Self-care in e-space and the need to Impress

Working with older adults you realise how unselfish a group they are with regards to their care needs: "spend the money on the children who need it, they are the future."

You also realise that although there are growing numbers of 'silver surfers' (sorry) and their number will swell - the use of digital technology by the general public remains yet another potential source of inequality.

Many years ago I came across HealthSpace (UK) as a fledgling approach and application. I was really impressed as it underlined the need for a generic conceptual framework for health and social care - from senior school through to older age.

It is often said that effective communication needs a channel that is noise free - well here in Hodges' model is a resource to reduce noise for health information across many contexts:

• education
• prevention
• consultation
• social marketing
• self-care
• care planning, evaluation and management
  
• carer support
• supervision

Demographics also underlines the opening remark in this post and for older adults and many younger that matter of choice arises when it comes to the deployment of digital technology. Yes, many forward thinking people will readily jump on board and use ICT to study, learn, commission, record and co-ordinate their own care - or that of a relative. But what about those who will not use HealthSpace or another personal health records [PHRs]?

For those who do not want to engage - are they to be literally pressed into service? Obviously not - and besides recruitment to the UK services is growing. Jokes aside though the pressure to get the public to add value to their own care is critical to the future sustainability of the health and social care system.

Which brings me back to HealthSpace and the following news on e-Health Insider:

'HealthSpace expansion plans shelved'

Last year’s Health Informatics Review outlined a wide-ranging role for HealthSpace, but the DH has now done a U-turn and demanded more evidence of the site’s value to patients before pushing ahead with further expansion.
...
An outline business case worth £80m to £90m – one source puts the figure at £98m - had been developed by CfH, which was to have been submitted to the Treasury earlier this year.

However, the DH is understood to have spiked the business case, seeking more evidence for the value of HealthSpace, which has not received the backing of Christine Connelly, director general of informatics.

Dr Neil Bacon, founder of the doctors’ website doctors.net and the patient website iwantgreatcare.org, said he was unsurprised that the DH had shelved its plans.

“I think this is their way of quietly getting rid of it,” he told EHI Primary Care. “In the commercial world, if a solution with more than 250,000 potential users had only been used by 400 people it would already have been put out of its misery.”

Dr Bacon said he believed there was a clear and growing demand for patients to manage their own health records but that innovative, entrepreneurial solutions rather than government-led solutions would meet that demand.

More to follow no doubt - but do take care even now if you live by the coast ....

Additional links:

Google Health

HealthVault Microsoft

DIY doctors: patients can boost NHS's value, 30 April 2009, HSJ, Paul Corrigan

Digital Britain

The Impress Service

The Royal Navy

Image source: Press Gang stamp

DrupalCamp UK Manchester: education and a (virtual) website

DrupalCamp UK in Manchester this past weekend was a great success. The organisers, sponsors and hosts the BBC on Oxford Road did a magnificent job.

My course through the schedule found me attending:

• Installing and creating your first site
• Drupal for Education
• Drupal and Scrum
• Drupal Forms API
• Introduction to Organic Groups
• Creating your first module
• Using CCK and Views
• The Forms API - again
• Migrating data into Drupal
• Using Photoshop to theme a Drupal site
• Views handlers

All this was really useful, but of particular relevance for me was Robert Castelo and Dominik Lukes's session on Drupal for Education. They discussed key modules and developments in Drupal and also related this to Moodle already well established in the education sector. Modules presented included:

• Biblio
• e-Journal
• WebForm
• Quiz
• Conference

They began with Drupal being applied to education for brochureware (wish the new site was there!). This will be my starting point for Brian Hodges' old notes. These obviously need a place on the site, an archive where they are accessible next to new introductory material written to reflect:

health and social care, public (mental) health
informatics
education
socio-politics and the challenges of the 21st century

Yes I know that is a broad agenda ('too much'), but this is about the learners, learning tools AND the models we teach being fit for purpose...?

Additional links:

Drupal.org

My review on W2tQ of Bill Fitzgerald's book 'Drupal for Education and E-Learning'

Drupal in Education - group

Nursing and Midwifery Council UK: Review of pre-registration nursing education

Colour my quadrants - theme my domains

Quite a while ago a basic colour scheme emerged for the care domains - quadrants of Hodges' model. It may be useful to explain why these particular colours were adopted.


INTER-INTRAPERSONAL: [mental health, psychology, psychological therapies, philosophy, creativity, theology ...] It is often said that green is a colour that calms people, it is and must remain a constant in our lives and hence in our world. Green reminds us of nature and who we are. There should always be a place for green wherever and whenever we live, for every individual one of us, whether residing in a metropolis, village or wandering across the land, or with no land. We must hope that green (and the blue) will always be.

SCIENCES: [anatomy, physiology, physics, biochemistry, neurology, systems, process ...] Blue is a mystical and spiritual colour. It suggests the metaphysical. It is our ET-ernal umbrella that points the way to the most external other that which is outside and beyond ourselves and our comprehension. Whether it is day, night or the inbetween with the terminator passing overhead it is there - clear sky or rain. It reminds us if you look, listen and feel our frailty, the true position of our laws, preoccupations and the passage of time that we cannot understand. But still we reach out.

POLITICAL: [policy studies, law, democracy, standards, development, activism, governance, citizenry ...] Black and white was adopted here as politics is often portrayed and practiced as being polarised. It is nice (economical of effort) when decisions are literally cast in black and white terms - true or false, yes or no; however, in politics things are never clear cut (especially when claiming expenses). This is another reason for 'black and white'. Not so much for the colours as the pattern they can pose. As posted previously Michel Serres cast Harlequin as a trope for mischief maker (and more) - something we all see in politics - especially at the moment.

SOCIOLOGY: [sociology, patients & carers, the seven ages, collaborative computing, anthropology, history ...] While a warning in nature and many cultures, red was assumed for its warmth. The gathering around the flame of the community, the flame of the hearth. Vibrant. Full of life. This is red. Love, passion and courage you will find here.
Red still stands. No, runs - as a warning. The flame can become a source of chaos in the hands of the mob, when families, peoples and nations fight each other. Red is the ember that is hatred, but red the creative, innovative spark can and will win through. From darkness : To light ...

In the near future I will write more about the positional relationships between the care (knowledge) domains.

What wright to care?

At senior school I had the challenge and pleasure of appearing in Arthur Miller's The Crucible at the age of 15. My part was of course that of Francis Nurse. I can still remember most of my lines [as I didn't have many ;-)]. I have always been interested in drama, but even more so - dialogue, which helps as a member of this family and a mental health care professional.

Over several years, the above plus studies in literature and philosophy prompted me to dabble with dialogues of my own. One from way back when concerned nurse training and virtual environments; while another was set in Athens addressing the impact of informatics upon nursing.

The professionals of dialogue - playwrights - feature on BBC R4 Start The Week and this made me think of another dialogue as I recognised that my colleagues and I are in fact carewrights.

Now though with long term medical conditions, self-care, recovery, personalised care, individualised budgets and other policy permutations we are not just concerned with the words we say. With patients and carers seen and heard as experts no longer are we just putting words into their mouths - they are putting words in ours.

So together -
lets literally go taste the health and social care culture and break a leg!

Image sources:
book cover Amazon
Drama mask image: Saskatchewan Drama Association

Additional links:

Top 30 languages of the world

Top 20 countries by number of languages

International Mother Language Day 21 February

I note there are several instances of 'carewright' as a surname, trade / commercial name - my use and the context should be clear.

Smiley career choices

It is nice to use smileys in e-mails and something now we take for granted. It made me smile placing this one on the page...

It is quite something else though when your job involves helping to put real smiles back on real faces, or more importantly helping people find contentment in their heart. ...


Additional links:

Mental Health Nursing

60+ Social Workers

Social Work careers

Heroes wanted to slay monster (or just thinking aloud?)

The four links pages devoted to the knowledge domains of Hodges model are I am told quite a remarkable collection for all that to me they are a bit of a monster. Apparently the links demonstrate that there may still be a role for human web-hunter-gatherers. Wikis and social media rely on provision of tools for links. The Twitter community is built primarily on links. H2cm's links are checked regularly, tools make the task much lighter, but ...

Most urls have long lives - a slight tweak and all is well. Some are clearly '404', while a few get taken over and become a cul-de-sac for questionable advertising. I even found one or two being used for promoting candidates in the US election. It would be great to have someone else involved a caretaker just for a category in order to:

• identify broken links
• sites no longer maintained or representative of the category
• any key resources missing (this might include a site you are involved with)

[I do mean 'key' resources]

You do not need to be a subject matter expert or a student, but it would help especially for the following domains and categories:

SCIENCES: anatomy & phys, nursing theory, research, astronomy, health informatics...
INTRA-INTERPERSONAL: psychology, mental health, therapies, philosophy...
SOCIOLOGY: sociology, arts and culture, patients and carers, collaborative computing...
POLITICAL: health policy, standards, democracy, activism, community informatics, citizenry, development ...

To repay your time there are a couple of options:

• You effectively adopt a listing and I can feature a link with a small graphic to your site at the top of the listing category.
• At least once a year I would post on the blog an acknowledgment of partners - be they companies or individuals.

OK the above is not hyperbole, but with the current website and hosting arrangements I would have to rely on e-mail to do this with me having to maintain the links.

Enter Drupal....

Considering the future site for Hodges' model I could readily drop the links, but I do feel there is potential here on several levels:

• educational
• community building
• commercial

- and I need to consider the options.

The links would be one way to involve and grow a community. Using Drupal to leverage this there is also the possibility of:

• voting on the existing categories
• suggestions for new categories
• use of mega-menus
• monitor link usage and reduce the listings
• use some of Drupal's link modules (or create a new one?)
  
• introduce the site and links to the semantic web - RDF
• start the collection from scratch and have the community submit them
• - emphasizing basic nursing and social care
  

The existing pages would also be re-written to utilise CSS and jQuery (as already mentioned on w2tq) it would make a world of difference to have the categories being collapsed upon the page opening. We'll see...

Additional links:

http://www.useit.com/alertbox/mega-dropdown-menus.html

http://www.bbc.co.uk/programmes/b00kpv23

http://twitter.com/h2cm

Mind the glass! Socio-technical engineering and vision

Amid the efforts to increase the ease with which technology integrates into our lives is the realization that some areas are more challenging than others. Education and health care spring to mind. In both of these fields if you are something of an expert in ICT and a subject domain expert then you can potentially pull off something of a coup. Being able to sit on the fence and appreciate two critical dimensions of an ensuing discussion about a clinical or learning system (perhaps even both) you can climb down off said fence and make a real difference.

From experience as a nurse, though it is (always) wise for any one practising as an informatics 'clinician' to constantly look over their shoulder. This domain is one that could be rationalised, automated, by-passed especially when we contrast new and emerging informatics roles across health disciplines with generic trends in health records EHR and PHR?

In the forthcoming generations of health record systems, informatics specialist will need to make their technical knowledge more accessible in their role as:

key contributors to -
SOCIO-TECHNICAL
- balance and patient (public and carer) engagement.

As community and personalised models of care influence the development of PHR, then hospital based EHR will themselves be forced to become transparent. There is also the matter of how the service integration agenda will influence how systems are described and 'sold' as a product and (essential) benefit. As the majority of readers will recognize at the end of the day - it's about the information - knowledge: not the technology.

Perhaps on reflection this is the key to new or existing informatics roles:

- we are engaged in "engineering transparency" ....

Inspired by a discussion on the LinkedIn HIMSS list.