Emerging technologies in health

Introduction

Keeping abreast of new and emerging tech forms part of the Technology Enhanced Learning (TEL) programme vision at Health Education England (HEE) so that we continue to train our staff to the highest standards, using contemporary pedagogy and tools proven to work.

In this WeCommunities Twitter chat, we explored the opportunity, implications, and readiness of some of the latest technologies identified through our recent scanning activity with #WeNurses community.

 

The TwitterChat was held on 28 September 2017 between 8pm – 9pm.  With a total of 70 contributors, 356 tweets and a reach that extended beyond 4 million people @HEE_TEL were delighted with the levels of participation.

What follows is a summary of findings taken from the tweets.

Findings

The #WeNurses community was invited to vote for which trend they felt had most potential for healthcare education.  The poll received 257 votes.  The top-voted trend was personalised and adaptive learning (54%) followed by virtual/augmented/mixed reality.

When asked, there was uncertainty about the outcome and supporting evidence for all the emerging tech trends cited, yet most were philosophical about the need for change.

Despite common agreement of the potential benefits for each technology trend, uncertainties about their widespread adoption for healthcare education included.

  • financial climate
  • lack of investment
  • digital literacy of staff
  • lack of evidence base
  • will it improve quality of care?
  • will it reduce cost?
  • speed of technological change
  • acceptance of the technology (AI)
  • skills loss
  • lack of understanding around the newer technologies (specifically AI and VR).

One contributor remarked that “uncertainty is a given” and that we should “encourage [a] spirit of experimentation!”

I think that virtual reality could be an amazing tool for education and learning. Also for patient experience!

Personalised and adaptive learning

There was common agreement that personalised and adaptive learning holds most potential for nursing.  Many of the student nurses supported this view; saying it would be most beneficial.  One suggested that they wanted personalised and adaptive learning to meet NMC standards.  Another remarked that personalised learning may become increasingly important for students who no longer receive a bursary.

Contributors provided broad insight on how personalised and adaptive learning may affect the education of health professionals by 2021.

  • Increased accessibility to more remote areas
  • Broader, deeper learning
  • Less pressure to learn just to pass exams
  • Improved learning outcomes
  • Professionals able to excel in ways that suit them best
  • Better patient care
  • Greater knowledge about how people learn
  • More confident learners
  • Competent staff
  • No “one size fits all” approach to learning
  • Improvements to the learning process.

#WeNurses listed several desirable outcomes regarding use of personalised and adaptive learning. These were:could encourage broader, deeper learning, less pressure to learn just to pass exams,use of #simulation to bridge knowledge gap

  • improved patient safety and outcomes
  • reduced costs
  • improved staff skills
  • better quality of care
  • person-centred care
  • MDT learning and working together
  • sustainable and mindful practice.

Yet if things went wrong with it, they were worried about having a suitably stable and modern IT infrastructure, with a system that could capture and store learning data with adequate data protection and security.  Some were concerned about the level of digital literacy of staff and that some staff may choose to leave the profession because the technology intimidates them.  An interesting point was raised about the acceptance of personalised and adaptive learning approaches by the regulators.

Looking at internal systems, #WeNurses offered their thoughts on how these might need to be change to support use of personalised and adaptive learning for healthcare education.

  • Systems must change to recognise the individual and not the job role
  • Support innovation
  • Have an acceptance of risk
  • Communicate what works
  • Provide access to external learning resources
  • National joined-up thinking
  • Provide smoother access to e-learning
  • Improve firewalls to prevent external manipulation
  • Stronger internet signal
  • Build confidence to use different learning modes
  • Organisations must be supportive of learning and development.

Visit http://www.wecommunities.org/tweet-chats/chat-details/4055#/chatSummary to view the complete transcript.

Resources cited by contributors:

http://medicalfuturist.com/augmented-reality-in-healthcare-will-be-revolutionary/

https://www.youtube.com/watch?v=SKpKlh1-en0

https://en.wikipedia.org/wiki/Personalized_learning

http://mfeldstein.com/personalized-learning-vs-adaptive-learning/

https://hee.nhs.uk/our-work/developing-our-workforce/building-digital-ready-workforce

Let’s do this!

We weren’t sure what to expect, to be honest.  We knew Hack Partners were experienced in pulling off these kind of events and some of us had a bit of experience at a Hack Partners’ hackathon but this was an exploratory exercise for us.  We knew that we wanted to innovate ourselves, we knew that we wanted to create a space, a time where we could bring together as diverse a range of people as possible in order to let them work together on the challenges that we face in healthcare education and training and, hopefully, come up with some techie solutions.

I think we, the TEL team, were all a bit blown away by what actually happened.  From the get go, we had some really sound pitches, most, if not all, that could easily have got a team around them and been worked on.  However, only the top ten ideas went forward to form teams and it was very interesting to see how quickly people abandoned their own idea and totally jumped on board with someone else’s.  There were still internal discussions and clear differences of opinion but there was no sign at all of any dysfunctional teams that simply couldn’t get their act together.  As an exercise in team-building and leadership skills alone, this was a worthwhile and productive learning experience.

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The weekend was intense, in every sense, and I finally understood what I’d been told in advance, that a hackathon can be emotional!  People were committing time and energy and real passion to their projects and this really showed when it came to the presentations at the end.  With only four minutes to present and then two minutes for Q and A, the professionalism, combined with the enthusiasm and confidence on display, was incredible.

Four winning teams emerged on the Sunday.

Team Score my Sutures had an image recognition tool to help training surgeons practise their suturing with immediate assessment and feedback.

Team Echo developed a project using iBeacon technology to help trainees, students, locums in clinical setting orientation and information.

Team Geyedlines had an application that delivers immediate point-of-care information via Google Glass. (Geyedlines also won the Big Data and Innovation awards)

Team iNurse had created a test/quiz-based interactive learning site for training nurses using gamification to increase interest and motivation.

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But TELHack wasn’t over.  We had a showcase event held at The National Science Museum on the evening of 10 November.  With the Information Age Gallery given over to us for the evening, courtesy of Bloomberg, we were utterly spoiled with this venue.  Surrounded by the technology solutions of C20th, we couldn’t have asked for a better setting to look again at the projects that teams had come up with.  One participant told me that they were too exhausted on Sunday to worry too much about presenting but that this time it was really nerve-wracking.  They all did a superb job.  This time our judges were focusing anew on the criteria but giving extra weight to the viability and sustainability of projects within an NHS setting.

Team iNurse triumphed again and were jointly awarded the top slot with Team Ward Words who had developed an interactive, audio-visual app for nurses with English as a second language needing to build confidence and language in clinical settings.

The TEL Programme will be continuing to work with the hack concept and to look for ways in which we can mentor and support innovation in healthcare education to try and ensure that ideas come to full development and implementation. It was more than evident through this experience that there are the brains, the talents, the enthusiasm and appetite for innovating in healthcare education. As Hack Partners are so fond of saying – let’s do this!

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They think it’s all over

The presentations at the end of a long weekend by all the teams completely bowled me over. The level of sophistication in presentation, design and working prototypes was quite amazing, as was the energy and enthusiasm in delivery. What seems so unfair is that each team only gets four minutes to pitch and two minutes to answer questions when they’ve sweated blood over their ideas and working models for so long. But that’s the nature of the hackathon and the competitive spirit was driving everyone to display the very best of themselves and their work. What was clear was that there were no ‘bad’ or unworkable ideas. Speaking to one of the judges after, it was obvious that coming to a decision had been extremely difficult given the quality of the outputs.

With Score my Sutures, Echo and Geyedlines coming 1st, 2nd and 3rd and the RCNi prize going to iNurse, I think that we certainly ended with prototype ideas that are of serious value and potential.

So, the prizes are won but this isn’t the end of the road. On Tuesday 10 November, we have our Showcase Event at the National Science Museum in London where teams will again present their ideas. There will be further judging and review of many of the work presented by teams over the weekend.

Health Education England intends to work in partnership with various mentor sites (Trusts/Hospitals) in order to see if the ideas created at TELHack really do have legs.

We hope that many, if not all, participants keep in touch with us, keep thinking about and even working on their incredible ideas to improve and enhance healthcare education and continue to look out for further events of this kind.

With the quality of people that TELHack was able to bring together, there is no doubt in my mind that this creative interface has a real future.

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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