Testing, testing..



On Thursday this week I got up very early and trundled off to London for the CCIO Annual Nursing conference. The conference had lots of great speakers but one speaker stood out for me:




Sarah Amani is a mental health nurse turned manager and I have been following her on Twitter and reading her blog “Mental Health Geek” for some time so I was very keen to learn more about her. Sarah gave a fascinating presentation about a mental health phone app that she has developed and whilst I did find this very interesting it was something that she said during the course of her presentation that really got me thinking. Technology is moving, developing and evolving at an exponential rate and because of this we are encountering problems in healthcare. Historically in healthcare anything new has been tested and assessed and then tested and assessed again then written about, then peer reviewed, then published and then we might think about dissemination. However Sarah’s point was that the difficulty we are encountering is if we apply this method to technology the technology will be outdated before we even get part way through the process. Well I could have shaken her by the hand (and in fact did!) because although Sarah was talking about phone apps the same applies to many technologies in healthcare including social media…

snailTaking twitter as an example: Twitter has only been around since 2006 and has really only taken off in healthcare in the UK over the past 18 months. This is a very short time period and the way in which individuals use Twitter seems to change as the mood takes them and with what’s on trend. However this doesn’t mean that it isn’t valuable or doesn’t work as a healthcare communication and support tool but how can we prove it works if methods of proof are slower than a snails pace in a slow snail race on a slow day?

smNow those academics amongst you please brace yourselves and try not to break out into a cold sweat but I believe that we need to look differently at how we test this value. We need to consider the use of stories from those who we are trying to reach and those who find value and consider sharing this via blogs and encourage our peers to review via comments. Social media is very fast and constantly evolving but it is extremely unforgiving in that if it doesn’t work it isn’t shared and adopted, so we should also look to measures that show sharing and adoption. Whilst we are very good at measuring and collecting the numbers I think that with our social media projects we should encourage more review and comments to really start to prove worth and so we can ascertain what works and what doesn’t in a more strategic manner. I believe that this will help us to drive rather than fall into solutions but I would love to hear what you think?

A big thank you to Sarah Amani for providing me with the inspiration for this blog and food for thought !

10 thoughts on “Testing, testing..

  1. Hi Teresa,

    Thank you for the shout out on your blog :) In the spirit of your key message about commenting on what works and what doesn’t, I am writing to give you a big thumbs up on your blog which is as always very thought provoking and informative.

    Thanks again & long may the sharing of ideas continue!

    Best Wishes,


  2. Thank you Sarah

    I am so glad that you approve – and yes lets keep sharing and learning and progressing


  3. Hi Sarah and Teresa
    This is a really important point that you are making – but not just for healthcare and nursing. Very few leaders in any sector have got their heads around this and the impact – for managing risks which are now 24/7 in social media – and exploiting opportunities as you say here.

    Food for thought here!!!

  4. Great post that resonates across a number of sectors. Our existing approaches to developing idea’s, project approval and testing and implementation and largely unfit for this new world. Thanks for sharing

  5. Thank you Victoria and Paul for commenting – Lets hope that we can share solutions to this challenge across sectors

  6. Hi Teresa

    Thanks for an interesting post. There are a couple of things in what you are talking about here. The speed of technological development and then the speed of implementation into healthcare. The implementation delay it not specific to technology or social media, doesn’t the story go it took 20 years to get a proven treatment for DVTs to all patients in hospital. There is a huge world of implementation science, knowledge translation, second translational gap etc out there some of which the National Institute of Health Research is trying to address through CLAHRCs amongst many other projects.

    The second bit is what is testing and what is implementation. If your new tech company wants to bring a product to market they will test develop and re test, in design it might be called prototyping. This will not be an Randomised controlled trial, or robust qualitative evaluation the product they are testing might not even be real ( see seminal work on cardboard computers ) you get quick feedback on what does and doesn’t ‘work’ and what end users might want differently. You get public engagement and you satisfy the moral imperative to involve the people who you are designing for into the process, and the practical benefit that you have probably created champions along the way…

    There is a but…

    The good old hierarchy of evidence, you might be happy to have an app in Beta testing, but the level of assurance the clinical negligence scheme for your local trust is different.

    That being said, I feel that the real power in healthcare is still to be inherited by the people and so your assertion that market forces and useability will choose the successful innovations stands. Self management is where the future of healthcare lies and that is in the hands of the consumer. There is a Miriad of health care apps out there and the NHS can’t tell people what to or what not to use.

    A parting note is that the regulators are trying to catch up, open design where anyone with a 3d printer can print anything from an inhaler to a

  7. Gah, dropped phone

    to a mobile phone case… is requiring a different approach, the Medicines and healthcare products regulatory agency are working out how you might have to designate someone’s bedroom as a manufacturing site.

    Things are developing fast and so the conversations need to fast too, thank goodness there is Twitter.

  8. Hi Dan, Thank you for you comment. Its nice to know that this is being thought about – from my own perspective its not really a product but a process eg by using “Twitter to share nursing best practice we are improving practice” or “Patient peer support groups via social media have a positive effect on health and wellbeing” But certainly with Sarah and the app these are all things that will help with a more speedy dissemination.

    I think that you are right when you say that the shift in healthcare towards being led by the patient is yet to come – but I am sure it will come. Yes i think that communities will validate a lot of the services and products that come through but we also have to take care with the most vulnerable in our society and therefore i believe that it is paramount that HCPs and health Organisations put in the groundwork now and become trusted and respected sources of information and “go to” points for those with concerns.

    You have made some great points that have given me lots more to think about – thank you


  9. Hi Teresa

    Came to look at your blog more to learn how to crete an interesting blog than the content but got sucked in to the ideas you are discussing!!

    25 years ago I remember having a discussion about technology law and ethics; the thrust of the argument was that technology was evolving so fast that the ethical and legal framework for decision making was not fit for purpose as technological advances were raising questions that had not been thought of ethically (or indeed legally)

    The general sense was that we needed a frameworks to help us consider decisions but those frameworks might need to pull on different types of evidence; the debate raged and eventually it was recognised that the views of patients could be considered as evidence!…..not sure we have taken this as far as we could have in the intervening years

    THe frameworks we use to look at evidence is and will continue to change: the ability of people to use social media is creating an evidence base that is not yet fully understood or acknowledged.

    If I was a betting man I would say that the most profound changes in the next decade we are likely to see in health care will be personalised care driven through social media; most health gain is through behaviours and genetics not through health care professionals. Technology that help drive positive change is to be welcomed; we wont always get it right and we never have but the ability of social media to spread innovation to the masses and not just the classes has significant potential


    PS I like the style of the blog as well!
    PPS Took me 10 mins to work out what CAPTCHA was

  10. Hi Ray,

    This is exactly why it is important that we share these thoughts and ideas as different perspectives and experiences bring something new to the debate. Your story is very interesting and it seems so odd now that we wouldn’t be able to take a patients view as evidence ! We will evolve to resolve this problem but it will take digital leadership and courage to do it. Social media will demand speed and healthcare will be owned by the people we care for. The dissemination of ideas has never been so easy or fast but like you say social media ability to do this is not yet fully understood or acknowledged.


    PS Thank you for the lovely comments about my blog
    PPS CAPTCHA gets me every time !!!

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