health – Tim O Lloyd

Riding in Swaledale

Swaledale, North Yorkshire — Looking East along Swaledale, from Crackpot

This month I revisited Swaledale in the Yorkshire Dales, for the first time in 17 years on a bike. It’s a place that is very special to me.

Swaledale is a brilliant place for mountain biking. I first discovered this around the age of 14, so I think part of the attraction is nostalgia. Whenever I visit I get the same feeling of discovery and independence that I did as a teenager, being allowed to roam around the Dale without Mum and Dad in tow.

On subsequent visits I made new friends, reaffirmed existing friendships and found new confidence on the bike.

Swaledale is far enough from home for a weekend visit to feel like a stretch, but still doable without booking a holiday.

The added bonus is a hamlet round almost every corner, and less of the bleakness and crowds of, say, Scotland.

There are loads of great places to ride mountain bikes in the UK, but what makes the Dales special in particular are an abundance of trails, and loads of great viewpoints. I’ve come to realise over the years that regularly riding, running or walking to the top of a hill or mountain, and savouring the view in rain or shine, is really important to my wellbeing.

Digital detox

I’ve started running with a club each week. It’s probably the fastest way that I’ve found to improve my fitness.

What I’ve also realised, somewhat shamefully, is that it is brilliant, and rare, downtime, away from the phone and a screen. We tend to run cross country and there is no coverage, even if I was inclined to blog my way through each kilometre. Which I am not.

The runners are a great community, who’ve known each other for the best part of a decade. As I get to know them, I’m picking up on some stories that demonstrate the support goes far beyond running and fitness.

And the best bit? No social media. I’m not connected with any of my co-runners online, except for a weekly email to confirm our meeting venue and route.

This is a welcome change from the Facebook/Twitter/LinkedIn environment I have become so reliant on. I actually have to stretch my memory muscles; remember names and faces, stories and backgrounds, sensitivities and interests.

Get yourself into a non digital community, and give yourself a whole new perspective.

The best training ever

Regardless of what the HR manual says, people working in digital need to live and breathe it.

You don’t have to be obsessed with social media, or a coder, or been doing whatever-it-is-you-do for that long. But you have to be passionate about something to do with the web.

That gets you started. Then you have to throw yourself in at the deep end, regardless of your seniority or experience. There’s no point pretending anyone ever knows it all, or can afford to ignore something they are not sure about.

I was in at the deep end when I started growing the #nhssm community with Alex Talbott, Colin Wren and Gemma Finnegan.

When Alex introduced himself and pitched the idea of a weekly Twitter chat for healthcare workers interested in social media, I was sceptical. It sounded like a void that didn’t need to be filled and would suck up more time than it was worth.

Happily, I was very, very wrong. A trickle of NHS communicators, nurses and doctors grew into a steady stream of health professionals, expanding to cover mental health workers, people working in private healthcare, academics and managers. Within a matter of months 8pm on a Wednesday evening became the most hectic part of my working week: dash home or stay late in the office, promote a topic or theme, seed some questions, then help facilitate.

Alex, Colin and I ended up meeting in a pub most Wednesdays, with Gemma Skyped in from Cornwall or on IM. The social side of it was no hardship, but the chats were so busy that it was nice to have each other there for support.

We were all learning a huge amount too: the spiky characters; their passion, arguments and tone all colliding in one short 60 minute burst of energy. Some nights there was a huge amount of useful information to curate and share, but it was also a steep learning curve knowing how to moderate conversation, to ensure people with useful contributions didn’t feel left out or were put off altogether.

I failed over and over. Topics that were of no interest, over moderating some people, ignoring others. Obsessing about branding and formalising this community, while at the same time dodging the occasional sniff from a compliance or security team.

Is this official? On your own time or the public’s? Who cares? I was learning more about online conversation and helping to manage a community than I could have experienced in a lifetime of courses or tuition.

The scary part was when we realised that this was not a true sandbox that we could afford to mess up. Exciting but serious opportunities came along: running an #nhssm conference with the Guardian, presenting to NHS Directors, talking to European health professionals.

And all the while the weekly chats continued to be the bulk of the work and the mainstay activity.

My own confidence to get involved with online conversations, to contribute, participate and defend a view, developed immeasurably. I now see those same situations I faced on Wednesday evenings, each time I look at a feed, forum or comment thread.

The best bit is that #nhssm is still out there and for Alex, Colin and Gemma it has helped them earn money for their expertise. Most of all it has helped make the NHS more open to social media. Things have moved a long way since that first phone call.

Want to really understand the value of conversations online? Get stuck in.

Looking for a little digital inspiration? Edrychwch i’r gorllewin

Last week I spent a day in Bridgend meeting the people behind some exciting communications projects in the local health boards and Welsh Government.

I’m part-Welsh, have family in Wales and enjoy spending time there, so I never need too much of an excuse to point my car towards the M4.

I met a group of people who represent a large proportion of the total communications expertise available to NHS Wales. And they produce a lot of good work.

I had been invited to share some examples of the digital engagement work being done at BIS, and during my time at Department of Health. I pulled together some examples, had a think about how to make it useful to the people who would be there, and was careful to acknowledge the fact that resources are very, very limited and no-one was a digital specialist.

In the end, I think it was me who came away more impressed.

One example that particularly stood out was the active engagement undertaken by the (bear with me) Abertawe Bro Morgannwg Health Board who regularly respond to local media coverage, publicly, in the comments field of local newspapers, and without shying away from the difficult coverage.

And if you haven’t had a look at the Welsh Blood Service’s campaigns, do. The #rollupyoursleeve campaign may not yet have yielded the level of response Kate is aiming for, but as an example of trying something thoughtful and putting real energy into it, I reckon it is brilliant.

There was also good evidence to support the work that 1000 Lives Plus has done to coordinate internal communications channels, to help improve patient outcomes. I’ve seen communication projects costing much more, supported by many more people, with less direct results than those that were presented.

On the downside, the teams in Wales face familiar issues around blurring lines between personal and professional online boundaries, outdated IT and associated policy, and in some areas little or no coverage from mobile carriers, let alone 3G or broadband. Digital won’t be able to solve all their communication challenges.

The 1000 Lives project publish some useful resources online. Take a look and if you are interested in finding out more, drop Andrew or Jon a line. Next time someone tells you they don’t have the resources to deliver some useful digital engagement, look West.

Why heart research is still important

I happen to think heart research is a very important thing.

In my opinion, it doesn’t get much coverage – there are many other health problems to cause us worry, and it seems the heart is generally accepted as an organ we know enough about.

Heart research is important to me because, when I was four years old my Grandfather died suddenly of a heart attack, at the age of 57. It isn’t something I remember, but I grew up aware that he had died, and, relative to survival rates for other men of his generation, that he was young.

Recently I got to thinking about other friends, family and colleagues I have known, who died suddenly of unforeseen or unknown heart conditions and were even younger.

There are lots of deserving causes out there, but we mustn’t overlook heart research.

British Heart Foundation (BHF) run lots of marketing initiatives (I am a fan of their social media work, from a personal and professional view), but if you didn’t know better, you’d say they were focused on smokers and CPR. It’s true that BHF target these subjects, but they also fund a huge amount of research into heart disease and its causes – the causes we don’t fully understand.

In this video, Dr Laura Corr talks about the hard truth of heart problems

[youtube http://www.youtube.com/watch?v=g38wdTF5tUw&w=480&h=360]

On Sunday, 17 June, I’m cycling from London to Brighton (and back again the next day) with Andrew Spires, to help raise awareness of the British Heart Foundation’s work, and in memory of Grandpa and others who have suffered from heart conditions.

If you know of someone who has died of a heart-related cause then add their name to the comments below, and I’ll ride in their memory too.

If you would like to sponsor me, the fundraising page is here.

From Land’s End to new horizons

Last weekend I found myself sat in an impossibly pretty Cornish village with colleagues from the #nhssm community. We’d got together to talk about how we can help to develop this modest community of healthcare professionals and communicators, which started a couple of years.

What started as a one-off hashtag to promote a single event now feels like a proper responsibility, consumes a fair amount of time and some cash too.

We’ve had some ideas about to make all the incredibly useful conversations and content that comes out of the chats more widely available, and how we might extend the conversation beyond a chat once a week and the blog. We’ve also identified a need to help the community answer the frequent questions and requests that we receive. First we need to put these ideas to the community as a whole, so more on that soon.

What really struck me as we strolled along the harbour side was the way in which this had all come together. Although three of us are geographically close, there is very little chance any of us would have ever met were it not for making the connection online. And putting real people to avatars is a significant next step in that relationship.

I don’t think we all have that much in common outside of #nhssm and our work, but our common enthusiasm for what we’re doing seems to be enough.

Getting to know each other as well as develop an online community at the same time feels like quite a challenge, but one that’s worth persevering with.

By coincidence this week is going to be another big one for #nhssm. On Tuesday 22 November we’re contributing to two events: the Guardian Social Media in Healthcare conference in London, and the AHCM conference in Birmingham. All the ideas and topics that we’re covering at each event have come from the #nhssm community and we’ll be sharing the feedback and new ideas online, so keep an eye on the hashtag this Tuesday.

Using Ideascale for health maps and apps

Six weeks flew by, and we’ve now closed the Maps and Apps website to new entries. We’ll be keeping the conversation going around apps for healthcare – more of that another time.

Behind the scenes, the real star of the show was Ideascale. For $849 the Department of Health (DH) could quickly produce a ‘crowdsourcing’ platform that allowed us to publish people’s ideas for new health maps and apps, as well as suggest their favourite existing examples.

Participants could also comment on other people’s entries and vote for them accordingly.

In the original plan for the project we were aiming for at least 1,000 interactions on the site: defined as entries, votes and comments. In the end we received 9,198 entries, votes or comments. Fair to say the team are very pleased with this, especially because there was no dedicated marketing. We used the DH corporate channels, held a launch event at Evelina Children’s Hospital and this generated some coverage in The Times, Wired and elsewhere.

Dr Shaibal Roy talks with patients at Evelina Children's Hospital — Dr Shaibal Roy and patients discuss health apps

Alongside the Ideascale platform we ran a simple sub-site with a blog, led by one of our judges, Dr Shaibal Roy. Entries are a mix of text, Audioboo and video. The blog has been a bit more of an experiment both for us and first-time blogger Shai. But it continues to be key to the project and a helpful way of expanding on some of the issues that Maps and Apps has raised.

We’re keeping the blog open as the project expands, so do have a read and ask questions.

Will we use Ideascale again? Yes, I think so. But I have a suspicion that its usefulness is determined by the topic and the audience. Using an innovative platform like this is appropriate for a topic like mobile health, which by definition involves innovation, but I am less sure how well people would take to it if, say, we wanted to apply it to a social care project.

If you are thinking of trying out Ideascale:

remember that when you set up your ‘community’ (this is the overall account and URL – ours is Department of Health) for a time-bound project, you will have to close the whole community at the end of the project in order for people to be able to review the content after the end-date. This is a slightly quirky feature with Ideascale. It seems that, at the moment, it is not possible to close a ‘campaign’ i.e. Maps and Apps, and still have it available for people to view.
campaigns can be closed and archived (so you don’t lose the information), but, as described above, it is not straight forward to review all the content in archived campaigns.
we received several comments about the fact that people had to register in order to use Ideascale, and that this wasn’t immediately obvious. I agree with this, although in defence of Ideascale, people can use existing social media profiles to register. In the end, 4852 managed to register successfully, but again this could be reliant on how whether or not your audience are web-savvy.
users are awarded badges based on how much they participate which seems like an excellent way to keep people involved. I haven’t got any evidence to prove this, but the Maps and Apps community has certainly brought out half a dozen or so regular and constructive contributors.
there are lots of useful moderation functions available. However, users are also able to flag content for moderation, which automatically removes the entry or comment from being publicly available. This caused a bit of upset among participants and could be open to abuse in other campaigns.
the support available from Ideascale under-promises but over-delivers. Big thanks to Rakhesh Nair and his colleagues who seemed to be available 24/7, despite being in the US. Very useful when I managed to turn the whole thing off one Saturday morning…
like any digital engagement project, plenty of man power is still needed, not least when it comes to moderating comments and entries. In particular users didn’t seem to understand or bother with tagging their entries, which can be very time-consuming to keep up with, but is pretty useful long-term.
the social media buttons and selection of RSS feeds made it really easy for people to promote the project across their own networks, and I think this contributed a lot.
however, it also meant that the most popular ideas were those that were best described, illustrated (participants can embed video and images) and promoted. I guess that makes them more deserving in some respects, but also means that some excellent contributions are buried a little bit further down each category.

Overall Ideascale is a very useful, cost-effective tool. There are some quirky features though, so it needs preparation, planning and ongoing management.

If you have used Ideascale, or are thinking about using it, I would be interested to hear your comments and suggestions.

Image courtesy of Department of Health and Evelina Children’s Hospital

Tags and categories: not big, but they are clever

A new website doesn’t feel that newsworthy, amongst the carnage in London of the past few days. However, a new-ish face for the Department of Health‘s corporate site appeared on Monday afternoon. I’m quite excited about it, as this represents the culmination of lots of hard work by my colleagues.

Essentially the homepage and some other important information now sits on our WordPress platform. We originally used this platform for blogs, but team head Stephen Hale quickly realised it’s potential to release us from the shackles of an old content management system. More importantly this new found flexibility helps us communicate more quickly and effectively with the Department’s audience.

The real story, though, is not about the technology that sits behind the site, but how it is changing the way we publish content. By carefully using tags and categories, we can start to ensure that information is presented in the way that people might expect to find it, instead of it being categorised according to how the Department is structured.

For example, in health, obesity is a subject that is dealt with by several different teams across the Department. Each of these teams would have published content on the corporate site individually, in the sections that covered their particular area of responsibility, or as a reflection of their location within the Department’s structure. Fine if you know your way around a Government department, or know exactly what you are looking for. Not so good if you are searching for the latest information about obesity, be that policy, campaign material or press release.

Department of Health website screen shot — Here it is, in all it's glory

Tagging and categories should hopefully allow this information to surface in a more intelligent way. I also believe that it will help colleagues within a large organisation think more about how their work interlinks with each other, because they’ll see their contributions to the website automatically appear alongside those of other teams.

By tweaking the layout of the home page, it was also a good opportunity to simplify the menus too. A spring clean is always a good idea.

This isn’t an easy process and I reckon the hard work is just beginning. The majority of the website is still sitting on the old platform. However, it has put the audience firmly back at the centre of our thinking about the website.

It has also got me thinking about hospital and regional websites. I wonder how the user experience could be improved if different disciplines and organisations within the NHS contributed content to centralised websites (defined by hospital or trust, for example), but tagged it consistently?

Highlights from Doctors 2.0

I’m still working my way through notes, video, links and tweets to try and and bring together as much as possible of the interesting content to come out of Doctors 2.0.

In the meantime, here’s a few of the hot topics:

Empowering the doctor, not just the patient
It’s easy to assume that digital health is all about encouraging patients to access information and communicate online. However, several speakers, including Kathi Apostolidis and Lucien Engelen, were keen to emphasise that, on balance, patients have been much more progressive in their adoption of the web. In many respects the more pressing issue is to help health care professionals acknowledge and adopt digital tools, so that they are better prepared for the informed patient who arrives in their surgery.

Taking the hype out of digital innovation

The main auditorium at Doctors 2.0 — Panel discussion in full flow, with huge Twitter wall recording proceedings, top right

On my panel of speakers, chaired by Bryan Vartabedian, we discussed the all-too-common fear of digital as a primary obstacle to adoption of the web for health information and communication.
My take-away from this was that while digital evangalists are an essential part of any organisation, they (and I guess I am one of those) can be almost as much of a hindrance. It’s important to take the ‘geek’ factor out of people’s perception of digital.

Evaluating success properly
It was apparent from discussions around the table, that healthcare organisations are still not clear how to evaluate success properly. Commercial organisations either evaluate social media by attributed product sales (very difficult to measure and possibly unsustainable) or simply by the number of ‘likes’ or fans they attract. Not a very useful way of measuring the value of social media, and either approach is likely to undermine the true value.
I don’t think Doctors 2.0 quite nailed an answer to this, but there were interesting conversations about the value of facilitating conversations between patients, so that they can help each other.

The role of Government in digital health
At one point the conference organisers launched an audience poll to ask the audience to what degree they thought Government should be involved in digital health.
Optional answers ranged from ‘none at all’ to ‘Government should pay for, regulate and control all online health content’.
Amazingly, the majority of the audience thought that Government’s should control as much of the information as possible; paying for, and regulating it too. I think this may be more a reflection of the international audience present, who acknowledged the difficulties posed by private sector organisations funding healthcare information.
Personally, I thought this question was a a little over-simplistic in its approach. We need to consider what is already available out there, the quality of that information, and most importantly the role of patients in governing and editing the information that is available.

That’s a quick run-down of some of the hot topics, with more to follow. I hope to pick up on some of these issues through #nhssm in the coming weeks.