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November 26, 2009

Belle Tolls

My interest was piqued by Clive James' encomium broadcast on BBC Radio 4 last Saturday. He compares her to Rommel and Martin Amis and acclaims her expertise in health informatics (he would know, right?)

Dr. Brooke Magnanti outed herself as the author of the infamous Belle de Jour blog just before the UK's tabloid press did it for her. Despite hyperbolic media speculation about her identity, it turns out she is a previously unremarkable UK healthcare research scientist with a qualification in health informatics.

I have never read the blog (honest!) though I knew about it and had seen the resulting books in Borders. OK, I was a bit envious that someone could make so much money out of blogging, but, I comforted myself, health IT does not have the same mass appeal as sex.

Back to Clive James: though I've read a couple of Martin Amis' novels, I did not enjoy them as much as his other writings and reviews; for example, take a look at War Against Cliche in which his feel for words and general erudition sparkle. No wonder he was named "Smarty Marty". So does Dr. M's writing really compare?

This article describing an autopsy was written under her real name. It describes man after the god has left the machine and even makes a couple of analogies with IT. The image of a cutting scalpel in a curved fist is one that sticks with me. She's good, not as good as Amis, but good.

But the events leading to the denoument form a subplot worthy of John le Carre. A fellow blogger guesses her identity and sets up an early warning Googlewhack on his website. Galumphing newshounds on the cyberscent trigger the alarm. The blogger tracks IP addresses back to Associated Newpapers: the game is up. Before being shoved, Dr. Magnanti steps out of the shadows. You can read all about this from
the blogger himself (under Me and Belle de Jour...).

The veil of Internet anonymity has been sliced open, what now? Well, placing your life (fact or fiction) into the public domain on the Internet can affect your health. No-one will regard you in the same way again.

November 18, 2009

Medibots

A month or so ago in a stupor before heading off to bed, I watched part of an episode of Holby City, a UK TV series which relates the quotodien of a fictional acute hospital. In that particularly overacted episode, two surgeons squabble over who will take the lead in robotic surgery. Many of you have have worked with real surgeons will know few of them are shrinking violets, probably a good thing, because they may have to take life and death decisions in seconds. It may come as a surprise then that in the future some surgeons may actually be invisible.

The latest edition of New Scientist* has a nice article by Gaia Vince titled Rise of the Medibots which suggests surgeons of the future may be too small to see.

The entomological metaphors in the article strike you: many of the devices are like centipedes or small spiders that are guided by humans through the heart, eye and other inaccessible parts of human anatomy. At this, some of you may think of that bug-thing that the Agents insert into Neo's navel in The Matrix, and it may be like that, though the ones described in the article are good guys.

Some of you may also recollect I posted about a discussion on BBC Radio 4 in which Professor Robert Winston took part. Prof. Winston was of the opinion that patients needed the human touch, and suggested robots were good but would never catch on. This is nonesense, of course. Healthcare in the future will apply robot and human touch.

* 21 November 2009 pp50-51

November 16, 2009

Bearing Up

I’m still riding high from the Yes concert tonight. I confess, after a day’s work, after getting up at tweet-tweet time to catch a train, I went wearily to Birmingham Symphony Hall to join the other fans. But after the first chords of “Siberian Khatru” (No I won’t. Look the meaning up yourself.) I was reinvigorated.

I sat bang in the centre of the front row, so I noted the veteran band members are looking a bit older these days (unlike me who hasn’t aged a day) but their fingers still fly nimbly over those arpeggios and scales. A night to remember!

I have a fascination for robots, probably stemming from trying to make one as a child from a shoebox, flashlight bulbs and odd bits and pieces from my Father’s workshop, So perhaps it’s not surprising I spotted an article in the BBC’s Focus magazine which made me hope when I do age a few days, I may even have one as a carer.

The Japanese are way ahead in the field of robotics, fortunate since they are short of nurses and have the most rapidly aging population in the world. Perhaps supporting a phenomenon named uncanny valley Japanese researchers found people warier of human-like robots. Robo bears are their solution. Cute…or what??

November 15, 2009

Learn from the Past

It's been a while since I last posted. Personal matters, my workload and the departure of the muse are among my excuses.

I am back at a time of transition. The NHS waits for the official line of the NHS National Programme for IT (NPFIT). The Department of Health’s November 2009 deadline for Local Service Providers (LSP) to have made significant progress is here.

Perhaps the plans for the NPfIT Southern Cluster are a hint to the future of ICT implementation in NHS. In limbo since the departure of its LSP, Fujitsu, it seems Southern cluster organisations might be allowed to select systems from the pre-competed framework contract, the Additional Supply Capability and Capacity (ASCC).

I have always suggested that allowing organisation to choose their own systems adhering to reasonable standards--whether from NPfIT, the ASCC or by independent procurement-- is where the NHS would end up. Indeed, some foundation trusts have already gone and done it, and the tide of trusts preparing to do the same threatens to end the 7 year interregnum imposed by NPfIT anyway. For many organisations the years of waiting for NPfIT to deliver while their existing systems became obsolete proved too long.

I may have suggested independent choice was the way forward, but I didn't say it would be a panacea. Successfully implementing major health IT is difficult. However, a legion of consultants and assorted contractors wait to help trusts through these challenges, particularly since LSPs have been downsizing.

During a recession, you can hardly blame people and organisations for presenting their experience in the most positive way, but the head of NPfIT's office must have been very crowded if all of the people and organisations who, according to their biographies, played a 'major role' in it were accommodated there.

Aldous Huxley quipped the most important thing we learn from history is that we never learn from history. We risk repeating the mistakes of the past if we simplistically believe that a different approach will be a better one, particularly if we (again) accept the advice of those who have little or no real experience of the challenges of major healthcare IT procurement and implementation.

If you are considering an independent procurement or are simply assessing your options take advice from someone who has at least implemented a major healthcare system and learned from the experience.