A Web That Works

I’m going to have to shut down this site. I’m paying for the hosting out of my own pocket, and it’s too expensive. I’m moving all the content over to http://awebthatworks.wordpress.com/wp-admin/  It’s a shame because it won’t look the same, but beggars etc. If you’ve enjoyed any of the posts on here, I hope you’ll join me over there.

Seems like there are other people who think this is the way things are going:

Web 2.0 revolution underway in healthcare

Internet developments that brought us sites such as Facebook, YouTube and Wikipedia are now set to revolutionise healthcare, according to a new research report from online news service and publisher, E-Health Insider.

What a great offer from Newsgator:

NewsGator Enterprise Server free for 20 users!

There’s no excuse not to give it a try now.

vnunet.com bring us news of a new report saying that collaboration is the big problem area for businesses:

Enterprises must ditch silo computing

Scottish GPs call for GP system choice

GP representatives in Scotland will this week hear criticism of government plans for an integrated primary and community care system and calls for Scottish GPs to have an initiative to guarantee IT system choice.

I have a lot of sympathy with the GPs, but there has to be some guarantee of interoperability between software packages. We need to have an agreed set of programmable interfaces so that primary care, hospital, community and centralised software packages can talk to each other. And then the onus should be firmly on the software *developers* to build products that comply. The current situation is that there are no standards of interoperability and 3rd-party software developers charge for each new interface. Not a good arrangement, I’m sure you’ll agree. The standards need to be independent of the software packages which implement them, not designed to suit whatever is currently in use. Once we have NHS standard interfaces, only those software products which correctly implement them would be approved for purchase.

It’s brilliant that research like this is being done:

Scottish government funds telecare and IT research

University of Edinburgh is to receive a share of £4m funding from the Scottish government to research telemetric supported self-monitoring of long-term conditions.

But am I totally off the mark in saying that the really big problem in NHS healthcare is software? (Quick poll round the office: everyone agrees with me! Actually there’s only one other person here right now.) Shouldn’t we be giving similarly large sums of money to Universities to work out how to end up with better-integrated, more usable software? Why is it assumed that private companies have already solved (or can solve) the big software problems? I’d say the evidence is to the contrary…

I’m starting to appreciate that the big problem with communications is providing context. If you look at a typical work-related email thread – especially when it includes more than a couple of people – every email includes the content of the previous emails. In other words, each email has to include all the necessary context. A long exchange of emails can come to resemble the pile of dishes on the draining board after a big dinner: a huge disorganised jumble in imminent danger of collapse, which no-one dare touch! The context provided by each email is usually incomplete of course. Even if the overall thread is completely self-contained, the conversation is very rarely entirely symmetrical (even if there are only 2 people involved).

On the other hand, a typical word-processing document has absolutely no context. You can’t see the raft of discussion and horse-trading which went into agreeing the content of the document. Nor can you see which individuals were involved in its creation.  OK, you can turn on the Track Changes option (not that many people do), but even then you’re missing loads of context because emails and related documents are not included.

Blogs and wikis are very good at context. Using comment threads and hyperlinks, they can have as much context as you like – but without any of the duplication or selective omission you expect in an email. Everything is laid out neatly, and everything is inter-linked. When you view a comment, you’re one-click away from seeing all the comments, posts and documents which comprise its context.

NHS CfH joins open source health collaboration

Open Health Tools has announced a collaborative effort between national health agencies, major healthcare providers, international standards organizations and companies from Australia, Canada, the UK and the US to develop common healthcare IT products and services.

[These opinions are my own and not those of NHS Orkney]

Have a look at this announcement from e-health insider:

Scotland and Northern Ireland have issued a joint tender to purchase a patient management system, with rich clinical functionality, worth between £30-120m over four years.

Scotland and NI tender for patient management system

So here we go again. The development is being commissioned in the same way as usual: spec a tender for a monolithic and very complex system; go to tender; give the work to a 3rd-party software consultancy; wait a few years; take delivery of the software; attempt to roll it out, only to discover it’s not fit for purpose. We’ve seen this pattern time and time again in the NHS and other public sector organisations. Isn’t it time we learned that this approach doesn’t work? Increasing the scope of the project and throwing more money at it – as has apparently happened in this case – is not going to fix the problem. Not that I have a solution, but surely the consistent failures of the last decade should be a clue that this traditional approach  to software development doesn’t work for the NHS. We need something more iterative and agile, with developers – physically and psychologically – closer to the end-users. My recipe for a new approach would be something along the lines of: systems analysts with proven NHS success and preferably employed directly by the NHS + iterative design + programmers distributed among the various health-boards + open-source software within the NHS network. What would we lose in at least trying something different?

If you’re in the UK, you’ll probably have seen the advertising for O2’s Bluebook service. I don’t see many TV adverts, but I do go to the cinema quite a lot and have seen the advert several times there. Bluebook is a service which lets you back-up the info on your phone – text messages, contacts, etc. I would very much like to be able back up my text messages, so I tried to register for the service. I signed in to my O2 account and tried to go to the Bluebook page only to be informed that I “no longer have rights to access this page”. It seems I’m not alone in having problems, as this thread on the O2 site demonstrates. Two things stand out in that thread: (1) not all phones are supported; (2) sometimes problems can be sorted by O2 customer support if you call them up. Am I the only person who finds those two facts astonishing for a service which is being pushed so hard in mainstream advertising? Sounds more like a beta than a release. This seems to me a typical mistake of the old-style big corporate marketing: use advertising to make people want something badly enough that they’ll put up with all sorts of nonsense to get it. But I think these tactics have a cumulative negative effect on their customers. Oh, and couldn’t they give a somewhat more informative error message?!?

I’m really looking forward to reading Clay Shirky’s new book Here Comes Everybody. I was therefore delighted to find that Penguin sell an ebook version. (For various personal reasons, I mostly read ebooks.) I purchased it on Monday 7^th April, but when I went to the download I got an error message: “invalid title”. I filled in the Customer Service request form on the website asking for help. I guess I’m spoiled by the responsiveness of other services I use: Newsgator and Traction CS usually respond within minutes; ADSL24, Clickwheel, Fictionwise, etc. all respond to CS requests within a day at most. Even O2 usually get back to me within 48 hours. Not Penguin. Apart from an automated response telling me my request had been passed to a CS representative, I got no response at all. On Wednesday, I emailed them again. Still no response. Emailed again on Friday: nothing. So I *phoned* them on Monday. It is very inconvenient for me to use the phone at work so I was pretty irritated at having to take this step. My call was answered pretty quickly, and once I described my problem I was told that only one person (!) can deal with ebook problems. I was given his name and number. Unfortunately, there is no answer at that number, not even any voicemail. I rang Penguin CS again: they said they would re-send my email to the ebook support guy and I should wait a day or two to see if he responds. So it’s now Wednesday 16^th and I haven’t heard anything. I phoned Penguin CS again. Once again they’ve sent my email to the ebook support guy and I’m being asked to wait another couple of days. *sigh* I can’t say this bodes well for Penguin’s recent committment to providing more ebooks. They really, really must get their support sorted out before expanding their range.

I think the above are two great examples of how big companies can really mess up their customer relations by not thinking things through properly. In both cases they’ve committed themselves to a service which they cannot properly deliver, and that has a cumulative negative effect on their customers’ perception of the company. I know from my own experience how difficult it is in a large organisation for the left hand to know what the right is doing, and that’s why the whole notion of blogging is so important. Imagine how much better my reaction to the Penguin thing would have been if I could just have gone to the ebook support guy’s blog page and either (a) seen that he was e.g. on leave at the moment, or (b) put my question to him directly. These endless coccooning layers of support – which are so common in large organisations – are not a good way to deal with frustrated customers, any more than the big flashy adverts which over-sell under-specified services.

UPDATE 2008-04-17 12:21 I got an email from Penguin. I am to receive a refund. The reason for the refund (and lack of ebook) will be explained at some point in the future apparently.