Reflections on TELHack from John Pyle – a mentor for the weekend

John has had to leave TELHack but has posted this to us to post here.

John Pyle – Director of OpenHealth Hub, Director of Nine Health, Director of Commade

TELHack 2015 (London): A perspective from a veteran of NHS Hackdays

I have been privileged to have been able to see the development of the TELHack from an idea into fruition, from a perspective of experiences with other health related hackathons.

I have attended almost all of the NHS Hackdays in England and one in Scotland. My role and rationale for attending has been to support the disruptive influence of these events, as a result of having been party to many situations where seemingly straightforward IT challenges for national NHS systems have been made more difficult then they needed to be (at face value) as a result of the relationships (including contractual) with suppliers, and the hierarchies , approval mechanisms, and current ways of working within the NHS. So I want to support any initiatives which would improve these ways of working.

For those reading this who are not familiar with hackathons (or hackdays, or hacks – I will use the term hack hereafter, for brevity) I would like to dispel some myths about what people attending these events believe can be achieved. No-one expects a product from a hack to be immediately viable in a real world environment. Everyone understands there are Information Governance, integration, security and other concerns which need addressing before any of the products would be safe to use. That said, to be able to demonstrate what can be achieved in a weekend of tackling the technology shows that there may be ways to take a similarly rapid approach to resolving all those other issues. As has been said at the launch of the TELHack, it’s not about what we can’t do, it’s about what we can do.

The TELHack differed from the many NHS Hackdays in that it was driven from the Health Education England (HEE) Technology Enhanced Learning (TEL) programme from the outset, with some clear goals (albeit that some of those clear goals were to see what could be done in terms of innovation and culture change, rather than simply requiring some solutions to stated problems) NHS hackdays have been less controlled, driven by a ‘do-ocracy’ philosophy – if you want to run an NHS hackday you can, and there are people who will help you, but there is no central control or rules of engagement (although certain principles such as inclusivity and accessibility are expected). Recognising the need to ensure the outcomes TEL wanted and their own limited experience with hacks, HEE set up a group of interested parties to shape the hack and then select a partner who would ensure the organisation of the event and involvement of appropriately skilled people in technology, healthcare and education to achieve the required outcomes. It was also clear from the outset that this would not be a one off event – the point was to start a ball rolling which included the further development of products from the hack, and further hacks to keep the pipeline full. In other words an innovation in the sourcing of education related technology to support the goals of HEE.

As a result of this more structured approach, the attendance at the TELhack was managed ot ensure a good mix of technologists, educationalists and health care professionals. There was also a different approach to determining which projects (pitches) got hacked. At an NHS Hackday all pitches are potentially hackable, with teams forming based purely on who wanted to support them. A the TELHack pitches were made then a voting process ensured that enough pitches were carried through to be hacked so each would have a team large enough to get the job done, but not so large that anyone would be ‘on the sidelines’.

At the time of writing the TELhack is still underway, but there clearly seems to be a lot of energy at the event, and I look forward to seeing what is produced.
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Deadline!

The teams have been reminded of the 4.30pm deadline and told to try and have presentations ready by 2pm for a run through, tech check and feedback, allowing time for any last minute adaptations.

Everyone seems calm so I’m guessing they’re all on track for deadline.

Some even found time for a power nap…

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On the Home Straight.

TELHack has now reached its final day, and the contestants done well to stay aware of time limitations – there’s still another seven or so hours for them to work on their projects, but many of the groups have began to form their end product already.

The productivity over the night remained surprisingly high, perhaps aided by the desire to win, or maybe just the late pizza delivery; many of the contestants stayed the night, with many of them managing to avoid falling asleep.

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Not everybody resisted the urge to close their eyes

Now 26 hours into the creative process, these final hours will make or break the designs of the teams, with the main goal seeming to be refinement and preparation for the 4 minute pitches that will begin once the night has drawn in the early evening.

More information to follow as the day develops.

Sunday morning and still going…

A few sleeping bags on the floor and some tired looking faces but walking in at 9.30am, everyone is hard at work and lots of progress has been made.

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Everyone seems positive about today and the clinical mentors have just arrived for the teams to ask for advice or guidance if needed.

Permission to think and do, Sir?

Lots of conversations over the past 36 hours about the ways in which working in healthcare and healthcare education works, doesn’t work and could work.

Overwhelmingly, people are here because of the opportunity to work with like-minded people, to learn from each other, to be creative but, above all, to work on a probelm collaboratively and to get something DONE!  Frustration experienced in the slowness, sil-mentality and stifling of creativity is evident in speaking to people and everyone wants to see the energy, enthusiasm and inter-disciplinary ways of working and collaborating that is exemplified in a hack event, translated into the culture of the NHS.  Hack events can, in some ways, provide the space to think, create, play and do, a space where people are literally given the permission to innovate in ways that maybe isn’t always possible in the busy, crazy, pressurised world of healthcare.

If innovation is forged at the interface of different people, from different backgrounds, with different skills and perspectives and a can-do attitude that is focused on specific problems or challenges, then increasingly the NHS is looking for ways to facilitate those interfaces.

Health Education England is exploring ways in which we can help facilitate such interfaces and  TELHack has been borne out of our desire to do so.   Equally important though, is what happens after events like this.

Hack your CV

A midnight conversation with Huiqing at TELHack furthered my understanding of the way that hack events are being used by employers to hire the brightest and best. I’d already learned at Hack Train, another Hack Partners’ event, that companies look for good hack experience on CVs these days. Huiqing, a veteran of AMEE Hacks and now on TELHack was saying that at a recent job interview they highlighted her interest in and passion for being involved in healthcare education hacks and that this had been one of the factors in securing her the job. So pleased were the firm about her participation in our event that they paid her travel expenses. Congratulations Huiqing – result!

Huiqing was saying that even in the world of IT recruitment though there is still a lack of knowledge about hacks and recommends using and explaining the experience in applying and interviewing for jobs. Her new firm were keen to send more of their devs to TELHack but it was too late in the day and all the places had gone. Next year!

Pizza and Onesies versus committee meetings?

Pizza and onesiesI had an interesting chat with some colleagues working in healthcare yesterday evening. They concurred that events like the TEL Hackathon were a fantastic idea and supported the concept of hacks to innovate and positively disrupt the delivery of healthcare and education within the  NHS. But, they exclaimed, back in the “real world” of NHS Trusts, a Hack would never work – the organisational culture is seemingly unsupportive of such disruption and far from embracing the idea of a hack, there would need to be business cases, meeting minutes produced and committees to approve the concept of any venture into disruptive technology. Pizza and Onesies, it seems, simply don’t fit within the corporate governance structure of the NHS.

But can such an informal culture really work within a modern NHS? There are certainly benefits to this less formal approach. While it is true that governance rules and a very rigid hierarchical structure are in place (with good reason – patient safety and patient care must be at the heart of all healthcare provision), there needs to be an element of disruption and challenge of the status-quo in any organisation to drive forward improvements and ultimately enhance the delivery of care to vulnerable people who need the support of the NHS at their time of greatest need.

Events like #TELHack are just one of many ways of delivering change in an organisation and while patient safety clearly comes first, maybe it’s time for the NHS to embrace an element of risk, particularly in healthcare education where trainee doctors, nurses and other health professionals can safely make mistakes and learn to deliver the best possible support for patients of the future? (Although you’ll never catch me wearing a Onesie!)

Dedication!

Going around the room and talking to the teams, everyone is ready to work through the night. I’m not sure how they still have so much energy… I’m exhausted just watching how hard they’re working!!

A constant supply of snacks and the excitement of presenting their ideas to improve healthcare tomorrow is keeping them going.

It’s amazing how fast they are working and things are really taking shape. I’ve had the chance to move between the teams getting an idea of the progress they’re making and I really can’t wait to see them present!

Top Banana – Working on their suture rating idea.

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No slowing down, even after a long day!20151107_215453

A break from the hard work

The participants have been developing their ideas all day, barely stopping to eat! So a well deserved Yoga session was much appreciated.

An opportunity to take a bit of time away from the laptops, relax and refocus and get back to work refreshed.

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Now it’s 9.30pm and there’s no slowing down (The caffeine might be helping). Speaking to the teams, everyone seems excited about tomorrow’s presentations! All this hard work and just 4 minutes to present the problem, the solution and a demo. How will they fit it all in such a short amount of time?

The Sun Sets Over TELHack

Th day is drawing in over London now, but the efforts of our teams are far from winding down – there’s approximately 24 more hours to go before the work stops.

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All of the teams have been putting their best efforts into making their ideas ideas reality, and it’s showing – many teams have began the construction of the code that will define the their end product, and with the assistance of medical professionals they have also taken time to refine their ideas.

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There’s no time for games at this hack.

As the night draws in the team will have to ensure that they stay focussed but also well rested, in order to make the deadline, and in order to make a difference.