Category: Health & Social Care

A smartwatch for wellbeing and health?

Posted on by The Information Badger in Health & Social Care, Information Technology, Life, Online Services, Privacy and Surveillance, Smartwatches, Technology

Last week the Badger attended his uncle’s 90th birthday. He sat with a group of mostly millennial adults and found himself watching how often they checked their smartphone or smartwatch, and sometimes both. Before the Badger’s uncle blew out the candles on his birthday cake, conversation in the group was convivial and centred on catching up since the last time everyone was together. A smartwatch noisily tinkled and buzzed, and the person sitting opposite the Badger got up and announced to everyone that their watch had told them they’d been sitting for too long! They walked away and returned a few minutes later. When they took their seat, they began talking in a way that sounded like a commercial for smartwatches equipped with health and wellness tracking apps.

A discussion ensued. People in the group were asked if they had smartwatches and found their health apps useful. Most younger adults nodded. A few admitted to being addicted to the well-being and health metrics their smartwatches provided. A couple said they had a smartwatch but rarely used the health and well-being functions, and the remainder, including the Badger, did not have a smartwatch. The Badger was asked why he doesn’t have a smartwatch given his IT/tech background, especially when, as the questioner put it, the health apps ‘would be beneficial at your age.’  In reply, the Badger made two curt points. The first was that his solar powered but otherwise conventional watch and the smartphone in his pocket met all his needs to function while out and about in today’s world. The second was that smartwatches are not approved medical devices, and so their health metrics fundamentally provide the same health guidance that doctors have given for decades – walk more, don’t drink too much alcohol, and maintain a healthy weight. You don’t need an expensive device and constant checking of metrics to comply with that advice. The cutting of the birthday cake stopped further discussion.

While the well-being and health functions on smartwatches do, of course, encourage good health and lifestyle habits for those individuals that need such prompts, many who glance at their smartwatch dozens of times a day to check their metrics are doing so unnecessarily. Does this habitual attention to the likes of step count, heart rate, sleep quality, and sitting too long simply illustrate that people are becoming needlessly addicted to another digital device? Possibly. Smartwatch firms are profit-motivated businesses not health services, and concern about profiling, advertising, and losing control of sensitive personal data would be prudent. Remember, it’s cheaper and better for privacy to simply do what the doctor’s ordered for decades, namely walk more, drink less alcohol, and maintain a healthy weight. Concentrate on living life rather than being a slave to metrics provided by your smartwatch. After all, the Badgers sprightly uncle has reached 90 years of age by doing just that…

The NHS; a super-sized jumbo jet flying with only one engine…

Posted on by The Information Badger in Delivery, Digital Transformation, Health & Social Care, Information Technology, Leadership & Management, NHS, Public Institutions

There’s one thing currently dominating the chatter of many people the Badger encounters, and that’s the UK Budget on the 30th October.  ‘How is it right for me to pay more tax for politicians to fritter away, when the Prime Minister doesn’t buy his own clothes or glasses?’ one pensioner commented. The Badger tries to maintain political neutrality, but there’s little doubt that the new UK government has got off to a bumpy start. However, it’s now starting to flesh out its ‘Change’ agenda and also setting expectations regarding the budget. On the former, for example, the government is calling on the nation to ‘help fix our NHS’. As reported in many places, e.g. here, it wants people to share their experiences and ideas given that we are all users of this huge institution employing more than 1.34 million people. The Badger, having had some exposure to NHS IT during his career and as a patient, has thus contributed to ‘help build a health service fit for the future’ via the government’s website here.

The NHS has been a political football for decades. There’s a regular clamour to give it more money. When it gets additional money, however, it never seems to make an impact, other than to fuel clamour for even more funds – at least that’s how it seems to the Badger. The NHS’s use of modern, integrated, IT is woeful, as neatly illustrated by this New Statesman article in March. By IT, the Badger means the systems that support basic operational processes within and across the NHS’s entities, not the diagnostic and robotic tools that get airtime in the media.

People often tell the Badger of their frustrating NHS experiences, most of which involve aspects where IT plays a part. For example, an NHS phlebotomist bemoaned needing 13 different logon/passwords to deal with blood tests. A relation was appalled on receiving a letter confirming a hospital appointment with Audiology when it should have been with Cardiology! A neighbour was dismayed when a consultant at a post-operative outpatient appointment told them they couldn’t find a CT scan ‘on the system’ even though the scan happened 6 weeks previously at the same hospital. A pensioner, referred from a local hospital for urgent follow-up at a regional hospital, enquired after hearing nothing for 2 months only to be told that ‘there’s no record on our system’ of the referral. The list of similar experiences is long.

Building a ‘health service fit for the future’ is like modernising every aspect of an aging, super-sized, jumbo jet while it’s flying with only one temperamental engine. Few government transformation programmes deliver real change to time and budget, but this one must break the mould, or the jumbo will soon spectacularly crash. That’s why the Badger has not only contributed on the website here, but also urges you to do the same regardless of your political views.

Is social media the new tobacco?

Posted on by The Information Badger in Health & Social Care, Learning, Life, Online Safety, Online Services, Opinion, social media, Wellbeing

The UK’s in the throes of a General Election and, whether we like it or not, social media is an important part of campaigning for politicians, political parties, and any person or organisation wanting to influence the outcome. Social media is the modern billboard. The Badger’s always been cautious about social media, and he engages with it in moderation. Why? Because his IT career spanned the time from its origin through to its evolution into being dominated by the global, revenue and profit dominated goliaths we have today.  He’s learned that it’s a minefield for the unwary, and perilous for those vulnerable to the tsunami of memes, misinformation, disinformation, sales and marketing spin, scams and bile that is regularly delivered. Social media is, of course, here to stay. The Badger, however, overcame any fear of missing out (FOMO) regarding its content many years ago. He thus ignores any content that is election related.

Aside from the UK election, something relevant to social media caught the Badger’s attention this week. It was the USA’s Surgeon General’s call for  tobacco-style warnings on the hazards of using social media. This struck a chord because the Badger’s quietly thought for some time that social media is the new tobacco! The Badger hasn’t lost his mind because, as they say, ‘there’s method to the madness’.

Tobacco’s been with us for centuries, see here.  Cigarettes evolved in the 1830s, and smoking was a norm for adults across UK society in the 1920s, driven ostensibly by cigarettes being included in First World War military rations and heavy advertising by tobacco companies. Smoking continued to grow, with the highest level for men recorded as 82% in1948. Tobacco companies, of course, grew fast, and became extremely rich and powerful. The health issues associated with tobacco were known long before the 1950s when the evidence of the impact of smoking on public health became incontrovertible. Since then, steps have been taken to eliminate smoking. The tobacco companies have fought to protect their revenues, and tobacco-related legislation only really started changing significantly in the early 2000s.

Doesn’t this progression of a product, mass marketing, widespread public adoption as a norm, the growth of wealthy and powerful companies protecting their product at all costs, eventual public realisation of the product’s damage to society and individual health, followed by long overdue corrective action resonate with what’s happening with social media? The Badger thinks it does. For tobacco, the progression has taken a century or more, but for social media it’s happening over just a few decades. The Badger senses that the Surgeon General’s call for tobacco style warnings has its place, but more needs to be done faster or society and individual health will be in an even bigger pickle at the end of this decade. Just a thought…

The Smartwatch and health care…

Posted on by The Information Badger in Digital Transformation, Health & Social Care, Information Technology, Public Institutions, Smart & New Technology, Tech for social good

Lots of information about the use of smartphones in the UK is available – see here, for example. In 2012, 66% of those aged 16-24 and 5% of those aged 55+ had a smartphone. By 2023 the percentages had become 98% and ~86%, respectively. Indeed, today 80% of those aged 65+ have a smartphone, which reinforces the fact that they have become an essential component of modern life for young and old alike. The main use of smartphones across the whole age spectrum is for messaging, emails, phone calls, internet browsing, social media, weather forecasts, online shopping, finance and banking, and maps/route navigation. Adults rarely leave home without them, and if they do anxiety tends to be higher during the rest of their day!

While younger generations are more welcoming of advances in digital tech, the rapid rise in smartphone use by older age groups since 2012 shows that seniors will embrace new technology that provides them a benefit. Which brings the Badger to the smartphone’s companion, the smartwatch. Across all age groups in the UK today, ~1 in 4 of us have one. Since the game-changing Apple Watch arrived in 2015, more and more of us have been buying them. The adoption trend looks to be following a similar pattern to that of the smartphone since 2012. Unsurprisingly, smartwatch use is greatest in digital native generations (millennials and younger), but the 55+ and 65+ age groups currently account for ~ 20% of UK users. Take up in these age groups seems to be linked to interest in watch functions associated with health monitoring (e.g. heart rate, ECG, blood pressure tracking), wellness, (e.g. sleep, stress, exercise), and emergency alerting (e.g. falls monitoring). By the end of this decade, it seems likely that most of the adult population will have a smartwatch on their wrist regardless of the device’s pros and cons, The versatility, convenience, and health/wellbeing benefits they offer far outweigh the cons, especially for those in ‘senior’ age groups.

But here’s a question. If every adult wears a smartwatch to complement their smartphone within a few years, will the UK’s National Health Service (NHS) integrate the health and wellbeing data from watch functions into patient care to improve operational efficiency, reduce costs, and care? Hmm, the NHS seems quiet on this, but the answer is ‘probably not’ because smartwatches are not certified medical devices. The Badger senses that this might ultimately change, because when he accompanied someone experiencing an atrial fibrillation event to hospital recently, one of the doctors on arrival asked if they could look at any ECG and blood pressure traces captured on their patient’s smartwatch! That’s surely a sign that smartwatches will ultimately have a more important role in an NHS which continues to struggle to be fit for the 21st century…

When is a service not a service?

Posted on by The Information Badger in Delivery, Health & Social Care, Information Technology, Leadership & Management, Processes and Practices, Public Institutions, Service, Transformation

As companies grow, they reorganise and establish different business units to serve their needs. Often, a number of units must cooperate to deliver contracted services to clients. This cooperation can sometimes prove difficult causing disjoint service delivery and strained relationships with the client. The Badger took many calls during his IT career from frustrated clients who experienced, and were frustrated by, poor cooperation between different units within his company. One call from a client he knew well, however, has long stuck in his memory.

Their call was to complain about constant bickering at service review meetings between two units, one delivering helpdesk, hosting, and support services and the other developing a new business application. They demanded that cooperation between the units improved to provide ‘joined-up’ service coherency, as required by the contract. Action was taken, but what became cemented in the Badger’s memory were the client’s general words about service, namely ‘Service is not a service when it fails to fulfil its intended purpose or meet the needs of users. A service should provide value, convenience, and satisfaction, but if a service provider’s internal problems become visible and are a hinderance then the service has turned into a disservice. The essence of service is not its existence, but its ability to deliver coherently.’

These words, and the context that triggered this client’s call, came to mind when two friends described their recent experiences with the UK’s National Health Service (NHS). One received an outpatient appointment letter from Audiology when they were expecting one from Cardiology! Enquiring revealed that the appointment was indeed with a cardiologist, but the wrong letter template had somehow been used to notify the appointment! The other attended a CT scan appointment arranged months ago only to be told when on the scanner with a canular in their arm that the scan could not proceed because they hadn’t had a prior blood test! The radiologist apologised but said it was common for scans to be aborted for this reason, because departments rarely tell each other – or the patient – that a prior blood test is needed! Having travelled some distance for the scan, the patient was understandably livid at having their time wasted and at having to await notification of a new appointment.

Irrespective of strikes, waiting lists, money, and political posturing, all of which are the mainstay of media reporting about the NHS, it’s no wonder that public satisfaction is at a record low (see here and here) when patients routinely experience interactions similar to these! The words of the Badger’s client resonate. The essence of service is not its existence, but it’s ability to deliver. It’s thus frankly shameful that ‘when it’s the NHS’ has become a valid answer to the question ‘when is a service not a service?’  Without redressing this, oblivion beckons for the NHS and its end-users…

Marmite, IT systems…and the NHS at 75

Posted on by The Information Badger in Health & Social Care, Information Technology, Leadership, Opinion, Public Institutions, Transformation

Two young mums and their toddlers were chatting in front of the shelves holding Marmite at the local supermarket. As the Badger politely reached between them for a jar, one mum grumbled ‘Yuk. You shouldn’t eat that stuff; it’s horrible’, and the other added tartly that ‘Supermarkets shouldn’t be allowed to sell it’. Supressing an urge to argue, the Badger saw the seriousness on their faces, took a jar, and moved on. If people think supermarkets should be barred from selling Marmite, then there’s no hope for society!

While cogitating on the way home, the Badger concluded that Marmite and the UK’s National Health Service (NHS) have something in common – the ability to divide and polarise opinions. How did the NHS come into this? Well, the seed was sown in the Badger’s brain by an early morning radio news programme during which an NHS interviewee highlighted how much time medics waste having to log on to different IT systems to treat their patients. Little seems to have changed since early 2020 when a Health Secretary said ‘It is frankly ridiculous how much time our doctors and nurses waste logging on to multiple systems. Too often outdated technology slows down and frustrates staff’. Other interviewees bemoaned NHS vacancies, waiting lists, delays to patients being discharged from hospital, and workforce strikes over pay. The seed was thus sown for the Badger to cogitate on the NHS, especially as it celebrates 75 years of existence on 5th July 2023.

Then this seed grew further when the Badger took a call from his cousin as he reached the supermarket. His cousin is recovering at home after an operation. Their NHS consultant advised that the waiting time for their operation could be six months, and so, instead of waiting in debilitating pain, they dipped into their savings and had their operation privately just two weeks later. The Badger’s brain was thus already cogitating on the NHS as he approached the Marmite shelves.

The Badger likes Marmite and the NHS, a huge, complex organisation employing over 1.3m people that has a special place in the public’s affection because we are all users and it’s free at the point of use. Unfortunately, perpetual transformations have long been strangling its vital signs and its service to patients, making it a political and ideological football and the centre of shrill media outcry. Current struggles as it approaches its 75th birthday imply that it is systemically crumbling in its current form, and something more fundamental must happen to make it fit for the rest of the 21st century. That, of course, is just the outcome of a cogitation on the way home from a supermarket with a jar of Marmite. One thing’s certain, however. Marmite and the NHS will divide opinions and generate highly charged debate for years to come…

Observing the NHS…

Posted on by The Information Badger in Change, Delivery, Health & Social Care, Processes and Practices, Public Institutions, Technology

Opening bleary eyes at 5:30am in a hospital ward bed to see the smiling face of a PPE-clad nurse wanting to thrust swabs into your nose and throat for a COVID test is an interesting start to the day! This test marked the start to each long, visitor-free, in-patient day that would eventually end around 10p.m. at night.

Patients were not allowed visitors until their stay surpassed five days. After that, one person could visit for one hour, but only once in every subsequent five-day period. No one grumbled. Instead, the Badger and fellow patients used video calls from personal smartphones or tablets to maintain contact with loved ones. The absence of visitors meant we experienced and observed ward operations performed without distractions, and we habitually shared our remarkably consistent primary observations during the quiet troughs that speckle an in-patient’s day.

Firstly, there was unanimous respect for doctors, nurses, and the ward staff who kept things shipshape (many of whom work 11 hour shifts with just a 30-minute unpaid break). Secondly, we observed that although the NHS is slowly transforming to the digital world, there’s still too much paper-based activity constraining efficiency. One nurse commented, ‘If someone borrows your drugs form before I get to you, it’ll take me half an hour to track it down’. Thirdly, we observed that nothing happens unless a busy doctor says so and signs a piece of paper, which they rarely do promptly. Telling a patient in the morning they’re being discharged, and then telling them in the evening that the doctor’s been busy and has gone home without signing the discharge paper is incredibly annoying and systemically inefficient!

There was also a consistent view that debates about NHS funding, a staple for media reporting, are red herrings because there’s much the NHS can improve itself that needs will rather than money. Its own Long Term Plan shows that it knows it must transform from a way of delivering health services that’s still locked into a model largely created when it was founded in 1948. It just needs to progress faster.

Finally, like most transformations, we observed that it’s the people and working practice issues of change rather than technology that is the biggest challenge. Transforming the NHS, the biggest employer in Europe and the world’s largest employer of highly skilled professionals with a headcount of 1.35 million, over half of which are professionally qualified clinical staff, is undoubtedly a massive task. It’s akin to reengineering a giant A380 plane full of passengers while it’s in flight, but it has to be done for the service to be sustainable. Even with its observable flaws, inefficiencies, and transformational strains, we all felt safe, in expert hands, and hugely proud that our country has the National Health Service as part of the bedrock of life across the population.

One in more than 15 million…

Posted on by The Information Badger in Delivery, Health & Social Care, IT Project Management, Project Management, Public Institutions

Way back in 2006, the Badger and a colleague instigated an annual ‘BAFTA’ style awards evening to recognise the successes of our company’s delivery and technical staff. Making the case for having such an event was straightforward because the sales community already had one, and the delivery and technical community had the biggest number of employees and deserved recognition because they did the real work that generated company profits! The first event, with Richard Hammond from Top Gear as a guest, proved a huge success.   

Those that do things always deserve to have their successes properly recognised. This point was at the forefront of the Badger’s mind as he left an NHS Vaccination Centre last Friday after becoming one of more than fifteen million UK people who have received their first COVID vaccination jab. At 5pm last Thursday, the Badger received an unexpected call from the local Health Centre to schedule an appointment for the jab. The appointment was made for the jab to be administered at a ~1000-seater concert venue serving as a vaccination hub on Friday at 5:15pm, 24 hours later.  

On Friday, the Badger arrived in good time and was immediately impressed. Everything from car parking, temperature checks, registration on arrival, guidance leaflets, socially distanced waiting arrangements, vaccination cubicles, and the monitoring for immediate side effects before leaving, was awesomely simple, well organised, and worked like clockwork. As someone whose career centred on programme and project delivery, the Badger found himself instinctively sensing that this programme is not only well thought through, but also being executed by passionate, professional, and caring people who want to succeed and know what they have to do.    

Musing on the way home afterwards, the Badger decided that this programme warrants delivery and technology ‘BAFTA’ awards like those mentioned above! It is not, after all, politicians, media pundits, or social media influencers who make delivery programmes a success, it’s the good people behind the scenes with no media profile who are doing the real work.  Those doing the planning and tracking, the IT, administration, vaccine manufacturing, logistics, marshalling the car parks, and the army of volunteers, all deserve our thanks and recognition, regardless of whether they work in the NHS or for its suppliers.

The Badgers sure that whatever bumps in the road lay ahead with this vaccination programme, they will be overcome if the politicians keep to its current objectives and approach. The fact that more than 15 million people have had a jab so far also shows that the British people have not lost their mojo, common-sense, or ‘can do, will do’ attitude. When  public organisations, commercial companies, and the British people work together to get things done then they are truly a force to be reckoned with…and long may that continue.

‘Blue Christmas’ and Alvin and the Chipmunks…

Posted on by The Information Badger in Delivery, Education, Health & Social Care, Press & Media, social media

A senior client at a large engineering firm asked the Badger to be an observer at a  meeting about a major programme that was off the rails. It was a whole day affair involving the client, the programme manager, and the key people from the IT, engineering maintenance, engineering operations, finance, resourcing, and stores and logistics departments. Throughout the day, individuals and departments blamed each other for  difficulties, belittled the programme manager and their decisions, and even questioned the company’s  strategic decision to embark on the programme. The Badger realised that everyone had lost sight of the big picture, were dwelling on the past, and engaging in internal politics and point scoring. At the heart of the  programme’s predicament was the wrong attitude, approach and behaviour of every one of those present.

At the end of the meeting, the client asked the Badger if he had an observation to share. The Badger just said ‘Today everyone has blamed someone else, dwelt on the negatives, and engaged in factionalised points scoring.  This programme is failing and so each of you is already tarred with failure. If you want to be associated with success then each of you needs to stop bickering and blaming others, unite around strategic objectives, and take personal responsibility for doing the right thing’.  There was silence. The client grinned and closed the meeting.  

The Badger was reminded of this last night while sitting by the Christmas tree cogitating on television, online and social media coverage of new restrictions to curb the virus that impact everyone’s Christmas plans. The interminable hand-wringing, hysteria, political point scoring, shrill cries of unfairness and woe,  and blaming others for disrupting Christmas is very similar but unfortunate reality of today’s instant attention-grabbing world. The reality is that every one of us, without exception, has a responsibility involving uncomfortable choices and decisions if this devious virus is to be beaten. Just like for the wayward programme noted above, our individual attitude, common sense,  behaviour, and collaboration is what will determine success. Yes, recent restrictions make Christmas even more difficult for everyone, including the Badger, but we are a highly adaptable species and so we’ll cope.  

This year Elvis Presley’s ‘Blue Christmas’ from 1957 will be apt for many of us. This  Christmas will be difficult but also a rich source of memories and stories to be passed down the generations for years to come and so it deserves something to put a smile on your face.   Let’s make Christmas ‘glass half full’ rather than ‘glass half empty’  and listen to Alvin and the Chipmunks as we focus on absent family and friends! It might help to alleviate the gloom and put a smile on your face for a couple of minutes. And on that note, the Badger wishes you all a safe Christmas with as much happiness as it’s possible to muster in these turbulent times…

Information pollution…

Posted on by The Information Badger in Education, Ethics & Regulation, Health & Social Care, Life, Press & Media, social media

After months of abstinence, the Badger treated himself to fish and chips  while visiting Crawley, a town which has seen sizeable unemployment during the Covid-19 pandemic due to its proximity to Gatwick Airport. The chip shop was open, all the appropriate virus protection measures were in place, and a rumbling stomach made it impossible to resist! 

The Badger placed his order and the counter assistant, a lady in late middle-age, made conversation while she waited for a fresh batch of chips to complete frying. ‘Will you have the new vaccine?’, she enquired. ‘Yes. What about you?’, the Badger replied. What followed was a torrent of reasons for why she would not have the vaccine.  The lady said the government could not be trusted, the vaccine had been rushed, short-cuts had been taken, pharmaceutical giants were only doing it to make big profits, and that everything she saw in newspapers, on television, on the internet and on social media had made her very wary. Looking at her smartphone as she spoke, the lady went on to say that she wasn’t going to take the risk of getting ill from the vaccine because her elderly mother and her children depended on her.  The Badger listened and inwardly sighed,  but at that point the fresh chips became available and the conversation went no further.

Mulling over the lady’s words while eating the food a few minutes later, the Badger decided  that her view provided an illustration of  how ‘information pollution’ influences many in the modern world. According to widely available statistics, we  look at our smartphones at least  every 10 minutes during waking hours, much of it to watch  attention grabbing, instantaneous social media feeds like Twitter and Facebook. As the thought provoking article here points out, speed of information availability eclipses accuracy, and so misinformation, distortion, selectivism, and falsities easily become the norm pushing fact into the background.

‘Information pollution’ is rife and it is one of the biggest ‘man-made’ challenges for digital-native generations to deal with if we want society to avoid descending into anarchy. Regulation and legislation are necessary and inevitable to ensure media and social media platforms genuinely tackle the issue rather than just pay lip service to it.  Pollution, after all,  comes in many forms. The chemical, oil, manufacturing, farming, and pharmaceutical industries have to comply with laws covering poisons and pollution, so why should  ‘information pollution’ be treated differently?

So, there you have it. A conversation in a fish and chip shop can make you think!  As the Badger finished the last chip, he resolved to maintain the healthy analysis of information to get at the facts that has stood him in good stead in his work and private life for years. Accordingly, even with ‘information pollution’ still rising, having the vaccine is clearly the rational  and common-sense thing to do. Life, after all, is full of dealing with risk of one form or another.