Alison Longwill

Nov 272014
 

Your action IS required.

Passing on the request from Dr Marcus Baw

I've mentioned this on the list before, but there is an area on StackExchange where suggestions are accepted for new areas. A Healthcare IT section has been suggested but the first time it did not get enough votes to become an official Beta.

This time, we have a limited opportunity to get it voted up enough it will be created.

This is a potentially helpful resource for discussing the technical aspects of healthcare IT and I think would overall benefit the NHSHD community. Could I therefore ask you ALL to take the 30 seconds to go to this site, login or create an account, and vote for the Healthcare IT Forum.

Of course, if you already know everything there is to know about Apple HealthKit, FHIR, HL7, SNOMED-CT, Read Codes, CTV3, openEHR, IHE, CE marking of medical devices, medical UX, etc, then you personally have no need of it - although I'd still like you to vote because we'd need a place to ask you questions 😉

Sep 192014
 

NHS England hosted the HANDI-HOPD Summit in London on the 18th September. This was attended by an invited audience of around 40 people to discuss plans to take the HANDI-HOPD platform forward to the NHS England Open Source Open Day on the 26th of November in Newcastle-Upon-Tyne where is will be launched as the Platform for NHS Code4Health.

HANDI-HOPD The HANDI Open Platform Demonstrator provides an experimental platform to demonstrate the power of emerging open standards and APIs to deliver the transformational power of the Internet to support digital health and care.

Ewan Davis introduced the HOPD, described where it fitted in the global development of open health platforms what had already been deployed and our plans for it's development.

Dr Ian McNicoll, gave an overview of how the platform worked and a description of the key open standards and how the could be used by developers to rapidly build interoperable health and care software. He also described how the platform provided a rigorous process fro the development, curation and publication of clinical content models and facilitated the easy engagement of clinicians in the process.

 

 

 

 

 

 

 

Sep 172014
 

OPENeP has selected the HANDI-HOPD to built its initial prototype app. It will provide further proof of concept and is the most ambitious project to be attempted on HANDI-HOPD so far.

OPENeP is an open source project intended to deliver a suite of medicines management apps to improve the safety and efficiency of prescribing and medicines management and demonstrate how new business models can create commercial opportunities for vendors focussed on delivering high quality service.

Medication errors and one of the biggest single cause of harm to patients in NHS Hospitals, causing death, disability and suffering and represent a significant cost to the NHS with wider negative economic impacts.  Many errors are amenable to mitigation through the application of digital technology and OPENeP is intended to help address these problems.

There are already a number of digital tools that support various aspects of the medicines management process, most are proprietary products and many of these are of good quality, but they are not designed to fit in the emerging open digital health ecosystem or take advantage of the latest technology.

OPENeP is intended to  explore how we build apps for the emerging digital ecosystem and  to enhance, not replace, existing EHR and Pharmacy systems and create new opportunities for vendors of such systems, who we hope might  include these components to enhance their existing product and service offerings. OPENeP apps  will be designed to facilitate integration with PAS, EHR, order communication and  pharmacy systems as well as proprietary  knowledge and decision support components.

The starting point for OPENeP will be the ePrescribing and Medicines Administration modules of  Think!Med Clinical which its creators Marand have agreed to release under the GPL open source licence. This product which is based on OpenEHR provides a proven solution using the latest technology  already successfully deployed in a large hospital and gives us a great starting point for our work. Our aim is to develop this to provide the suite of apps described below which will initially be deployable via a common interface (API) as either the eP/eMA component of a OpenMaxims EHR or as a "standalone" solution which will operate on any OpenEHR backend

The focus of OPENeP is on the hospital inpatient setting, where it is intended to integrate with existing systems and other apps to deliver digital care at the beside. However, it is designed so that it can be extended to deliver facilities in other settings.

The currently identified components of the OPENeP suite are:

  • Medicines reconciliation – With modules for both the patient and healthcare professionals to ensure an accurate view of a patient’s medication at handovers of care.
  • ePrescribing – To help ensure safe, efficient and appropriate prescribing compliant with national guidance and local policies.
  • Medicines Administration – To help ensure safe, accurate and timely medicines administration.
  • Personal Medication Record – To give patients a view of their medication to support self-care, concordance and the safe and effective use of their medication.
  • Medicines Utilisation and Audit – To support pharmacists and others in the review totality of a patient’s medication and monitor and audit medication usage, administration and patient concordance.
  • Medicines supply management  – To support the transfer of orders for medication both for individual patients and for local stock to pharmacies, including support for orders for discharge medication to hospital or community pharmacy.

The Initial focus with be on prescribing and administration and we intend to use HANDI-HOPD to build some initial prototypes. Like everything on HANDI-HOPD these prototypes will be purely experimental and will not be used with real patient data. However, because HANDI-HOPD uses open standards we expect others to take them and deploy them in an operation environment.

Our priority is to create a user interface (UI) that delivers a user experience (UX) that make the apps a joy to use and in doing some makes the processes they support more efficient, easier and safer. To do this we want to bring together domain expertise in medicines management, frontline clinicians and patients with engineers, designers and informaticians working together using user centred design techniques.

In order to operate effectively and efficiently OPENeP apps will need to interoperate with a range of others systems including:

  • GP Systems – To support medicines reconciliation on admission and discharge
  • Patient Administration Systems (PAS)  - To identify and track patients
  • EHR Systems (EHR) – Access the clinical data about patients needed for safe, effective prescribing.
  • Hospital Pharmacy Systems – To manage medication orders and supply
  • Community Pharmacy System – To support delivery of discharge medication in the community.

We will use existing open interface and define new open interfaces where none exist, ideally in collaboration with target system vendors.  The OPENeP apps will be designed to work with FHIR APIs on target systems (with openEHR archetypes mapped to FIHR resource profiles) but we will provide middleware components to allow interworking with APIs based on other standards.

Basic functionality can be implemented without interfaces to most of the above systems, but certain basic EHR data is essential for safe prescribing and OPENeP will provide basic EHR functionality, using openEHR to allow these data to be recorded with within the OPENeP suite when an external EHR data source is not available.

Partners in the project are:

  • NHS England Open Source and e Prescribing Programmes
  • Fivium http://www.fivium.co.uk/ - A mid-sized SME with experience of delivery solutions based on source to Government in the UK and elsewhere including the provision of the system to operate the Pharmacy Benefit Scheme to the Australian Government. http://www.fivium.com.au/health.html
  • First Data Bank http://www.fdbhealth.co.uk/ –The UKs most experienced provider of drug knowledge for use in ePrescribing systems.
  • Neova Health www.neovahealth.co.uk/  – A UK based SME successfully delivering open source solution in the NHS include eObs a nursing observation app which is a natural companion to OPENeP at the bedside.
  • Marand  www.marand-think.com/   – A Slovenian SME that already provides much of the technology for HANDI-HOPD and who have delivered ePrescribing for the Slovenian Health System
  • IMS Maxims - http://www.imsmaxims.com/opensource/ - Original authors of OpenMaxims open source EHR

 

Aug 072014
 

An appreciation of the current situation and identification of requirements.

Prof Mike Martin - KITE (Centre for Knowledge, Innovation, Technology and Enterprise) Newcastle University

The impact of current developments

The stated aim of the Public Services (Social Value) Act 2012 is to strengthen the social enterprise business sector and make the concept of social value more relevant and important in the placement and provision of public services. The context of this initiative is a wider policy to shift service delivery responsibilities from public sector organisations, particularly Local Authorities and to encourage an expanded social enterprise sector, and the private sector, to provide service delivery capacity.

The NHS represents a complex cluster of distinct procuring authorities operating at many different levels from the centralised and outsourced NHS Supply Chain to locally and regionally operating Trusts and the new local CCGs. The act applies to the NHS at all of these levels.

The small scale survey and analysis reported here has been undertaken in the context of local developments in health and social care in a period where the introduction of the Social Value Act, has coincided with the inauguration of CCGs, the introduction of personal budgets in health and social care and the development of social prescribing. In addition to these organisational, legislative and social changes, we have also seen a growth in interest in, and the use of electronic channels, services and devices in delivery and management of caring services providing opportunities for participation in, and coordination of, services at home and in the local community. They have also increasingly been the medium for discussion and debate about these services and the experiences of service users.

The mandates and opportunities of social value commissioning , however, represent only a very minor aspect of the legal, managerial and governance challenges that are being faced by the newly forming CCGs. The first report of the King's Fund and the Nuffield Trust joint project to assess the implementation and impact of CCGs[1], identifies member relationships, the relationship with HNS England and the demarcations of responsibility for the procurement of primary care services, as the major issues and the significant challenges which have been dominating the agendas of the CCGs in their first phase of operation once the challenges of achieving the basic capability and capacity requirements under which they are approved for operation have been met. It is clear that uncertainty and the demands for change that are being experienced in this context mean that any creative response to the opportunities of social value commissioning will, at this stage, be local and fragmentary at best: this is not an issue which is able to command the attention of key players in the CCG arena.

The longer term perspective

If we accept the situation as described above and recognise that now is not an appropriate time to be addressing CCGs collectively and directly about the challenges of Social Value in their commissioning approach, we are then faced with the further question regarding what can be done now to prepare the ground and accelerate the processes by which such innovations could come to fruition as early as possible.

The implementation of a sustainable, social value based approach to commissioning and procurement[2] (SVP) involves a series of conversations between commissioners, potential and active service providers, service users and wider community beneficiaries. There are a number of pre-conditions for such conversations to be possible and fruitful. Some work and investment is required by all the parties to achieve these pre-conditions and to establish the required connections and relationships. All of this implies that work is required to achieve a community based readiness for SVP.

Commissioning Processes

The basic legal constraints of commissioning have not been changed with the Social Value Act. Their dual purposes are to protect the public financial interest and to provide fair access and competition among suppliers. The change implemented by the Act concerns what is allowed to be taken into account, and to which a value can be attached, in the selection between bids. A feature of procurement rules and processes, which is relied upon to achieve this fairness and protection, is the partitioning of the process into strict phases which are defined by the sorts of conversations and information exchanges that are allowed to take place within them and are not allowed between them. This results in four phases:

  1. Pre-procurement: In this phase potential procurers and potential bidders can talk to each other about what might be needed and what could be supplied. Such conversations may be public or may be in confidence but public procurers have the responsibility to demonstrate transparency and fairness and that preferential relationships are not being formed.
  2. Initial Procurement Phase: In this phase, a procurer announces the intent to procure in a particular area of supply and conversations can take place to clarify the needs, specifications and evaluation criteria and processes.
  3. Tendering phase: The procurement document is fixed, tenders are prepared by bidders and submitted within the deadline and are then opened and evaluated. The selection process defined in regulations and in the procurement document is executed to select a supplier and produce a contract.
  4. Delivery phase: The supply processes and relationships of the contract are delivered, reviewed and evaluated. This phase may then merge into phase 1 above as the term of the contract approached.

An important observation which must be made in the context of SVP under the new act is that phase 3 does not change in any way. The only things that can be taken into account in the selection process are the criteria explicitly defined and published in phase 2.

This implies that the precise definition and scoring methods of the Social Value dimensions for each procurement but have been defined and published beforehand: new concepts of social value cannot emerge in the evaluation process.

This factor is critical in the understanding of the pre-conditions required for SVP. If the legal requirements of the public procurement are to be respected while at the same time the creativity and innovation potential and social value are to be realised then both generic (phase 1) and specific (phase2) conversations and debates about what could count as social value and how precisely it will be valued, must be instigated, facilitated and sustained. They must also be informed by the experiences of phase 4.

Two further, related factors then come to the fore regarding these debates and the channels, media and mechanisms that support them. The first of these is participation: the four grouping identified above: commissioners, suppliers, users (carers and the cared for) and third party, community beneficiaries all need a voice and need to demonstrate a willingness to listen in this process. The second factor concerns the aegis, channels and media under which such debates can be conducted and trust in the provenance of the content guaranteed.

As stated in the first section, this survey and analysis has been undertaken in the context of a cluster of developments including personal health and social care budgets. The debate about social value, priorities and outcomes, which is key to both personalisation and localisation, is dominated by, but not limited to, Health. The remit of the CCG, under the current definitions, covers the clinical needs of:

  • Mothers and newborns
  • People with need for support with mental health
  • People with learning disabilities
  • People who need emergency and urgent care
  • People who need routine operations
  • People with long-term conditions
  • People at the end of life
  • People with continuing healthcare needs

All of these groups also have social care needs of one sort or another and these must also be included in the evaluation and decision making about outcomes and priorities if a user centred and joined up approach is to be delivered. In this conversation about priorities and outcomes, the individual and community perspectives as well as the clinical and social perspectives must all be taken into account.

Conclusions

We have observed that the current state of accommodation to significant reorganisation and redistribution of responsibilities in the NHS means that a creative and constructive response to Social Value in service commissioning is unlikely to be high on the present agenda. We have also observed that any longer term approach to developing good practice and sustainable operation in this area requires a wide and on-going engagement in conversations and debates about what count’s individually and locally as social value and individual benefit. Such a debate must be mediated through a variety of media and modes and must be conducted under appropriate aegis. While Local Authorities are designated as “market makers” and “place shapers” in the rhetoric of current policy, they are not well placed to provide the mediation and infrastructure for this wide ranging and multi-agency participation. Similarly, the CCG, Local Commissioning Boards or Senates cannot be expected to deliver this wide ranging remit on their own.

There is, therefore, a need to develop a partnership concept around social value commissioning and multi-agency care which provides a “stake holder engagement service” to the commissioners of personal health and social care services. The precise scope, possible providers and the means and mechanisms for the operationalisation of such a service, which could be defined and jointly commissioned by CCGs and Local Authorities, would require some careful thought, consultation and design.

Jul 302014
 

An opportunity has arisen for software development intern to work with HANDI on the HANDI-HOPD project www.handi-hopd.org

The role will involve developing the platform software, which is already deployed in prototype form, to extend the range of components and content available via the platform and improve the facilities it provides to support health and care professionals and software developers to use the platform to learn how to use open standards based systems to create and curate clinical content and build apps able to participate in the emerging open digital ecosystem in the NHS.

Candidates should have completed at least two years of an undergraduate course in computer science, software engineering or a scientific/mathematical discipline with a strong computing element, have an evidenced expectation of a first class or upper second degree and demonstrable experience of software development in a Internet/Cloud environment with a good working knowledge of Linux and at least two programming languages preferable including either Javascript, Python or Ruby.

We are also interested in hearing from candidates who have completed their first degree and who might be able to pursue HANDI HOPD as part time as an element of study for a higher degree.

Candidates should have some knowledge of the health and care sector and a desire to pursue a career in digital healthcare or healthcare informatics.

The initial engagement would be for approximately 3 months and there is the possibility of an extension beyond this for candidates in a position to offer a longer commitment.

Location would be Central London or Central Birmingham (to be agreed) and payment would be between £12.5k and £25k pa depending on qualification, experience and length of commitment offered (the lower rate would apply to a short term undergraduate internship.)

Candidates MUST be able to start immediately and have substantially unrestricted availability over the summer period.

Interested candidates should send a CV and covering email to jobs@handihealth.org – All applications will be acknowledged and we will also endeavour to answer any questions you may have via this email.

Closing Date – Due  to our desire to make an appointment quickly we will process applications on receipt and close applications once we have a pool of suitable candidates.  Applications for this post are currently open.

Date issued 29 July 2014

Jul 292014
 

Programme for HANDI Health Apps @EHI Live at the NEC, Birmingham – 4th & 5th November 2014, is available to view HERE.

We will have the HANDI App Village in the main exhibition area as last year, but this year with our World Cafe where you can come and discuss digital health issues with members of the HANDI team,  our speakers, exhibitors and other delegates.

We are managing our conference stream differently this year, responding to your feedback from last year that told us you wanted more time for question and discussions. So this year there will be just one keynote speaker each day and we are running 7 workshops over the two-days on subjects our members have told us they want to hear more about. These will follow the format that went really well at our Spring Symposium in London earlier this year. Each workshop will have a panel of 3 or 4 speakers who will each spend 5 minutes to set the scene leaving around 40 minutes for delegates to ask questions and contribute to the debate.

The panel members will be people with expertise and /or direct experience in the subject area. We have already identified some interesting panelists but would welcome volunteers or suggestions from HANDI members.

The themes are:

Wearable Tech

Learn about the rapid development in wearable technology. How these will impact health, care and wellbeing and how you can get wearable devices working and integrated into your digital health strategy.

Integrating Apps

Hear about the challenges associated in getting apps integrated in to the digital health and care ecosystem and the technical and governance challenges associated with interoperability, patient held record and record access and federated information architectures.

HANDI-HOPD

Hear about the HANDI Open Platform Demonstrator and how you can use open standards to create and share clinical content and build apps that interoperate.

www.handi-hopd.org

From Idea to App

Learn what's involved from taking an app from an idea to sustainable product. How do you do it, what might it cost, how do you find partners to work with, what are the regulatory issues and what business models can work for you.

Apps in use

Hear from panellists (both developers and users) who have real world experience of health apps in use and discuss their successes, challenges, and what they have learned from their experiences.

Co-creation for care

This session will explore the latest thinking about the design of new models for care delivery by on patient centred design methods. This session will describe and draw on ongoing work by HANDI in the development of digitally enabled, blended service models for mental health, but the approach has general applicability for all care sectors.

Gamification

The session will explore the use of gamification in health and care services to improve engagement of patients and service users, improve wellbeing and facilitate lifestyle and behavioural change and will discuss apps and digital tools that use a gamification approach.

If you want to volunteer to join a panel or have suggestions of people you would like to hear contact: ewan@handihealth.org

 

If you interested in sponsorship opportunities or exhibiting in the Village contact: jill@handihealth.org

You can book online for free now www.ehilive.co.uk

Watch the web site and our Twitter Feed @handihealth for more information soon.

Jun 122014
 

HANDI will be participating in the Digital Mental Health Workshop at the International Initiative for Mental Health Leadership Conference in Manchester today (12 June 2014) IIMHL www.iimhl.com/

The presentation will be given by Dr Alison Longwill of Woodcote Consulting www.woodcote-consulting.com

Alison Longwill is a Chartered Clinical Psychologist with substantial clinical and forensic experience. She holds a PhD which examined psychological factors in diabetes, an MBA and Diploma in Clinical Neuropsychology. Alison has substantial NHS management experience including Board level experience in a large mental health trust. She founded Woodcote Consulting in 1996 and has delivered a wide range of projects for NHS, criminal justice and third sector organisations and has a successful psycho-legal practice. Alison is a Director of HANDI and leads its work on mental health and wellbeing.

HANDI

The HANDI Vision

Videos and presentations from HANDI’s Digital Mental Health Workshop Birmingham 15 July 2013

The HANDI-HOPD Open Platform Demonstrator www.handi-hopd.org with some video presentations at

Contact Details

Other References

Woodcote Consulting.  Our blog   contains pieces on a wide range on mainly technical issue around digital health, innovation and adoption,  health informatics, open standards and open source in health and care.

Jun 052014
 

Our web site is not great and doesn't support much of what we want to do online, but until now we have lacked the resources to do much about it.

However, we have now had an offer from one of HANDI’s corporate members Boiler House www.boilerhouse.co.uk to apply their considerable web development expertise to re-develop the site to give us a better look-and-feel, easier navigation, more content and more facilities.

Work is underway on the new site, but we now need someone from the HANDI community to take on lead responsibility for site content as our Web Editor.  This would involve ensuring the site remained up to date, commissioning people to produce content (i.e. identifying interested stuff and cajoling people to produce content on it) maybe the odd bit of content creation yourself. We are sticking with WordPress, so the web editing skills required are minimal. You can expect web development, design, video facilities  and tech support from Boiler House. You can also expect admin support from Jill Riley (HANDI's administrator who is good at chasing people who have agreed to do stuff, as a proof reader, and familiar with WordPress able to upload content/updates) and for members of HANDI's Executive to flag stuff of interest and produce content.

The job requires in order of importance:

  1. Commitment and enthusiasm – With the ability to commit  2 – 4 hours per week
  2. Domain knowledge about health and care apps – You don’t have to be a great expert, but enough to know what’s going on and what’s interesting in the sector and have networks that you can tap for content.
  3. Able to write copy and proof read and have insights in to other forms of web content.

We offer the opportunity to join the HANDI executive team and work with HANDI at an interesting time.

If your interested and would like to discuss, without any commitment drop an me an email ewan@handihealth.org and we can agree a convenient time to talk

 

 

Apr 222014
 

Run by Plymouth University and funded by the Intellectual Property Office, the Health App Challenge is running two user-led app challenges: one for diabetes in collaboration with Diabetes UK and the other for weight loss surgery in collaboration with WLSInfo (a smaller charity), with support from HANDI.

 

The Health App Challenge (HAC) offers patients with diabetes or post weight loss surgery the opportunity to join us in reviewing or creating an app (i.e. mobile application or website) to help manage the conditions and improve healthcare outcomes with technology innovations: for patients and by patients.

 

We plan to follow on from the success of the Diabetes App Challenge of 2012, a two-part challenge where young people with diabetes and teammates created innovative apps to help with preparing for clinic appointments, then offered to other young people with diabetes to try out and review.

 

We aim to develop a best practice model for similar competitions to allow medical charities to collaborate with patients and developers, to create new condition-related apps to benefit patients.

 

Supporting the challenge is a community interest organisation, HANDI, whose work with patients, developers and healthcare professionals aims to encourage innovation of digital technology to improve patient health and wellbeing.

 

HANDI will be offering their skills and expertise to the Health App Challenge with involvement in our one-day developer workshop, technical support to participants in bringing their innovative ideas to life and appraisal of the submitted apps.
To review or create an app for the Health App Challenge, visit our website from mid-May 2014 to find out more at www.healthappchallenge.org.uk

 

Follow us on Twitter @healthappc and join us on Facebook /healthappc