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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