Sir Isaac Newton said he saw further than others by "standing on ye shoulders of giants" thereby acknowledging his sources and influences. Celebrity psychiatrist Dr. Raj Persaud seems to have attempted an easier ascent by using ye copy and paste on the published work of others without such clear acknowledgment.

The UK General Medical Council found Dr. Persaud had behaved dishonestly and had undermined public confidence in the profession. Some examples of his plagiarism are at the bottom of this article.

But giving Dr. Persaud a kicking is not on my mind. I am more interested in the reaction to the GMC's decision.

The UK media are notorious for building up celebrities only to bring them crashing down. However, in this case the journalists seem to have shuffled uneasily in their ergonomic chairs. A web search will reveal the majority of the coverage is ambivalent, many journalists and others trying to deflect the debate by saying what a good chap Dr. Persaud is and that blatant plagiarism does not mean he is not a good doctor. Fair enough, but let's stay on topic, guys.

In the main, journalists earn expert status vicariously. It takes about 10 years of intensive work to be considered an expert in a field, and few journalists--particularly in healthcare IT--have that experience. Hence, we get the phenomemon of journalists interviewing other journalists, who are meant to be experts but in reality have a superficial understanding of their subject. It is no longer necessary to invest 10 years to be considered an expert. A few hours of web searching and mugging up can give that impression without the hard graft.

Comments allegedly made by Richard Madeley and Judy Finnigan encapsulate my area of concern. It was on their TV programme--which considers itself qualified to comment on life, the universe and everything--that Dr.Persaud first came to media prominence. They have stated they wish to continue working with Dr. Persaud. So it seems professional honesty comes second to presentation skill. Is the Internet taking us to a form of celebrity medicine where the ignorant are led by the superficially informed?

Posted by Colin Jervis, Kinetic Consulting at 05:26 PM | Permalink | Comments (0) | TrackBacks (0)

I've been reading Garrick Alder's Mind Bombs which is a collection of short articles designed to galvanise your thinking.

He reports Professor Richard Smith, editor of the British Medical Journal until 2004, said only about 5 percent of the entire planet's scientific papers came up to scratch. In most journals, Professor Smith said, it was less than 1 percent.

I have a comparable view of most of the Health Informatics publications I have read. They fall into two categories: the bean counting variety best kept by the bedside as a soporific and the other weak and subjective.

Health Informatics faces the same challenges as fields like sociology and psychology which also depend highly on the interpretation of human behaviour. At this stage in its evolution, the success or failure of healthcare IT is largely determined by how well users apply it. Therefore, IT must become fully integrated into healthcare, not seen as something separate. This goal is not best served by the creation of another specialty, Health Informatics, in a field already overflowing with them. That just gives practitioners an excuse to continue to pass the buck: "It's not my specialty, mate".

Posted by Colin Jervis, Kinetic Consulting at 02:09 PM | Permalink | Comments (1) | TrackBacks (0)

It's been a while since Peter wrote for FHIT, but he's back. You can also read some of his previous entries. Let's rock!

‘I was looking for a job, then I found one. Heaven knows I’m miserable now’. How often have you heard these words for real in the workplace? Poor morale and motivation account for massive waste in effort, costs and profits in even the most successful organisations. So what can Morrissey, Minztberg, Meatloaf, Maslow, Motorhead, Madonna et al teach us about how to create a work climate and culture that rocks? In the book ‘Sex, Leadership and Rock’n’Roll’ I explore classic ideas about motivation through a rich mix of great academic thinking ‘tamed’ with the pithy wisdom of rock and pop culture. Let’s start with a look at the Blues.

Can’t buy me love?
Most Blues songs begin: ‘Woke up this morning’ and then move on to motivational problems such as ‘The landlord wants to repossess my home’ or ‘My woman left me’.

In the modern workplace, you cannot have a Blues that goes ‘Woke up this morning, the server was down’ or ‘Woke up this morning, I got a good HR manager who self actualises me!’

Quite surprisingly, this cheesy contrast makes a great deal of practical sense. Frederick Herzberg pointed out the difference between those factors that merely remove dissatisfaction at work, e.g. pay, administration, supervision (called dissatisfiers) and those factors that encourage job satisfaction e.g. responsibility, advancement etc. (called satisfiers). Just think about those ‘fly like an eagle’ motivational posters in some hospital corridors. Yes, they are cheap, but they do not create workplace satisfaction.

Many reward systems only focus on removing dissatisfaction - it’s no surprise that they fail to motivate – just try doubling someone’s salary and notice how long they work twice as many hours! As Prince said ‘Money don’t buy you happiness, but it sho’ ‘nuff pays for the research.’ i.e. inadequate pay dissatisfies, but no amount of pay will produce long term job satisfaction. This is especially true for Generation Y and beyond, who crave much greater things from work today. Companies such as First Direct, B&Q and Prêt à Manger have learned this point well and surpass others with people who bring their heads, hearts and souls to work. The NHS is well positioned to offer people some Herzberg satisfiers e.g. career development, intrinsic job satisfaction etc.

Key point:review Hertzberg’s model in the book and ask yourself ‘How does our motivational strategy line up with his findings?

River deep, mountain high
Coming back to our Blues examples, repossession of the home and losing one’s lover are located towards the lower levels of Abraham Maslow’s hierarchy of needs i.e. shelter and belonging. Maslow crucially pointed out that there was a hierarchy of needs from physiological through to ego and self actualisation. So we really cannot have a Blues that starts ‘Woke up this morning, I got a good manager, who sets meaningful performance goals and leverages my talent in ways that provide long term career development tailored to my talents’ unless the basics are also in sufficient supply. As an aside, the lyric does not scan well either!

Key point:HR needs therefore to be not only strategic and visionary but also tactical and detail conscious in the way it motivates staff.

I want it all and I want it now
In a culture of mass individualisation, employees expect to be treated as individuals, yet many HR systems tend to treat them as a collective in the interests of fairness, equity and conflict avoidance.

Key point:personalisation is the key to individual motivation. This requires motivational systems that are responsive both in speed and flexibility. Ask your HR people to tell you how the HR system achieves these ambitions.

We gotta get out of this place
Blues can take place in New York City, but not in Newark. Hard times in Minneapolis or Canterbury is probably just clinical depression. Chicago, St. Louis, and Kansas City are still the best places to have the Blues, not York, Bath or Slough. You can’t have no Blues in a shopping mall. The lighting is all wrong.

The physical and psychological environment are important components of motivation. Although working conditions are a Herzberg dissatisfier, poor working conditions really make for poor performance and, more importantly, these things are not so expensive to put right. Companies that recognise the contribution of the built environment on performance include Pfizer. However, as I pointed out earlier, décor is cheap but insufficient if people feel unable to do a good job. Furthermore, a pleasant work environment is no substitute for the least expensive and most effective motivator – behaviour that encourages others to give their all, which leads us to our last point…

I’d do anything for love, but I won’t do that
I did a gig with Lorraine Crosby, who sang on Meatloaf’s classic song, but failed to discover what ‘that’ is in the context of the song, so we’ll concentrate on the ‘love’ part… Praise is the least expensive but highest value motivator. It merely takes time and must come from the heart.

Key point: the built environment helps people to feel good about work, but how people behave is crucial to long term motivation. Find ways to spot people doing things well and let them know about it.

You can buy Peter Cook, MD, Human Dynamics's book: Sex, Leadership and Rock’n’Roll – Leadership Lessons from the Academy of Rock.

He is also speaking at a conference for the NHS Innovation Institute HR Network Scotland Conference on February 14 2008.

Posted by Colin Jervis, Kinetic Consulting at 11:03 AM | Permalink | Comments (0) | TrackBacks (0)

This weekend I went on a nostalgia trip back to the North East of England and sat for an hour in the Rendevous Cafe sipping coffee and contemplating the incoming North Sea. The feel of the Cafe is encapsulated in a poem by local poet Julia Darling, who died in 2005 after a fight against cancer and a photograph of her drinking coffee on her final visit hangs on the wall. Throughout her illness she promoted poetry for its healing properties, particularly in this collection of poems which I have.

"Poetry should be a part of every modern hospital, not just as something to keep patients amused. It's a powerful force, which can help us through the darkest times."

The rising tide of technology will wash away much that is commonplace in tackling illness, but the role of the human spirit will stand.

Posted by Colin Jervis, Kinetic Consulting at 06:45 PM | Permalink | Comments (0) | TrackBacks (0)

I have been working on identity management recently. It’s a Tír na nÓg for techies: tokens, certificates, assertions, authentication. But the real challenges may have more to do with human processes than technical ones.
Recent workshops suggest the biggest problems may be in user management and the granting and revocation of access rights.

The NHS has implemented high levels of security with its use of smartcards based on chips with high levels of PKI encryption and sound processes for user registration and authorisation. But this article shows how users can still thwart security, in this case by remaining logged in and allowing colleagues to use their access rights.

Gerald M. Weinberg says (I probably misquote): all problems are people problems. Perhaps one day someone will come up with an incompleteness theorem like Kurt Gödel’s: that confirms no matter how sophisticated IT becomes users will always break the system.

Posted by Colin Jervis, Kinetic Consulting at 06:30 PM | Permalink | Comments (0) | TrackBacks (0)

At a recent conference a woman studying Health Informatics in London told me she'd seen this blog: "Oh yes, its about robots, isn't it?" Which probably means I have to make my intention clearer. Nonetheless, I can't deny a passion for them since reading about them as a child in old copies of the Eagle Annual I bought at a church jumble sale. So, at the risk of missing my intention, here are a couple of articles I spotted.

Professor Rodney Brooks talked about domestic and military robots in his RSI lecture for the British Computer Society. Prof. Brooks reckons that we are at the beginning of an exponential growth in the use of robots, partly driven by an aging Western population and our likely need for replacement body parts.

I also remember as a child reading a satirical SF book which somehow remains in my mind called Bill the Galactic Hero. Bill becomes a hapless hero when he accidentally destroys a Chinger command ship in a space battle. The Chingers are vilified by the humans who post questions on the decks of their space vessels like: "Would you let your sister marry one?" But another robot article I spotted in London's Metro might cause you to ask: "Would I be married by one?"

"Yes" is the answer of robot designer Seok Gyeong-Jae. Tiro the robot recently officiated at his wedding in South Korea.

Posted by Colin Jervis, Kinetic Consulting at 06:44 PM | Permalink | Comments (0) | TrackBacks (0)

Some progress in healthcare can be helped by IT and technology and some can’t.

In the mid 19th Century Ignaz Semmelweis showed handwashing reduced cases of puerperal fever among new mothers. But newly published figures for care homes in 2005 make me wonder how far we have progressed. Clostridium difficile was mentioned as a cause of death in 144 cases.

In a low tech approach to reducing the march of superbugs like MRSA and c. difficile in UK hospitals, the Chief Medical Officer Sir Liam Donaldson suggests patients should ask doctors if they have washed their hands. This is yet another example of the need to inform and empower patients.

Read Death toll from 'superbugs' is soaring for some background.

Posted by Colin Jervis, Kinetic Consulting at 11:45 AM | Permalink | Comments (0) | TrackBacks (0)

Dale Hunscher (who runs the US cousin of this site) has written a book: Blogging for Health Professionals Using TypePad: a jump-start approach. The Internet fundamentally changed the relationship between patient and clinician and blogging is a way for healthcare to adapt. More than ever clinicians and healthcare organisations need to build trust with their customers, and the use of social software, like blogs, is a way to do it.

Dale tells healthcare practitioners how to set up a blog on Typepad that will build their reputation and attract customers. Each stage of the set up is clearly described and once your blog is up and running he tells you how to drive visitors to it.

Dale sells Blogging for Health Professionals Using Typepad as an eBook, which means it's less expensive and you can download and read it now .

Posted by Colin Jervis, Kinetic Consulting at 05:37 PM | Permalink | Comments (0) | TrackBacks (0)

A mobile phone carrying a breathalyser is about to be launched in the UK the Sunday Times on 9 July 2006 reported. The Samsung LP4100 tests drinkers's fitness to drive and may also lock out certain numbers to prevent embarrassing drunken calls to bosses, former partners or the local takeaway. The phone is multifunctional, even offering a remote control for karaoke machines.

I also spotted this article about a breath test for metabolites asssociate with breast cancer.

Lack of testing and diagnostic devices not needing specialist intervention have limited remote monitoring and the development of carebots, but that's changing fast with breath testing a promising area.

Posted by Colin Jervis, Kinetic Consulting at 02:00 PM | Permalink | Comments (1) | TrackBacks (0)

I have just written an article on convergence in healthcare. I interviewed a director of a major software company (I will post more when the article is published) who reminded me that most healthcare companies have concentrated on developing products for 1 billion of the world's population; 5 billion in the developing world have, by and large, been neglected.

I spotted an article in London's Metro newspaper about a device costing £1.50 (less than $3) that prevents deaths from water borne bacteria and viruses causing typhoid, cholera and diahorrea. Half of the world's poor suffer from water borne disease.

Lifestraw uses a slalom of filters to purify water and has been used in Asia, Africa and South America.

Off topic and low tech, I know--but effective.

Posted by Colin Jervis, Kinetic Consulting at 06:00 PM | Permalink | Comments (0) | TrackBacks (0)

This blog is mentioned today in an article about the business benefits of blogging on the UK's Daily Telegraph website.

I have also joined the blogging team at Healthcare Today a new website that should appeal to all healthcare professionals. On the home page you can download a free version of the publication, register or subscribe.

Posted by Colin Jervis, Kinetic Consulting at 04:46 PM | Permalink | Comments (0) | TrackBacks (0)

FHIT is reviewed by Healthcare Today. You can download free a PDF of the April 2006 edition here. The review is at the bottom of page 21.

Posted by Colin Jervis, Kinetic Consulting at 09:00 PM | Permalink | Comments (0) | TrackBacks (0)

On the London Underground everyone seems plugged into one. Even above ground in healthcare MP3 players are becoming ubiquitous.

Continue reading "Sounds Healthy: iPOD in healthcare" »

Posted by Colin Jervis, Kinetic Consulting at 07:29 PM | Permalink | Comments (1) | TrackBacks (0)

In 1995 I visited the exhibition in London's Tate Gallery of the (infamous) Turner Prize shortlist. Stepping into the darkness of Mona Hatoum's installation Corps Etranger I watched a video journey through her intestine and other bodily passages. Today she could avoid the discomfort of the endoscope in the interests of Art by using the multi-vitamin-pill sized Smartpill®.

When swallowed, SmartPill records its trip through the digestive tract using its battery of on board equipment and sensors, like a thermometer, pressure gauge and acidity meter.

Unlike the miniaturised submarine carrying Raquel Welch et al in the 1966 movie Fantastic Voyage, SmartPill is propelled by peristalsis. When excreted 24-48 hours later, a doctor downloads its data in less than 10 minutes and analyses them, a process which could transform the diagnosis of conditions like dyspepsia, constipation and irritable bowel syndrome.

For more see Roger Dobson's article in the UK's Daily Mail of 25 April 2006 or visit SmartPill Corp's website.

Posted by Colin Jervis, Kinetic Consulting at 01:14 PM | Permalink | Comments (0) | TrackBacks (0)

On 21 March 2006 the BCS London and South East Health Informatics Group sponsored a lively and light-hearted debate at the HC 2006 conference:

“This house believes that real innovation using ICT in healthcare delivery is driven by clinicians rather than informaticians.”

Simon Dodds and Mark Outhwaite proposed the motion and Ian Herbert and I opposed with Keith Clough in the chair.

I argued that healthcare in the UK was facing illness because of a shortage of cash and qualified staff and an aging population that is likely to lead to an increase in chronic disease. Never has healthcare needed ICT innovation more—but who will provide it?

I tacitly accepted that clinicians and informaticians must work as a MDT, but I was speaking against the motion. I had three main arguments:

• Clinicians are experts in patient care, informaticians in ICT;


• Informaticians have a broader view of healthcare than clinicians; and


• Innovation is not about ideas, it’s about the implementation of ideas.

Cyber means “art of steering” in ancient Greek. Informaticians would be the cyberanauts building the pathways and finding the passages that led to a coherent, patient-centred healthcare system.

All to no avail, I'm afraid! After contributions from the audience—one of whom said he thought clinicians should be leading ICT innovation, and asked why then they didn't get on with it—the motion was carried by 18 votes to 9.

Rod from Informaticopia also wrote an official blog entry on the debate. In addition, Simon Dodds, a Consultant Vascular Surgeon and Innovator, is allowing me to use some comments that he emailed me in an entry to follow.

Reposted by FHIT on 29 March 2006 adding the hyperlink to Simon Dodds' entry.

Posted by Colin Jervis, Kinetic Consulting at 07:00 PM | Permalink | Comments (0) | TrackBacks (2)

I taking part in a debate at the Health Care 2006 (HC 2006) conference in Harrogate, UK on 21 March 2006. The motion is:

“This house believes that real innovation using ICT in healthcare delivery is driven by clinicians rather than informaticians.”

I am speaking against the motion. If anyone has any ideas, arguments, interesting or amusing anecdotes for me to use, I would be pleased to read them.

Posted by Colin Jervis, Kinetic Consulting at 05:28 PM | Permalink | Comments (2) | TrackBacks (0)

Shocking, but there are two Future Health IT Blogs! Dale Hunscher made his first entry shortly before me, but I started regular blogging a bit earlier. Fortunately, Dale deals with the duplication in magnanimous style in this entry.

I am relieved our chosen areas differ. Dale concentrates on biomedical research informatics technology and you should pay a visit to his site.

Posted by Colin Jervis, Kinetic Consulting at 07:46 PM | Permalink | Comments (0) | TrackBacks (0)

Why QWERTY? Why indeed.

This keyboard layout was designed in 1874 by Christopher Scholes. An alphabetical layout caused the machine's levers to jam, so he positioned the most frequently used letters as far apart as possible. To assist salesmen to demonstrate, Scholes craftily arranged all of the letters needed for the word "typewriter" to be in the top row.

I think this is an awful input device. I have been using it for many years and learned to touch type when I was completing a Masters dissertation. Time and again I watch users hunting and pecking their way across the keyboard. Imagine the time wasted in this painful process.

This article on Slashdot refers to a Swedish study that shows that the keyboard is a bacteria farm. It is inhabited by 33000 bacteria per square centimetre, compared to 130 on a toilet seat.

Covering a keyboard makes it easier to clean, important in these times of super bugs like MRSA. But what about ridding ourselves of it altogether? It's time for FHIT to look at other methods of data input.

Posted by Colin Jervis, Kinetic Consulting at 07:00 PM | Permalink | Comments (5) | TrackBacks (1)

Regular visitors will notice that FHIT has had a makeover. We hope you like it. If you notice any problems or glitches please let us know. We hope you enjoy the site and will continue to contribute with your comments.

Posted by Colin Jervis, Kinetic Consulting at 07:06 AM | Permalink | Comments (1) | TrackBacks (0)

This is a re-post of three entries about the increased mortality reported in “Pediatrics” after the implementation of a Computerised Physician Order Entry System (CPOE) for the convenience of delegates at the “Successful Implementation of NPfIT 2006” in London. These entries relate to discussions during the sessions I chaired on 30 January 2006.

First entry on the Pediatrics article.

Second entry on the article.

Third entry and link to post-publication peer review.

Links to other relevant blogs and websites are in the postings.

Posted by Colin Jervis, Kinetic Consulting at 10:00 PM | Permalink | Comments (2) | TrackBacks (0)

At this time of worry about a possible flu pandemic and terrorist attacks its good to know that computers are helping medical staff to prepare.

This article Bits and Bytes: Video Games and Disaster Training describes how gaming software is being used to prepare staff to deal with major incidents.

In the December 2005 edition of "Wired" (p208) "Reinventing 911" describes how a community in Portland Oregon has improved its emergency services.

No matter how much we plan, disasters are addressed by intelligent improvisation. In order to be effective and overcome the human tendency to pause before acting, warnings must not be seen as single events but as a series of triggers for actions by informal networks.

The Emergency Digital Information Service (EDIS) aggregates weather forecasts, alerts and official warnings into a single database which can be transmitted to police, emergency centres and television newsrooms.

A common alerting protocol (CAP) tags events by location and urgency, allowing emergency services--police, firefighters and paramedics--to share information in a common format and to filter it according to its relevance.

Posted by Colin Jervis, Kinetic Consulting at 06:46 PM | Permalink | Comments (0) | TrackBacks (0)

Good news for bibliophiles, technophobes and cynics: digital paper is a reality and the "paperless" hospital might never be.

This article in the Guardian describes the "Librié" a new product from Sony, Phillips and E-Ink.

Charged black and white microcapsules in oil line up in response to an electronic charge to form words on a screen. The Librié can hold the equivalent of 10,000 pages, about 40 novels, which can be reloaded. The boot of a Consultant's 4x4 may never have to be full of patients' notes again! (Only joking, guys!)

Digital paper is already used for in store displays that can be refreshed by wireless links.

However, Siemens has developed paper thin displays that could replace conventional labels. Walking down the isle of the supermarket could soon be like strolling around Piccadilly Circus as the labels of goods present us with changing, alluring images and displays.

And, don't we already have e-books on PDAs and displays that respond to digital signals? Oh, and where do those digital signals come from? Computers?

Though I love gadgets, it's difficult to see what more digital paper offers. It may be yet another solution looking for a problem. Suggestions for healthcare applications on white pulp or (better) in the "Comments" section below, please.

Posted by Colin Jervis, Kinetic Consulting at 07:18 PM | Permalink | Comments (0) | TrackBacks (0)