Name: Carl Plant
Position: Director at Bitjam
Carl is a director with a unique skill set. He originated as an NHS practitioner, with a background in creating technology and software applications, from web development to building high-impact and secure software solutions for public sector organisations. As director of Bitjam, Carl fuses his experience in frontline healthcare with his avidity for technology and a passion for creating solutions that have social benefit.
How did you merge your experience as a healthcare worker with your enthusiasm for complex software development to found Bitjam?
Most of my earlier digital work was building websites and applications, using very early – almost primitive – technologies compared to today. Much of my early work, especially in health and data visualisation, I began to share through a blog. I then got involved in the open data movement looking at ways to turn data from spreadsheets into stories or applications such as maps and graphs.
During early 2005 I was successful in getting the position of National Development Officer (NDO) for the UK Association for Solution Focused Practice (UKASFP). While developing the platform and building an online community I got the chance to develop a website for an NHS Mental Health Crisis resolution team. Soon after I began to work on numerous digital projects including an online support platform for people with learning disabilities which tested the ability to build accessible web applications. Meanwhile my datablog was attracting support, presenting opportunities to present and consult with the Royal College of Nurses, National Institute for Healthcare and Excellence (NICE), Nursing and Midwifery Council, marathon open data hacking sessions at The Guardian plus numerous health data hack sessions around the UK.
What advantages did this experience give you to develop Bitjam in to a niche software solutions company for public sector organisations?
Over the years I’ve led on many digital projects in the public sector, working through the challenges of creating a solution that solves the problem at hand, rather than making a solution fit a problem. Understanding the barriers to adoption is a key learning point, using an agile approach that works closely with the end users, and not being afraid early in the project to reject assumptions.
Bitjam prides itself on working with organisations and projects that have a social benefit. As director, why is this important to you?
I used to work in a company that made wiring harnesses for the military, I left this career to work with people, to make a difference to society and that need has stuck with me. This led to working with those with learning disabilities, then on to Mental Health as a nurse after going back to University. This need to do good remains with me today, I’m driven by the desire and understanding that digital technology can improve the lives of people. I see lots of companies who only see health tech as a commercial opportunity and you can see the effect that has on the products, when they don’t achieve the desired outcomes. I believe I can find the balance between creating a strong business while achieving good outcomes for society.
Bitjam’s tagline is “Developing technology from small ideas to global growth”. How do you achieve this using co-production techniques and agile methodology?
We work in partnership, walking side by side with our partners. I guess it’s my nursing experience that allows me to listen and develop equal relationships with clients. I believe the clients and the users of a digital services are the experts in their sector or life experiences and we need to tap into that rich resource. This isn’t always easy especially when working with marginalised groups, or people who have accessibility barriers to breakthrough.
We have expertise in how technology can be wired together and deployed, we can only create success by working in this close relationship with a shared set of goals with the users of the service.
I believe it’s important to allow flexibility in the development process, to allow testing and revision, and crucially, to allow your assumptions to be challenged.
After spending many years working with technologies and keeping on top of newer stable versions, and importantly having fantastic staff, we have the ability to launch solutions to scale, in some cases taking them global.
What do you think is crucial for digitalising the healthcare sector in the future?
Sometimes the best solutions are simple, they perform a singular task and perform it very well. We see the opportunity for emerging technologies like AI, VR etc. These will only work if they are designed for a specific purpose and not off-the-shelf solutions designed for other sectors bent to look like it solves a problem in health. Also as Clay Shirky once said, “Communications tools don’t get socially interesting until they get technologically boring”, this is true with many technologies.
We must not shift our focus too heavily on new technology and forget that older technology such as SMS and MMS provide perfect means of building effective solutions. Lastly, we have been sidetracked by Big Data and having been overlooking small data we use daily in datasheets, databases etc. We have yet to fully harness small datasets, and we need to continue connecting systems together. I believe the work that NHS Digital are doing to improve interoperability is key.
If Carl’s history and experience are suited to your own healthcare technology project, you can get in touch by sending an email here. He’s always got the kettle on!
A patient with more than one condition – diabetes AND kidney disease for example – with several life-changing symptoms, requires them to take lots of medication that might have multiple side effects. Such difficult health conditions can be challenging to live with and some people find it hard to deal with the pressure, especially when patients are discharged or in-between services.
Combined Healthcare realise that many long-term sick patients aren’t simply somebody with one condition – they tend to have a number of health areas that they would like to manage better. This can be a frustrating experience for the patient, as often the information is not readily available, and they might also have to deal with polypharmacy if they are being passed to different services. It’s equally as challenging for the clinician, as they lack the time and resource to give the patient the full care they require.
This is why the idea for BeAble was born. A post-discharge system that provides the clinician with a library of more specific illnesses and treatments that aren’t just pulled in from NHS Choices(our research has considered this to be too long-winded and not specific enough). The library also provides the clinician with ideas for therapeutic activities to encourage a more active and happy patient. The patient is then provided with personalised information and a tailored plan about how to manage their conditions post-discharge, to stop relapse-prevention.
Bitjam are building two parts to the BeAble system – a mobile app and web platform from which clinicians will be granted access.
BeAble will have a number of core features, including a library of specific information and intervention suggestions for clinicians, written in a way that patients will understand, as well as encouraging patient control as they will have the opportunity to be more active about their condition (behaviour activation). Patients will have their care plan accessible from their mobile phones which will have the ability to connect with other technologies such as Amazon Alexa and Google Fit, enhancing the user experience by linking with apps that are useful to their ongoing recovery.
At the heart of BeAble is the idea of supporting patients who might be between many services or post discharge with the need to provide relapse-prevention support, to ensure patients are receiving quality and accurate care.
Patients will work more closely with their clinician to decide on appropriate therapeutic activities, which will help to establish and strengthen a relationship between clinician and patient. Any questions that the patient might have can be written in the app and up for discussion during appointment times. This is known as “channel shift” and it’s shown to improve communication. Patients can message as and when they need to. Channel shift could be the beginning of a move away entirely from the traditional appointment times as the idea is to reduce the number of necessary appointments with accuracy.
Issues such as poly-pharmacy can be tackled using a service like BeAble, to decrease the chance of patient relapse-prevention. Poly-pharmacy is an increasingly common phenomenon that demands attention at clinical level as it can threaten rather than improve a patient’s wellbeing if it’s not managed effectively.
Technologies such as BeAble can ensure best practice in medication management and enhanced self care which are fundamental to independent living with multiple long term condition.
Technology for Social Good
At Bitjam we prefer to choose projects and work with clients in the public sector such as healthcare and education. It’s not only an area we’re more familiar and have more experience in as a collective set of skills, but fields that we have personal preference for as we are contributing towards improving societal communication. You can read more about our projects on our portfolio page here.
If you would like to talk about BeAble, more of our “social good” projects or if you have an idea for a communications project yourselves then you can also drop us an email to chat here.
What Is Interoperability in Healthcare
Interoperability is the extent to which systems and devices can exchange and interpret shared data. In healthcare, effective interoperability occurs when IT and software systems to exchange shared data to create information that can be used to assist clinicians and other medical professions with patient care.
Issues Healthcare Staff Are Currently Facing
“Staff suffer from increasing workload and stricter performance measures with less flexibility. This has caused psychological and physical stress…” Science Daily.com
It’s no secret that digitising healthcare IT systems has been a slow and frustrating process for all stakeholders involved, especially the end users who have the responsibility of delivering safe patient care in a secure manner. This adds further pressure to staff who are already suffering from increased workloads and limited resources.
“We physicians have the longest training time of any profession, yet we now spend roughly two-thirds of our workday as data-entry clerks, tending to digital paperwork and administrative burdens” – WSJ.com
How Is Data Currently Manifesting Itself in Healthcare?
- Notes entered into the EHR (electronic health record)
- Documents that have been scanned as image files or pdf documents
- Discrete data such as lab test results.
“The data arrives from many different sources and systems and in multiple formats. It has to be parsed into a format that everyone understands and has been trained to act upon in an appropriate manner” Alan Brookstone
- The Tech
Data presentation can negatively influence decision making if it is presented in an illogical or intuitive way
- Human Skills
The computer skills of all staff members and knowledge of their EHR has a significant impact on data interpretation. There are many reasons why some people are less digitally literate than others.
- Upgrades and Disruption
According to AmericanEHR one of the most frequent complaints of users is that their EHR does not have the necessary tools or capabilities to perform a certain function. Sometimes the staff are unaware that their EHR has the functionality as they haven’t been trained to use the product properly. In other cases their system may require an upgrade. Upgrades can be complex and entire servers may need to be shut down for maintenance. Consequently, upgrades are often delayed because of the disruption.
How Can We Succeed?
Lack of interoperability leads to poor outcomes, therefore the issue must be tackled to ensure quality control.
We believe merging simple-to-use, reliable technology and adequate human support and training will result in the ultimate success of any EHR implementation.
So a move towards cloud-based systems will have a definite advantage as the software is updated centrally by the vendor with limited need to update technology at the user end.
The most significant impact would become apparent with changes to government regulations. G Cloud is an initiative that assists with the procurement by public sector departments in the UK of cloud based commodity IT services. Traditionally, vendors have to be certified as compliant by the Department of Health which inhibits better products and slows down new system implementation. G Cloud is a way of shifting away from more primitive systems and offers a positive step towards improving the efficiency of EHR software and communication tools.
At Bitjam we pride ourselves on finding continuous ways to improve developer documentation, with cloud-based systems and use of more consistent data design at the forefront of what we do. Our mission is to use technology for social good, so if you have a digital healthcare problem that you’d like to solve, email us at [email protected] to find out more about our previous work.