently Jane Sarasohn-Kahn wrote a report and article on Social media on the Internet are empowering, engaging, and educating health care consumers and providers. IMHO, I thought it was most important article written in 2008, I was wrong, her most current article, Trust Driving People to Web Social Networks for Health Info, is even more important... You can read her most current article...

Or go to her blog at or e-mail her at

Thursday, May 01, 2008

RCN vacancy for e-Health Nurse Adviser

The Royal College of Nursing (RCN) has today advertised for an e-Health Nurse Adviser.

The advert says "This is an opportunity to influence policy and practice in the area of e- Health and to support and engage nursing staff in it. You will participate in UK government and international initiatives and build the RCN’s profile in relation to e-Health issues."

Further details & application form can be obtained by putting in the reference number: NU0210/0508 at

I will be interested to see who is appointed to this role and whether this changes the RCNs position or actions on e-Health.

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