NHS Hack Day

NHS Hack DayNHS Hack Day sees clinicians, developers, designers, patients and anyone with an interest in the NHS Team up and create disruptive solutions to the problems facing NHS IT.

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The weekend before last I was up to my eyeballs in code, surrounded by extremely enlightening people and running round John Radcliffe University Hospital desperately seeking my caffeine fix. Yes, last weekend I was at a hack day. NHS Hack Day to be more precise and it was awesome.

NHS Hack Day sees clinicians, geeks and patients get together, talk about what isn't working for them and they spend around 12 hours working together to create a solution to the problem. Sounds simple but having been working in the NHS for the past three years I can tell you that some of the projects that get proposed would take years to complete if handled 'in-house'. The fact that teams are able to create online cell counters, patient feedback systems and redesign the NHS e-portfolio in a day is amazing and shows how disruptive solutions could benefit the NHS immensely.

This was the first NHS Hack Day that I actually went up and proposed a project, normally I'll listen and then work on someone's idea but I decided given recent events at work it was time to take the plunge. We're currently trying to revamp the site I work on (although there's been loads of set backs) so I proposed a NHS acute trust website audit (catchy title eh?). I originally wanted to scrape accessibility data and then use this to show how accessible NHS websites were but due to time constraints my team and I scraped the technology used.

This sounds quite boring but actually it opened my eyes to some of the things floating around in the NHS web space. Some things didn't surprise me (like how 68.5% of NHS websites are run on IIS, the NHS is very Microsoft orientated) and some things shocked me (loads of NHS websites don't return a 404 and redirect to a search page!). If you want to check the project out you can at http://rjmunro.github.com/accessibility-scraper/. A big shout out to Jamie Munro (@rjmunro) for his help scraping and saving me from Git time and time again, Mariana Mota (@marianamota) for her excellent design work and Harry Jones (@hjonesdesign) for not giving up when the internet screwed up!

Why the NHS should be taking part

Although I work in the NHS I never realised the easy win solutions from the projects proposed. In the NHS I live in my own little hospital based world where my main focus is getting information to patients via web, print and apps. I never stop to think of the issues that clinicians have with the technology they are supplied with as most clinicians only talk to me when they need to inform patients or staff about their services.

One project that really stands out as a shining example of this is @wai2k's Cell Countr. Wai Keong is a haematologist who counts different blood cells to diagnose patients, there are 11 types of blood cells that Wai Keong needs to count. The next bit always cracks me up, to count these 11 types of blood cells Wai Keong uses an abacus, which only has eight levers! The solution that the Cell Countr team created was a javascript webpage that essentially turned a computer keyboard into an abacus.

Great solution but here's where the NHS will screw it up for this type of project (at least it has for me). Cell Countr will most likely be accessed via a browser. The NHS basically runs on IE7 (IE8 if you're lucky, IE6 if you're really not) meaning that the javascript used on Cell Countr will be severely limited to IE's rubbish javascript support. If a clinician wants to change browsers they either need to be crafty or they need to contact the IT service desk (where their request will be logged as non-critical) and also get sign off from various people. This means that it can take weeks or months to finally have the right setup to use the tool which ultimately means the adoption rate of Cell Countr will drop off.

This is a massive shame and something that the NHS needs to address. Understandably IT departments want to avoid risk and also create an environment where they know that all their computers have a certain setup so they can roll out changes on mass without red herrings messing it up. As clinicians take more of an interest in technology to solve the problems they face and as modern browsers have progressed the baseline of web technology a setup based on Windows XP (which hasn't had an update in 4 years!), IE7 and locking down other browsers doesn't cut it. It looks like Wai Keong is working on this issue though and has found a way to install Google Chrome on his NHS PC.

Who's behind it

NHS Hack Day is run by Open Health Care, a company run by @drcjar, @rossjones and @thatdavidmiller, it's also sponsored by the NHS Commissioning Board, NESTA, O'Reilly (who's logo I only just noticed blinks!) and various others (full list here).

The next NHS Hack Day is going to be taking place in London if you're interested in attending. I'm currently working the system with @puntofisso to put a bid into host it at St George's, fingers crossed the next blog post will be about how I rocked up with my Mac Pro and dual monitor set up much to the envy of those using laptops.