Processing people ... in Nursing and Social Services

 When the nursing process was introduced in the UK in the late 1970s - early 1980s, the change was resisted to a degree with concern that patients were at risk of being  'processed': assessed, care planned, interventions delivered then evaluated, discharged or re-assessed. ...

 Individual
  |

     INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

play  my quality of life my quality of care Emotional, Health and Care Plans Teaching Assistant provision continuity of care  'demand'	time my quality of life my quality of care self-care - feeding 23% rise in demand  for school transport Human geography 'supply'
families 'informal carers' needs that can (supposedly) be met at home Government funding crisis social inclusion social capital Care in the community 'demand'	£4bn overall funding gap in children's services Children and Families Act Index of Multiple Deprivation Needs-based funding? Children with special educational needs and disabilites (SEND) Parental resort to specialist tribunal courts: 96% legal challenges successful (2022) National / local taxation 'supply' 'broken' social care market - "dysfunctional"

"The costs are rising inexorably," he said. "Children are very often being processed rather than looked after."

Williams, J. Children at sharp end of council funding crisis, FTWeekend, 2-3 December 2023, p.3.

🤔Just a thought - every supply has a supply' every demand a demand' potentially duplicated across the care domains.

Book: The social atlas of Europe

See Europe as never before!

The social atlas of Europe

Dimitris Ballas, University of Sheffield

Danny Dorling, University of Oxford

Benjamin Hennig, University of Oxford

"An insightful look at today's Europe - through the underlying realities that Europeans live every day, all brought to life in charts and maps that reveal the human geography of this vitally important area of the world." Robert B. Reich, University of California at Berkeley.

The social atlas of Europe is the first human geography atlas to consider the European economy, culture, history, human and physical geography as a single land mass and a more unified European people. It provides an accessible overview of Europe and a human geography contribution to debates about a wide range of topics. It includes:

- Maps on over 80 topics ranging from life expectancy, greenhouse gas emissions to Eurovision Song Contest voting patterns

- Uses innovative full colour visualisation methods

- Explores Europe's society, culture, economy, politics and the environment

- State-of-the-art Geographical Information Systems (GIS) and new human cartography techniques

More information about the book is available on its website www.europemapper.org

Available at the special price of £19.99 (plus p&p) at
https://policy.bristoluniversitypress.co.uk/the-social-atlas-of-europe

Kathryn King

Marketing Manager

Policy Press, University of Bristol

www.policypress.co.uk

My source: EUROPEAN-SOCIOLOGIST list at JISCMAIL.AC.UK

FatFonts - fonts with real weight: Giving space and data form

Links now appear broken ...

How it works (from fatfonts.org):

Fatfonts are designed so that the amount of dark pixels in a numeral character is proportional to the number it represents. For example, “2″ has twice the ink than “1″, “8″ has two times the amount of dark ink than “4″ etc. You can see this easily in the set of characters below:

Source for the above and animated: http://visual.ly/fatfonts-player?view=true

My source: Jacob Aron, Making numbers punch their weight, New Scientist, 5 May 2012, 214, 2863, p.12.

CASA - Centre for Advanced Spatial Analysis: Working Papers

Date: Sat, 24 Nov 2012 10:24:30 +0000
From: Willard McCarty
Subject: CASA Working Papers


Many here will find something of interest, I suspect, in the Working Papers series of the Bartlett Centre for Advanced Spatial Analysis, University College London,
http://www.bartlett.ucl.ac.uk/casa/latest/publications/working-papers. 


[updated]
 https://www.ucl.ac.uk/bartlett/casa/about-us/publications

In particular my eye was caught by Martin Dodge and Rob Kitchin, "The ethics of forgetting in an age of pervasive computing", CASA Working Paper 92.

Undoubtedly those with GIS-related concerns will find much more than that.
Yours,
WM
--
Willard McCarty, FRAI / Professor of Humanities Computing & Director of the Doctoral Programme, Department of Digital Humanities, King's College London; Professor, School of Computing, Engineering and Mathematics, University of Western Sydney; Editor, Interdisciplinary Science Reviews
(www.isr-journal.org); Editor, Humanist
(www.digitalhumanities.org/humanist/); www.mccarty.org.uk/

My source:  Humanist Discussion Group, Vol. 26, No. 520. www.dhhumanist.org/
With CASA logo added here. 
                

Integrated Health and Social Care Data: GIS torch

Last month the HSJ announced plans to integrated health and social care data (July 5th, pp. 6-7). The purpose is specific to support care commissioning, but ...

The related topic of integrated care is a round-robin element of policy debate. It may go quiet for a time, but it is there, needing to be fed in successive governmental and policy turns.

You might reasonably expect that integrated health and social care data, would be a by-product of integrated care. So the fact that data integration remains a 'to-do' demonstrates the patchwork nature of care integration and the many levels by which it can be defined: commissioning, practice (within domain) across care domains, budget, teams - disciplines, service organisations, care and education, public involvement and data.

I hope the integration of health and social care data at the commissioning level might also put data into the hands of clinicians and social care teams - integrated of course!

The local insights that could flow would represent a real, tangible benefit. The news item stresses the potential value for commissioners. There are as ever several caveats:

• To what extent can health and social care staff influence the shape of the dataset?
• Is it crystallized (centralised) already?
• Can the new role for councils in public health finally ignite the GIS torch to illuminate what is really happening in the local community?

It happens that:

data 'integration' 

also = data 'orientating'

So - come on policy people, commissioners and managers, don't leave the workforce out of the loop. Staff on the ground are disoriented enough by the relentless pace of change. They need a sat-nav for care. Give them the torch they need.

What is that you say? They don't have the time to critique their (integrated) practice, to formulate their questions. And anyway - they don't have the access or the skills to use the informatics resources, let alone the nous to interpret the data! Well, if that is the case then shame on you.

h2cm: Globalization, Accommodation theory and Relativism (Grayling, 2010)

From A.C. Grayling's Ideas that Matter, 2010, Phoenix.

Globalization: p. 235-236.

A more neutral account of globalization describes it as the process of making things known, done, available or possessed worldwide - such as Internet access, telecommunications, medical knowledge and benefits such as vaccines, transport technologies, political ideas, art and music, books and much besides.

Grayling also explains how the increased distribution associated with globalization is unequal, hence the sense of injustice that is felt resulting in protest.

The health care domains model is concerned with making things known - helping to make knowledge available on a personal, group and family level. This is no Mercator projection, not even Peter's projection but it is a global map.

Accommodation theory: p. 3-5.

Accommodation theory states that when people talk to each, they adjust their behaviour and manner of speech to take account of (to accommodate themselves to) the topic, the circumstances, and the other people engaged with them in conversation.

There are many theories to explain how we communicate and thereby model(?) ourselves, others and the world. Imagine a doctor's surgery and the morning's clinical consultations, it is easy to envisage the role that accommodation routinely plays. The one-to-one conversation (dialogue, argumentation, debate) can be extended, and viewed as the combined chatter, the whole series of multidisciplinary Q&A with the breaks (the silences when we are listening!). Accommodation theory has proved of value in multiculturalism, especially on policy concerning immigration and integration. p.5

The care domains provide an ethnoculturally neutral space (it could be argued) for the accommodations that are demanded in the 21st Century. 

Relativism: p.433.

There is a distinction to be drawn between moral or cultural relativism, on the one hand, and cognitive relativism on the other. The former concerns the difference between cultures, or between different historical phases of the same culture, with respect to religious, social, and moral values and practices, that is, with respect to what might be called the 'superstructure' of the culture's conceptual scheme. Cognitive relativism concerns the 'infrastructure', the level of basic beliefs about the world, such as that there are perception-independent, re-identifiable and individually discriminable objects or events, occupying space and time, interacting causally, and bearing properties of various kinds.

Much is said of the games that people play. Whether the care domains model provides a game board that can accommodate both the super- and infrastructural conceptual levels is open to question. In the health career model the infrastructure level concepts are light - as we find that they reside in the upper part of the model: perceived, individually discriminable (INTRApersonal) objects occupying space and time (SCIENCES) with mass, weight, inertia. ... The political domain prompts access to values and how these shape the total conceptual landscape(s), the conversations and silences that go on there ...

Health, social care and personal map making

There have been two series running on BBC 4 in the UK over recent months and currently with a cartographic and historical focus:

see - The Beauty of Maps

This Vermeer - The Art of Painting - was featured in one programme and reveals the power and status of maps as Wikipedia also explains.

It is natural to see the health career model as a map, but this map is not just the preserve of the wealthy. Hodges' model can be used universally by all - a common framework.


Use of the term map and its synonyms is in turn common in medicine in many forms:

The map of medicine
The Malaria Atlas Project (MAP)
HealthMap

The above sites reveal how maps, charts and atlases relate the individual, geography and health.

In addition to its geographic connotation projection also has a psychological meaning. Hodges' model provides a substrate on which to project personalised, national and global health.

An individual; a people; a nation: for each a journey .... and for each a map ....

Image source:
http://en.wikipedia.org/wiki/The_Art_of_Painting_%28Vermeer%29

Injustice: Why social inequality persists by Daniel Dorling

I first came across the work of (Prof.) Danny Dorling in the 1990's in connection with workshops on visualization in the social sciences and Geographic Information Systems (GIS). The other week I read a feature on his (very timely) book in the Society section of The Guardian (O'Hara, 2010).

You do wonder exactly where we are in policy terms given the interval since the Black Report. Dorling's book then sounds like a must-read, with the information posted below from the publishers.

In addition in Waterstones at the weekend I found The Spirit Level, available on their 3 for 2 offer. The links also posted below with an insightful 2009 review of The Spirit Level by Daniel Ben-Ami on sp!ked; plus a related LGC & HSJ event:

Implementing the Recommendations of the Marmot Review:
Reducing Health Inequalities

Injustice: Why social inequality persists

About This Book
Few would dispute that we live in an unequal and unjust world, but what causes this inequality to persist? Leading social commentator and academic Danny Dorling claims in this timely book that, as the five social evils identified by Beveridge are gradually being eradicated, they are being replaced by five new tenets of injustice, viz:

• elitism is efficient;
• exclusion is necessary;
• prejudice is natural;
• greed is good; and
• despair is inevitable.

In an informal yet authoritative style, Dorling examines who is most harmed by these injustices and why, and what happens to those who most benefit. Hard-hitting and uncompromising in its call to action, this is essential reading for everyone concerned with social justice.

"His attack on elitism and despair is impressive, his factual evidence undeniable." Rt Hon David Blunkett MP

Additional resources for Injustice: http://www.policypress.co.uk/injustice_appendix.asp

Dorling, D., Orford, S. and Harris, R. (1998) Visualization in the Social Sciences, A Report for the ESRC/JISC Advisory Group on Computer Graphics, AGOCG Technical Report No 41 (ISSN 1356-9066).

O'Hara, M. (2010). Why Britain's battle to bring down social inequality has failed, p.1 of the SocietyGuardian section of the Guardian on Wednesday 21 April 2010.
The Equality Trust, established by the authors.

How can maps provide motivation?

"The class of maps that go beyond navigation to consolidate thought and convey a message belong to the broader class of infographics that aggregate words and numbers in a visual medium. While charts and graphs are often used to show progress to a goal, nothing personalizes the objective like measuring status, and revealing shortcomings, on a map."

-- Matt Ball, editor, the Americas / Asia Pacific


My source: V1 Newsletter Volume 4 / Issue 13/ March 30, 2010

http://twitter.com/spatialsustain

Sahana OSS response in Haiti

My source: Community informatics list [ciresearchers]:
Sahana Software Foundation
Haiti Earthquake Response
Status Report #1
January 17, 2010 00:00 UTC

The Sahana Software Foundation and the Sahana community responded with a massive voluntary effort immediately following the earthquake that has devastated the poor country of Haiti. Working around the clock, we have set up a hosted instance of Sahana (the first deployment of SahanaPy following a disaster!) on a public website that is already filling gaps in the information management requirements of the massive relief operation.

Major Accomplishments

We have a Haiti 2010 Sahana Disaster Response Portal - a live and active website up at http://haiti.sahanafoundation.org which contains a feeds from many of the relief agencies and links to Sahana modules that are actively being used to help coordinate the relief effort.

We have a Sahana Haiti wiki page where we are tracking all of our and others' activites at: http://wiki.sahana.lk/doku.php/haiti:start

We have a requirements page where we record all the modification, configurations, and changes to Sahana based on the mission requirements at: http://wiki.sahana.lk/doku.php/haiti:requirements

See - https://sahanafoundation.org/products/eden/

The Haiti 2010 Sahana Disaster Response Portal provides the following functionality:

1. An Organization Registry - serves to track organizations and offices working on the ground in Haiti. Organizations are encouraged to self-register and report their office locations - alternatively, individual organization office or lists of offices can be e-mailed to haiti-orgs AT googlegroups.com and we have volunteers to assist with data entry and to aggregate lists from other sources. We have entered data from pre-disaster lists of organizations working in Haiti available from UN OCHA. We can assume that these organizations will be working on the relief efforts, but expect that most of their office locations will be different as most organizations have been forced to move into tents given that few buildings remain standing and usable in the capital. We are working to validate these lists with the organizations directly.

The site serves up both KML for Google Earth users and GeoRSS for everyone else, and will generate reports of organization activities and the gaps (uncovered sectors by geographic location). This site will hopefully become the main resource for accurate information about the organizations working on the ground, where they are located, and what activities they are engaged in, and the resources in terms of staff and equipment that they have available to them. (Currently, data is admittedly sparse but we expect more details to become available as the coordination efforts take root on the ground). We are coordinating with UN OCHA, Google and others on sources of accurate lists and updates.

What are the gaps in our information collection? We have a large and we think accurate list of organizations, but not much office location information. Without this, it becomes hard to generate data that can be used as a layer in a GIS system. We are encouraging people to report this information - preferably by GPS coordinates, but any location information that we can use to manually geo-reference the office is valuable. We hope to be able to enhance our capabilities such that we can produce polygons showing organization's areas of coverage by sector. Please direct organizations working in Haiti to our site to register their offices and activities!

2. A Missing Persons Registry / Disaster Victim Identification (DVI) Registry - we are working with Google and others on an agreed common standard for the exchange of Missings Persons data using the PFIF standard. The Google site at http://haiticrisis.appspot.com/ is the main aggregator collecting all missing and found persons reports and we are encouraging all people to send data to that site. [We are struggling a little as Google's feed is not fully PFIF compliant and the lack of unique record identifiers makes it more complex to set up true synchronization without the creation of duplicate records. We continue to work with Google on this and hope to have a resolution and solution within the next few hours.] We will also be embedding Google's widget on our site for collecting missing person information. Google will be making their data available via a PFIF feed and we will be importing it into Sahana's Missing Persons registry. From there, Sahana can add value to the simple lists being collected.

In particular, Sahana's Disaster Victims Identification registry - or DVI - which is used to management the handling and tracking and tracing of the deceased, dead bodies and their identification. There is currently no other known application for this and we hope that those working in this area will find Sahana extremely valuable. Sahana will have the ability to cross-reference missing persons information with the identified and unidentified deceased, thus facilitating reconciliation efforts. The Sahana Missing Persons registry has additional physical description information fields and we hope to be able to utilize some of the image matching capabilities available to extend these capabilities further. Organizations interested in utilizing these capabilities (which will not be made open for public use) should contact the Sahana team at
sahana-haiti AT lists.launchpad.net.

Any updated missing persons status information will be pushed back to the main Google repository from Sahana.

3. Situation Mapping - Sahana's site is able to map all of the geo-referenced data within Sahana - primarily the organization data, but we have also manually entered a data layer of hospitals and medical facilities. Sahana has worked with members of the OSGeo community to obtain a fast tiled set of the current imagery being made available by Digital Globe. Sahana is also leveraging the constantly updated set of Open Street Map tiles. These are acting as backdrop for the offices that are being entered as part of the Organization Registry. Other data sources that are ready and available to be leveraged by Sahana and SahanaPy for other deployments include reports from Ushahidi, various point layers from Open Street Map, location names, USGS earthquakes, and locations from GeoNames. We will continue to build out these capabilities further as relevant layers are made available.

Capabilities we are working on:

The following capabilities are in the process of being developed and we expect will soon be available:

4. Request Management: We are working with the US State Department, Ushahidi and some other voluntary efforts on a project to process SMS messages with requests for assistance sent from survivors in Haiti. SMS text messages sent to a short code in Haiti will go into Ushahidi, who will have volunteer translators to add some structure to the message, identifying the sender's name, location (to the extent possible), and category of the message - a missing persons report, a request for assistance, etc. The message will go into a Ushahidi GeoRSS feed that will be captured by Sahana and fed into a simple Request Management system where the requests for assistance (such as "send water" to a certain village or neighborhood) can be made visible to relief organizations working on the ground. Organizations can fulfill or claim requests for handling and message the person back that assistance is coming. (Missing persons information will be captured by Google).

5. Translation: In addition, our translation project is now set up for Kreol and French translation and we may utilize a pool of Kreol-speaking volunteers being set up by the Service Employees International Union (SEIU) to help in these efforts. Interested translators should be directed initially to:
http://translate.hfoss.eu/wiki/Translation to become oriented in the process.

6. Shelter Registry and Disaster Victims Registry: In the coming days, we expect that there will be a requirement to start tracking the location of temporary shelters now being established, and possible registration of the survivors. We will prepare Sahana's existing registries for such purposes, which will produce further consumable data layers as well as additional missing persons reconciliation capabilities.

If you want to help:

We are using the IRC #sahana channel on freenode as our main coordination tool. Join the chat room to volunteer for tasks and someone from our core volunteer team will direct you - this room is actively staffed on a 24x7 basis.

But first, please check out the wiki pages to see what are the current requirements and areas of focus. We have a lot of volunteer Python and PHP programmers already working on the codebase, but we can probably use more. Please review the requirements page in particular to see where you might help.

We also have a large need for non-technical help - particularly for documentation support - user guidelines and instructions in particular - including some nice screenshots.

...

Finally, we could use help maintaining our own wiki - both the main page and requirements... much of this can be culled from the chat room logs - and helping to update some of the common public repositories of information about similar efforts, such as the crisis commons wiki at
https://crisiscommons.org/, although they are doing a pretty good job at tracking us ourselves.

Remember to add yourself to the wiki as part of team, and what you are doing.

Acknowledgements

Personally, I have never been a part of such a collaborative and cooperative effort on the part of different organizations to come together and to help each other and to not replicate efforts. The Sahana community has worked closely and constantly with InSTEDD, Ushahidi, haitianquake.com, Google, the Crisis Camp participants, and others I apologize for not mentioning and we wouldn't have been able to accomplish all that we have without this, and for this I am very grateful.

The around the clock efforts of many of the Sahana community are too numerous to mention here, and at risk of leaving anyone out, I would just like to thank everyone for all that they have done and been able to do while juggling responsibilities such as full-time jobs and families.

This has been a new model for Sahana deployments - rather than waiting for a specific customer to come forward to take ownership of Sahana, we have self-deployed and I think this will be a likely successful model for the future. More and more, technology projects are stepping forward and doing good directly.

So go forth and do good.

Best regards,
Mark
==========
Mark Prutsalis
President & CEO
Sahana Software Foundation

Nursing management consultants & being optically challenged

Being somewhat optically challenged at present (need new glasses!) I have nonetheless managed to sort some old papers. I came across a more recent news item from the Nursing Times 8 September, p.3 by Sally Gainsbury. What use is late news?

I raise this now because public sector health finance provides the impetus, so this subject is perpetual motion. It is also reported ongoing by HSJ. I refer to this not to take sides, but to acknowledge that politically there is a need to make decisions and find the required £20bn efficiency savings. The news line reads:

DH told 1,500 district nurses could go with no damage to patient care

The item focuses on a report for the DoH produced by McKinsey management consultants. The government has distanced itself from the reports recommendations, but the need for action remains. The Nursing Times news item includes two clocks (with the total nursing time available depicted as 1 hour) that break down the time spent on patients on general medical wards and community wards. While this is just one aspect of a report of more than 100 pages, the findings are of great interest. ...

GENERAL WARD: 15 mins Physical care; 10 mins Psychosocial care; 35 mins non-patient care.
COMMUNITY NURSES: 17 mins Antenatal activities; 13 mins Postnatal; 27 mins npc; 3 mins other and classes.
I have not worked on a general or mental health ward for a long time, but I was surprised to see the time spent on patient being less on the wards than the community - 25 minutes v. 30 minutes. There are challenges in comparing different clinical areas, but I would have thought travel, administration - including paper and e-record data entry would impinge much more on community. On mental health wards there has been an effort to free nurses to nurse - with protected time? So pause for thought there - but only for a moment....

Thinking about community - providers will no doubt vary in the way (district) nursing teams are organized, the location of their bases and how that impacts average journey times. Districts also vary in the way the population is distributed, especially those neighbourhoods were social and economic deprivation is higher and need may be increased.

This is why access to GIS (geographical information systems) by team managers and members is crucial and should not just be some esoteric academic and intelligence artifact. While we should not under estimate the potential use of GIS to inform inpatient care, it is community services that are best placed to benefit from improved intelligence, planning and decisions.

There is a long thread here and the politicians of all parties know it leads into the forest ....

For example, much can be read in a single word "... McKinsey found that only 15 minutes was on the "physical care" of patients while the remaining 10 minutes went on "psychosocial" care, such as talking to patients." I hope that 'only' does not suggest that talking to patients is 2nd best, even though basic nursing care is the factor in the news regarding public perception of the quality of nursing care. This is a constant problem as we move to outcomes. Are we going to have patients saying - "The physical care was excellent, but I felt like I was in a religious retreat. Nobody hardly spoke, explained anything." Patient education, self care, staying well, the effective use of medication and treatment ... is predicated on psychosocial engagement.

What is also very troubling is that cost savings might mean detrimental changes in the skill-mix; the ratio of qualified to health care assistant staff. Some of the best 'natural' nurses I have worked with and work with today are dedicated HCAs. They have a major role and contribution to make, but if safety gains are to be maintained and improved upon then 'safe' skill-mix is critical.

Given the present demographic, 'nurses' are not new to cuts. In the public sector cuts are part of that perpetual motion I mentioned at the start. What frustrates is working on the holistic care mosaic to produce something that is safe, effective, quality care; then as we come to finally add the threads - clinical supervision, PDP, health IT, outcome measures, public engagement we have to unravel and start again.

Image source used with permission and thanks: D L Ennis. Visual Thoughts http://dlennis.wordpress.com/

NHS data breaches: the 'cogeography' of who and where?

Computing this past week featured an item (extract below with link) -

Five more NHS trusts involved in serious data breaches
Written by Tom Young
Computing, 17 Jul 2009

Privacy watchdog the Information Commissioner's Office (ICO) has found five more NHS organisations in breach of the Data Protection Act.
The Royal Free Hampstead NHS Trust reported the loss of an unencrypted CD initially thought to contain medical treatment details of 20,000 patients from the hospital’s cardiology department.
Chelsea and Westminster Hospital Foundation Trust reported the theft of an unencrypted memory stick containing 143 patient details including sensitive medical information.
And Epsom and St Helier University Hospital NHS Foundation Trust has been storing hospital records insecurely for nearly two years following data being transferred between hospitals. ...

Straight away reading this I thought of my previous post about cogeography and commented accordingly (which registered twice - oops!). In light of the previous post here's that comment with some additions....
Such events merely (without trivializing) highlight the human capacity to ERR big(gish) time. Is it not possible for tech to help? If info systems through to mobile devices had a sense of where they are and their status as carrying sensitive data recognised through digital IDs - plus additional meta-dynamic data, then 'cogeographic awareness' might result?

I blogged about this with ref to conceptual spaces.

This would be an artificial example and would make it possible for data previously designated as confidential, sensitive, - HOT data if you will - to self-destruct, 'e-vaporate' if it found itself beyond a given combined virtual or physical environment be that hospital, Trust boundary, SHA, or National border...? This capability already exists no doubt in the security services (although sometimes you wonder) or as suggested in the realms of 'MI' and '007'.

Cogeographic or (cogneographic) may be a neologism and seeks to conjoin the cognitive (cognition) involved in defining, representing and using concepts in conceptual spaces; AND the finding that knowledge is invariably situated - that is knowledge has a geography.

Copies of NHS and social care
data could - should - MUST
have a geography too...?

Another comment rightly questioned the ability to put personal data on
CDs and other media in the first place. Amid the emergence
of renewed debate about the future of e-health
records, clinicians may have a professional
duty to demand cogeographic
properties no
less ...?

Image source: http://www.tapintoquality.com/facts/glossary-d.html

Happy Anniversary 20th July!

GIS a look (and learn)!

Starting work yesterday my colleagues and I had a real surprise.

The boss greeted us as positive, jovial, forward thinking and smiling as ever. Something seemed strange, but as we got to our floor we were handed some note paper and briefed - very briefly - about a "local surprise for you hard-working, dedicated clinicians".

So it was off to the desk and on with the log-in. The surprise came with the provision of a series of maps and questions and exercises. The maps just like google maps, multimaps and other variants provided various views and choices of emphasis; street, satellite and several boundaries: our organization's borders the frontiers of partner PCTs, GP practices, social services. After all these decades GIS had arrived on the clinician's desktop.

There was more to follow though. My mug-shot was there in addition to my colleagues (ah... I'd wondered what that recent (online*) form was for). Drag and dropping this beautiful pic on the map the nursing homes pulsed (as if to confirm that I am alive at least clinically) and changed colour. I know something about drill down, aggregation and such like and there they were: caseload parameters: gender, referral source, diagnosis (if known), drug classes, MMSE. I was getting heady as it was possible to look at clients living at home AND/OR residential care. I nearly flipped when there was more available about the referrers and not just the frequency of referrals but the expected frequencies too. There was going to be quite a compare and contrast exercise there post-2011 Census.

On another map I suddenly thought of 'use the bus Ethel': a carer who when she could went everywhere and also used the trains. Active body : Active mind and there it was - the travel logistics and public transport routes across the patch. This was not just GIS on the clinician's desktop it was GIS for the caseload manager. What proportion of my caseload was within 2, 4, 6, 8 and 10 .... miles of base?

Individual insight aside there was team oversight too, a tool to engage in peer group supervision - with (and get this) tools for the 'integrated health and social care team' to investigate local commissioning and how that factors in geographically. Amazing! Yes there are tools to do all this now, but they are not in the hands of the people they should be. Reports are just for managers? What a waste!!

I was just really getting ready to do that piano-playing-finger-flexing thing that you do when you are about to be extraordinarily creative. I mean I had waited for this, public MENTAL health.... my mouth was dry and here it was - GIS nirvana...

Then it happened....

It was time to wake up and get to work.

I won't stop dreaming though....

*I should have recognised it was a dream at this point.

Additional links:

Welcome to the GIS Files

Free Our Data

ESRI

Mapinfo


Image sources: Ordnance Survey

Crossroads - was c/o http://www.photochart.com/photo_1189_Crossroads.html
and Copyright Olga Dunaeva

Datasets: an organisational province?

For over twenty years I have been fascinated by data visualization and yet this remains by and large the preserve of scientists, with many social scientists still to identify the potential applications and benefits let alone reel them in. It isn't that social science can't call upon large volumes of data it can and does. It is having the appropriate forms of representation and display that are sympathetic to people actually working in those fields dominated by the humanities. This is not the only difficulty...

Recently on a community informatics list someone asked about their particular project that includes social inclusion within a community and the availability and sources of data - especially datasets. The brief dialogue that ensued set me to wonder about some new (for me) and recurring questions in informatics:

• the definition of informatics;
• the interdisciplinary and transdisciplinary boundaries of informatics disciplines;
• how these disciplines relate to each other;
• the range of datasets in terms of formal (statutory) and informal - community driven datasets;
• what names (if any?) do we give to these datasets and how do they relate to each other?

Although the purposes may be informal - the datasets required are usually formal. Local statistics (UK) has an informal air about it, but this is data from the people, collected by the centre, produced by the centre, used by the centre and available (in anonymised form) for everyone. Public health observatories, councils and related agencies are making local data perspectives and resources available as per:

• Health Profiles

As communities seek to engage in the political process they will need access to data (information and knowledge) to effect analysis - synthesis and change. How groups can find or generate this data is a key consideration. This may prompt and is no doubt prompting the creation of mashups, combining what are usually disparate formal data in new ways. Given the 'politics of data' which includes:

• personal sensitivity
• legal aspects and duties
• confidentiality
• security
• anonymisation
• ...

- it is easy to see how dataset players tend to be 'organisations' (I am excluding the emerging 3rd sector players here - but this may be a (big) mistake?). How then can community groups generate data(sets) that can help inform and solve their local problems?

Using the (UK)patient and public involvement (PPI) program as an example, a key part of this important initiative is that statutory health care providers (and commissioners) must ensure there are adequate resources to support PPI in and across the community.

What then of community, urban, mobile health and other forms of informatics? There may be a lot of data washing about in the cyber-community. This may however, be out of reach for those who need the political and evidence-based leverage to be gained from parochial* datasets?

Additional links:

Free Our Data (UK)

W3C SWEO Community Project: Linking Open Data

Acknowledgement: Community Informatics list, Andrew R. Clark, and Brian Beaton (K-net.ca).

*parochial - used in the local sense.

Source: by Peter Jones, Welcome to the QUAD 2009

Plush HQ foyer, shame about the mannequins!

If h2cm is about anything (or any-think) it is about locating and crossing boundaries. For health and social care organisations, their informatics staff and academic partners travel is essential. This assumes though that the organisation:

a) wants to cross boundaries
b) recognise the need to cross
c) have the ability to cross

Working through a-c THEN

1) If a) is a 'yes' - can you find your way? That's why partnerships matter!
2) Is this quest important enough to be recognised? Without executive buy-in - no tickets!
3) Given 1-2 as the team don their boots they will find a way using some new tools and learning new skills.

Visiting a health care organisation HQ the reception area often features the latest report, plus a statistical or public (mental) health display that explains what the organisation about, what projects are ongoing and what are its future plans and aspirations (to use a word of the moment). ...

One way to check where you are is to take a look at your fellow travellers and what is happening in the 'shop' windows? The mannequins reflect many aspects of local lifestyles.

I have this image in my mind of cardboard cut-outs or mannequins showing the 'average' local members of the public and the 'average' users of local services.

Suitably attired - dressed with information these statuesque models, although mute, can speak volumes and tell us at least two things...

1. Who may need to call in to 'buy' our services; and
2. Who are the existing customers.

This really is about crossing boundaries. If you haven't anything to dress your mannequins in - well that's a bit embarrassing isn't it? That is not all though...

Medically, we know a lot about what makes people tick [sciences-political]:

What about the tock [social-intrapersonal]?

When people engage with health and social care services - do they have heads?

Original mannequin image source Planet Visual with thanks.