Category: Innovations

Types of Clinical Developer #Doctorswhocode

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There are lots of different kinds of clinical developer but they generally fall into 6 different broad disciplines as represented by the different colours of the octagon above. In a way the disciplines are somewhat artificial, as what really matters is getting results and not which broad category you fall into. For instance you cannot be a frontend developer and not be at least slightly interested in user experience design. However, they help to give others some idea of your background strengths when it comes to building a team.

Note: Not all of these roles even require much coding skill. Some developers can get by without coding at all! I will cover this in future posts.

Clinician Frontend Developer

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‘Frontend’ generally pertains to the parts of the website that you as the visitor can see. These developers focus on producing visible web presence. They range from those who rely entirely on pre-built products (this is a completely acceptable way to start and can actually get you quite far as I will show you) to those who code in HTML, CSS, Javascript, SQL and often other languages as well. If your main aim is to produce a tangible web-presence then this is the route you want to take at the start. 

Clinician Backend Developer

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‘Backend’ is all about the things you can’t see. This type of developer tends to deal with everything from servers and members-only areas on websites, to fully functional web-apps and sometimes whole online platforms. They tend to code in some of the higher-order languages like Python, PHP and Ruby. It is quite difficult to be a backend clinician developer without having at least some basic coding skills. However, there are all sorts of frameworks that make things much easier (I will explain about these as we go on). If you want to build web-algorithms or fully functional websites with members areas etc you will need to know at least some ‘backend’ skills.

Clinician IoS/Android App Developer

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These clinicians focus on phone apps. These require a whole different framework in order to build. I won’t go into it now but this whole area is changing extremely quickly and standalone phone-apps probably aren’t the best way to start-out if you are starting a business. However, once you have an established product there is definitely sometimes a place for building a ‘phone presence’. Some clinicians have built incredibly successful businesses using phone apps.

Clinician Data Scientist

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This is my personal area of interest. The clinician data scientist knows how to use computers to solve complex data issues and build algorithms. They generally code in Python or R and use algorithms to analyse data. Machine learning problems are solved by this group and I believe we are only just at the beginning of seeing the impact data scientists will have on our clinical lives. However, the problems specifically require detailed experience and understanding of the problem in order for them to be solved. This is where the clinician data scientist has a massive advantage.

Clinician UX Specialist

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UX stands for user-experience design. These clinicians focus on making things flow by reducing ‘friction’ and making things ‘human’ shaped. This can be achieved by relentless testing, market research, attention to detail and most importantly focussing on what would best solve their own problems. The clinician is well placed to be a UX expert as they have deep personal experience of the issues which beset those they care for and fellow clinicians. It requires a very open mindset and is not so much about the technical aspects, although many are very adept coders as well. If anything is going to work it needs good UX to be woven into it. 

Clinician Full-Stack Developer

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This is the full package. Fluent in many languages they can basically do everything above to a degree but possibly not to the depth of someone well versed in one discipline. If you need one person to test out ideas quickly this person is your best bet. They can also network very effectively with other developers and because they can iterate ‘build’ very quickly they are a real asset to any development team. In the future they will be common but at the moment they are rare.

To find out more visit : www.clinicaldevelopers.org   – signup to our mailing list for updates, tips and tricks.

Why Become a Clinical Developer?

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A time is coming when technology and medicine will be synonymous. For the first time in history you can build your own toolbox for almost no money and iterate (build things) really quickly.

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At present clinicians are increasingly working with developers to produce technology. However, because there doesn’t yet exist a common language between the two worlds this can result in communication difficulty. Enter the clinical developer who knows the difference between an SQL database and a host but also the real problems on the ground and some of the subtleties of healthcare.

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One way a clinician developer can communicate their ideas is by building a prototype. This prototype can be built quickly and enables the clinician to test their concept quickly but also show a professional developer what it is that they want to achieve. As a beginner the best way to start is by using tools. There are hundreds of these available nowadays and they are the best way to ‘get into’ a field quickly to achieve results at a very low cost. Some of the best tools will be covered in a following post.

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Tools may be all that a clinical developer needs to achieve results, and indeed most will. However, some will want to take things further. This is where you need to decide what kind of clinician developer to become. This will be covered in the next post.

To find out more visit: www.clinicaldevelopers.org – signup to our mailing list for updates, tips and tricks.

The Clinical Developers Network #doctorswhocode

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Welcome to the Clinical Developers Network,

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Who am I?

I’m Matt Stammers and I just founded the clinical developers network.

I am a Gastroenterology registrar currently working in the UK NHS full-time. I love my specialty and I love the NHS, but I am persistently frustrated by IT issues both within, and outside of the system.

For a long time I have looked on as successive groups have tried to change things without much success. There are many reasons why these projects normally fail – (lack of lean thinking/planning, lack of cooperation/joined up thinking, low involvement of users and lack of attention to user-requirements, etc.) However, if I was to pinpoint the single biggest reason that would be: A lack of engagement from clinical staff. They are not engaged because they were not involved in the project development, they don’t understand how ‘geeks’ think and fundamentally the project wasn’t designed with them in the forefront of the developer’s minds.

This is a major challenge to both software designers and clinicians – until it is addressed there will continue to be failure after failure in implementation.

Enter: The clinical developer

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The clinician developer is a hybrid-doctor who understands both worlds and knows how to speak to both sides. Now the clinical developer comes in many shapes and forms. Some like me love the technical things and machine learning, others love UX and design, others just love building websites and some don’t actually code themselves but they use tools to develop. This is for the majority the best way to start.

After all, the clinician developer doesn’t seek to displace full-time developers but rather to bridge the gap. What does the clinician bring that no other can? A deep understanding of the problems! Only clinical staff have this perspective.

So if you want to find out more then head over and sign-up to join the community. Tell me what you think and most importantly tell us about who you are and what your up to!

Together we can #change #healthcare for the better

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To find out more visit www.clinicaldevelopers.org – signup to our mailing list for updates, tips and tricks.

Exponential Medicine 2016 – Harry Thirkettle #NHSClinEnt

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Exponential medicine conference 2016

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Edwards – amazing new valve technology

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Microsoft

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Robotics, 3D printing, Genetics, Precision Medicine, Functional Medicine, AI / Deep learning

They saw all sorts of amazing new projects.

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A lot of the advice given by many of the innovators was not to leave clinical practice because then you lose touch with the problems at source.

Mark Hyman, Director of the Cleveland Clinic explained that we need to start looking at the causes of disease and treat those instead. The key is to find the path to wellness. One of the Cents is setting up an institute of functional medicine.

“You better Uber yourself before you get Kodak’d”

 

Can UX Improve the NHS? #GiantHealthEvent

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Panel chaired by Dr Gyles Morrison of Dr-Hyphen.

UX is shorthand for user experience design. It is a hot topic at the moment, particularly as ‘UX experts’ like Apple move into healthcare.

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The premise was put to the group that NHS UX tends to suck. However, it is not just the user interface that needs to change but the problem needs to be looked at holistically from all angles. It’s no good if a piece of software becomes easier to use at the cost of overall utility. There will also be knock on – unexpected effects which UX seeks to solve. For instance the interface might look good and become very usable, but if the system slows down as a result this is an un-acceptable trade off. what-exactly-is-ux-design-01

Some of the panel then made the point that clinicians and frontline staff are not consulted by any of the decision makers. One of the panel members – an orthopaedic surgeon believes we need to fight back against the legacy systems we currently have.

One of the audience then suggested that part of the issue is commissioning. Managers will look for the simplest single solution that ticks the most government boxes and UX doesn’t come into it at all. He gave the example of script switch which almost invisibly switches your script around, saving money and time.

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UX crosses the boundaries of lots of different sectors. The orthopaedic surgeon then told a story about consultants in his hospital being told to see patients within 14 hours of their admission. This was agreed with the CCG than the hospital would hit a 90% target of achieving this. This was not discussed with the consultants until after it had been agreed. They then realised they had a major problem – the staff had no buy in and the managers had no mechanism to actually measure their success.

The GP in the audience then argued that the problems we are trying to solve are normally artificial. We should rather be working out which steps add value to patients, clinicians and managers.

One of the other panel members suggested that the key is to solve a single problem rather than try to tackle many problems at once. I then suggested there is a danger here that we end up like the app market where there are multiple individual proprietary platforms all competing together for money. This could lead to an increasingly fragmented health service which may not serve patients well.

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All were agreed that empowering patients therefore is important, but how this happens and how we cater for patients’ future needs will be key to whether or not we succeed in creating a better future for all patients or only some.

Panel interview with senior members of some prominent healthcare AI startups #GiantHealthEvent

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Data Science representatives from Eagle Genomics, Babylon Health, Touch Surgery, Myrecovery, Creation were interviewed by Cognition X.

All these companies use machine learning in different ways either to analyse the genome, diagnostic/surgical implications or helping patients directly.

All of the panel agree that AI is coming back after going through a ‘nuclear’ winter.

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Eagle Genomics feel that by 2025 there will be over 250 million patients with their genomes sequenced. This constitutes several zetabytes of data. This cannot be analysed by humans but only machines. We have a burgeoning data management crisis that can be solved in no other way. We need to turn big data into actionable insights.

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Babylon health say they want to make healthcare affordable to all – that is their vision. They believe in augmenting doctors and making them safer. Babylon feel the biggest need is in Africa. That is why they are working in Rwanda because the needs are so great.

They think that in the next 5 years there needs to be some sort of regulatory mechanism to govern the use of AI diagnostics. They want to improve the productivity of doctors not replace them.

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Touch surgery feel that humans alone cannot deal with all the data alone. They feel that it is essential to use that data in order to learn how to make their product as good as they can. Currently they are trying to use machine learning to improve the user experience and training. They believe that the technology should also help the surgeon in the same way that power-assisted steering and GPS enhance the driving experience.

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Myrecovery are analysing how their users are using the apps as well to try and predict their recovery. A lot of people complained about the US election predictions. Garbage in = garbage out. Longer term they see it as a core asset to the business. They feel that the present situation is unsustainable. We can’t compete with robots any more, we need to work with them in order to get the job done.

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Creation feel that it will be essential in the future but at the present are focusing on building data sets and getting them verified by medical professionals. They talked about developing a system that could analyse a photo via a network – like instagram for medical diagnosis. They feel that doctors use social media quite a lot. Sometimes they have found doctors answering individual patients on social media. They feel the barriers are breaking down. They also sited the microbiome. He talked about machine sentiment analysis and how it is currently largely useless. Most ‘AI’ is still heavily dependant on human interaction to make it work but in the future this won’t be the case.

Then Charlie asked the panel what advice they would give to tech startups thinking about working in this field. Their advice was:

  • Get good at selling yourself.
  • You need to be in it for the long haul. (We are in the middle of a revolution).
  • Be prepared to change your business model several times.

The UK’s first ever exponential medicine conference

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Welcome to GIANT

This marks the beginning of a shift in the mindset of health technologists in the UK. There have been other events like the NHS EXPO but their purpose was very different.

This conference as illustrated by the programme is going to be very different.

This is exponential medicine conference, UK.

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The speakers at this conference are not your usual health technology conference speakers. I am currently sitting in the middle of an audience full of outside thinking, border pushers within healthcare. A mixture of professionals from medical, business and technology spheres all in one place.

This is the infancy of a small silicon valley type community for health technology in London but it has none of the glitz and glamour of exponential medicine conference. This has much more the feeling of the first DEF CON in June 1993 (I was not there, I was only a child then but I imagine this is what it was like.

Barry Shrier, the Founder started by introducing the term moonshots. These are radical innovations which lack any immediate method of becoming financially successful but have enormous potential in the future.

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The challenges that face us in healthcare now have never been greater. Therefore, the need for a ‘moonshot’ or more likely many smaller ‘moonshots’ to succeed has equally never been greater.

This is the interface at which they occur:

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Barry then talked about the ongoing impact of the NASA program. It is his conviction that we can achieve enormously big goals and we should set out to achieve them for the good of the world. The vision: “To improve the health and wellbeing of humanity, by supporting entrepreneurs and supping healthtech innovation.” He dedicated his presentation to the late Helen Keller. “Life is either a daring adventure, or it is nothing”. H.Keller

It is the spirit of ‘I can do it’ that will enable us to overcome the enormous challenges that humanity faces.

Finally: My two favourites from Expo 2016

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My Clinical Outcomes

As someone who was the first doctorpreneur I ever discovered and who is a genuine and honest guy. Tim Williams has helped me more than he realises at an early stage on my doctorpreneur journey. What he is doing with @myclinoutcomes is great and we need more of it. It’s only by measuring the metrics of health that we can feed back into the learning cycle and make sure we don’t waste effort (ie. think lean) but more importantly patients will be protected from harm. (Tim to the left). Lorie his analyst and Joe Mcdonald chair of the clinical CCIO network are to the right.

I want great care

In the middle is Neil Bacon. I had heard of Neil before and have even once for some reason been asked if I had founded doctors.org.uk! (apparently many have claimed to be the founder. If you are one of the other founders I would love to hear from you…)

Talking to Neil was like talking to an even more vivacious and talkative me! His passion for what he is doing shines through and I have to say what he is doing with Iwantgreatcare.org is fantastic. I signed up straight away and so should all doctors. What you might think is just a ‘trip advisor’ or ‘checkatrade’ for Healthcare is actually a powerful feedback and analytics platform that enhances patient safety and outcomes. If you use it you WILL be helping your patients!!!

That’s it from me from NHS EXPO 2016. It’s been a great conference. Next up GIANT health con November!

Matt

Novel Imagers / VR kit

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In the last couple of weeks I have been contacted by several people who have designed various gadgets for Medical VR/interaction. They are iridescent imaging, VIZR, D-EYE and Gesturetek. 

First up Iridescent Imaging 

Mitch Downey founded this company to create fantastic small and life-size VR projections.m  see more images here: http://iridescentimaging.com  The technology looks fantastic but as you might expect it isn’t cheap. I can really see how these might be useful for virtual clinics, particularly in specialties where walking in front of the doctor is a key part of the exam: ie. Rheumatology / Neurology. However, a remarkable product needs a great website and this is something that needs a bit of work. 

Then there is D-EYE. 

This thing looks excellent. It can effectively enable an ophthalmologist to diagnose a child remotely in another country using just their smartphone but more likely it will be a great clinic application. To be honest I want one on my emergency unit as it looks so easy to use but again these things are new and therefore costly. https://www.d-eyecare.com

Next up VIZR

This is more like a clinician assistant (like Google glass) they feel their user interface and information is more up to date. It looks like a smart gadget but as the video on the site demonstrates it is not entirely unobtrusive to the patient looking at the doctor http://www.vizrtech.com

Time will tell whether there will be enough uptake. My feeling is that unfortunately for this device we are still several years away from IoT and the effects of Big Data having their full impact to help this device work. 

Finally we have http://www.gesturetekhealth.com

These guys are doing something a bit different. Trying to get physical controls to work for rehab /those with disabilities. Unfortunately the website is dire which is a shame as they have some really cool products like Irex-an upper and lower extremity training system. 

It looks like they are doing a great work in their niche. 

Note I have just started a medium blog as well and plan to integrate them later so watch this space. 

Some new wearables / healthtech

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Firstly there is Ozmo https://www.ozmo.io a drink bottle that measures your fluid intake. Seems like a good idea as it can connect to a variety of different other wearables but weighing in at $70 it’s not cheap (especially as I have a habit of leaving these things behind). 

Next there is Heart-In http://heartin.net/heartin.html

Not a great website but looks interesting. Unfortunately, the product is not that different from lots of others and I can’t work out how it is differentiated. 

Finally there is pulmaware by strados Labs. http://www.stradoslabsllc.com. 

This one looks the most interesting and unique of the lot. The website is clear and the product something that most asthma patients will understand.

 This one definitely gets my pick if the week and if I had lung disease I would strongly consider getting it.