Just a couple of weeks ago we launched a new service at the Hospital for Tropical Diseases in London to help the doctors and nurses who run their Emergency Walk-In Clinic. At the clinic, travellers who have returned from the tropics and are acutely unwell turn up without requiring an appointment to get treated by specialists in tropical diseases. The service tracks patients on their journey through the clinic, from initial triage to following up on lab results that arrive after they’ve left.

We worked closely with the staff who run the clinic, making sure that we met the different needs of different types of user - in this case admin staff, the nursing staff, doctors, as well as the service managers who wanted data on what activity was happening. Just like we do with all of our services, we brought them into our agile development process as we iteratively developed the service based on research and their feedback.

Clinical digital services too often fail to take into account the experiences of the people on the ground who have to use them in practice. At Open Health Care we don’t think that’s acceptable for something as important as delivering health care.

Because of that we will continue to regularly meet with users of the service to conduct usability testing and actively seek feedback so that we can continuously improve the service. That feedback loop needs to be a part of the ongoing operation of digital products and services in hospitals - not just something that happens as part of an initial design phase - and we’ve seen before just how useful it can be as we’ve been able to respond to changing user needs and changes to the context and processes that surround users experiences of our services.

Use data to design services.
It makes things better

One of the key goals of the project was to allow the team at HTD to gather high quality data about the cohort of patients that they treat. This data is hugely valuable, both academically for research purposes, and because it enables the team to understand their workload.

When the tools that are used for routine day-to-day clinical care don’t collect usable data, the cost of analysing what you’ve been doing become huge. With the new Walk-in service however, all of the information that the institution knows about a patient, from demographics to observations, travel history to treatment, gets stored as high quality structured data.

That means that anyone can get an accurate answer to a question like “How many patients did we see with Dengue fever in the last year” in seconds, rather than it taking hours or days of painstaking work reviewing case notes, or manually curating and maintaining their own databases.

We’re excited about the possibilities for service redesign and research that this new capability has opened up for the team, and we’ve already been brainstorming ideas - so watch this space!

How it all came together

The service was built as a plugin for OPAL - our open source framework for building high quality digital services in a clinical setting, and is deployed as part of elCID - an existing service that we run for UCLH to manage patients with infection.

We love delivering high quality digital services for doctors. If you’d like to explore how we might be able to help you out at your institution, get in touch - we’re always keen to meet people with interesting problems to solve as we try and make sure that the digital services that clinical staff in the NHS use in their day jobs is as good as the services they use in their personal lives.

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UK Health Camp - it’s happening.

Some great things have happened to digital in the NHS over the last few years - and we’re excited to have played a part in it. We’ve seen a wonderful community blossom around NHS Hack Day - catalysed by their desire to make NHS IT less bad. We’ve seen high quality, user needs focussed, open source clinical facing digital services launch in an increasing number of NHS trusts. We’ve seen open data used to demonstrate huge potential cost savings to the NHS - helping to reinforce the commitment to transparency and openness throughout the system.

And those are just the pieces that we’ve been involved with - there are so many more happening all through the NHS.

One of the great strengths of the NHS is its decentralization - although it’s a public sector institution, much decision making is devolved to a local level - which means that you see pockets of innovation springing up all around the country as its remarkable staff strive to deliver better services to patients. The downside of decentralization is that sometimes those innovations and best practices don’t spread as quickly as we’d like - which is how we end up with variation in services.

We believe that local excellence is not good enough - we need scalable excellence if we’re to deliver digital services in health care that are fit for purpose in the twenty first century.

Which is why we’ve been working with a super team of friends from across the health system to create a space to help connect people doing great work in this space with people who understand that we need to do better, faster, wider. A space to connect, share ideas and make things happen.

That space is UK Health Camp.

UK Health Camp is a free unconference for everyone interested in digital, design, technology and data for health and care. It’s happening in London on the 28th November, and it’s going to be the most exciting conversation around for people who want to understand how we can deliver better services to patients by using better digital, better data and better design.

We haven’t released tickets just yet, but we expect them to go fast when we do release them - so sign up to the mailing list to get notified when they do become available.

We look forward to seeing you there!

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We’re delighted to announce that NHS Hack Day is coming to Manchester on the 12-13 September. This is the first time we’ve taken the event to Manchester, and we’re all very excited to be doing so with the help of the super Marcus Baw!

NHS Hack Days are weekend events that bring together “geeks who love the NHS” to have fun, build community, and work on digital projects that promote health.

The format is that we begin on a saturday morning with people pitching real-world problems they’ve encountered in the NHS or in health care generally. Anyone can pitch. We end on Sunday afternoon with a competition for the best solutions made over the weekend. In between people pick projects to work on, work on them, and have lunch (provided).

Previous NHS Hack Days have looked something like this:

Do check out some of the projects that have come fom the event and read our summary of the previous NHS Hack Day

Why should I come to NHS Hack Day?

You’ll meet bright people from different disciplines you wouldn’t usually meet You’ll play a part in making NHS IT less bad You’ll have fun

We especially want people who aren’t sure if this is for them to come, a lot of the value of the event comes from the diversity of the participants, we need you! Imposters are welcome

How do I get involved?

• By attending the event, tickets will be released this evening from www.nhshackday.com
• By sponsoring the event - email hello@openhealthcare.org.uk
• By becoming part of our community - joining the mailing list, coming to pre event meet ups or talking to us on Twitter
• By spreading the word, tell your friends!

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This post is the prose form of a workshop we recently ran at the Department for Business, Innovation and Skills about hack days.

So, you want to run a hack day?

A hack day is an event in which domain experts with user needs collaborate with people who have skills in delivering digital products and services including developers, designers, user researchers and product specialists. Hack days typically last between a day and a week. Some hack days are intended simply for educational or social purposes, although in many cases the goal is to create usable software.

Hack days are a great way to get multidisciplinary teams working together to create creative tangible solutions to real world problems.

Why are you doing this?

The first thing you’ll need to figure out is why you’re running a hack day.

There are broadly five reasons people run hack days.

1. To build community
2. To educate people
3. To get focussed fast paced R&D
4. For PR
5. er hack days are cool, what do you mean why?

You should make sure you have a clear answer to why you’re doing this before you start running a hack day - because this maximises the likelihood that you and your attendees will have a great time and get lots of value from the event.

For instance, with NHS Hack Day - the events that we run around the country for “Geeks who love the NHS” - we have a few reasons. We’re aiming to:

1. Build community and friendships between members of the clinical and technology sectors
2. Show front line clinical staff just how good Digital Services can be, empowering them to demand better from their institutions when they go back to work
3. Showcase Open Source, Open Governance, and the power of collaborating in small heterogeneous teams of domain experts.

That’s reasons 1, 2 and a little bit of 4.

You might be looking to build the cross-disciplinary skills of your teams, introducing people to Digital ways of working, thinking and approaching problems, you might be looking to provide concrete examples of products and services aligned with your policy goals - understanding that showing is more powerful than telling. Whatever your reason is, make sure you can explain it clearly so that you remain focussed on that throughout.

What do you need to do?

So, you want to run a hack day ?

Great!

There are lots of documents out there that will take you through the low level details, we’re not going to go through those again in detail, but you basically need to put five things in a room:

1. User needs
2. Wifi
3. Power
4. Coffee
5. Technologists who know how to deliver Digital

Start with needs

The value that comes from the event is directly related to the quality of the ideas for projects that are in the room. The best hack day projects address specific real world user needs. It’s well worth thinking about these before the event, and seeking feedback from others - particularly from people who’ve attended hack days before.

With NHS Hack Day, we encourage people to discuss their ideas on our mailing list, on Twitter, and in person at meetups so that we can help people come with well formed ideas that inspire our attendees. For more focussed commercial hack days we work with people to frame and present their ideas in such a way that they work well within the context of a hack day.

Basic logistics

Hack days have some slightly special logistical requirements of the room that you’re going to be in. The most frequent problem is that the Wifi isn’t good enough. As the Hack Day Manifesto says:

Don’t just trust anyone who tells you that “it’ll be fine”. People from the venue or their commercial partner will tell you all sorts of things you want to hear but keep in the back of your mind that they may not have any clue what they are talking about.

In addition to this, you’ll also have lots of people wanting to plug in their laptops, so try to make sure that there is good access to power points. Providing tea, coffee and other beverages as well as lunch and breakfast is always appreciated by attendees, as are easily accessible whiteboards, flip charts, post-its & sharpies.

Making your ideas a reality

At the end of your hack day, you’ll have a wrap up session where everyone presents what they’ve been working on. There will be lots of excitement and energy in the room, you may even have judges and prizes! If all has gone well, several prototypes of new Digital products or services will exist that didn’t at the start of the day.

If your aim was to build community and educate people, then you should already have gone a long way to meeting your goals! Sometimes though, you will want to find a way to take promising projects forwards and make them genuine products or services.

If you’re looking to do this, then it’s worth thinking about that path before the event. This might involve providing investment or support for teams who want to go forward with their idea, promising people time to work on their project, or giving projects marketing and promotion. The details are often dependent on who you are, and what kinds of user needs you’re looking to meet.

Still want some more help?

If you’re still unsure about how to run your hack day, Open Health Care UK provide strategic and logistical support to organisations in healthcare and the wider public sector looking to run great events - so drop us a line at hello@openhealthcare.org.uk to see how we can help.

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For the past couple of years, Open Health Care has been working in collaboration with UCLH and the Hospital for Tropical Diseases on elCID (the electronic Clinical Infection Database) - an Open Source clinical Digital service for managing inpatients and outpatients with infections.

elCID solves two key clinical problems - first it provides an interface for recording day-to-day clinical care. We’ve developed this interface in close collaboration with clinicians with a strong focus on usability, using user centred design techniques, and frequent iterations, to make sure that we meet the real needs of our users.

Second, elCID captures structured data about clinical activity, and features advanced interrogation and extract capabilities. This enables data driven feedback loops in the design of clinical services, by enabling high quality audits to be conducted much faster than was ever possible before.

Working with some of the academics who’ve been instrumental in developing the project, we recently published an analysis of the early findings from this process in the Journal of Infection.

As the paper outlines:

elCID brings together disparate silos of clinical data collection into a single, rapidly searchable database resource permitting unprecedented interrogation of our clinical practice.
However, the benefits of the system go further, having vastly improved the quality and transparency of communication between the Division’s teams, audits of day-to-day clinical practice are now rapidly and routinely performed using high quality prospectively collected data, and research study data collection can be conducted within the main database, facilitating improved integration of the clinical and academic arms of the Division.

elCID is an Open Source, Open Governance project built on the Open Source OPAL framework. It is available to infection services and comes with full support and customisation from Open Health Care. You can find out more information about the software on the elCID website.

If you’re interested in seeing how elCID might help at your organisation, or if you’d like a copy of the full paper, don’t hesitate to drop us a line at hello@openhealthcare.org.uk

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