I had an interesting point put to me last night on Twitter from Dr Kunal Kulkarni that I think will be helpful for the mHealth training course that I provide to medics.
The original tweet posted was from 10 days ago when watching an interesting Channel4 TV programme called ‘Confessions of a Junior Doctor’ that showed a busy junior Doctor who had been working long hours under pressure and turned to a printed copy of the BNF, a Hospital windows PC and his iPhone 6 Plus while he hurried to prescribe a steroid to a child in his care.
I think the discussion thread provides a good insight into the challenges that engaging on social media sites like Twitter can present to practicing Doctors. Even though Dr Kulkarni isn’t following the GMC’s advice to the letter (eg. he doesn’t list his own GMC registration number on his Twitter profile) he asks me to confirm that I am a practicing clinician after accusing me of accusing a Junior Doctor of bad practice (“If a member of the public reads your statement at face value, it suggests what the doctor is doing is bad practice. That’s not the case”).
I think this Twitter conversation might be useful in training medics on the challenges of social media as it shows how easy it is to discourage medics from making the effort to be helpful and share their thoughts eg. if I was a GMC registered Doctor there is enough confusion expressed by Dr Kulkarni in this thread for anyone to start a medical council disciplinary investigation against me for starting it.
For the record I think what I saw there in that program was to my mind worse than bad practice it’s CONVENTIONAL practice in an administrivia laden NHS and it’s why we have Junior Doctors leaving the Profession (and the Patients who really need them) and suffering from burn out whenever they try to tolerate it. There’s nothing inherently unsafe about using a brand new printed prescribing text book but clearly you as a Doctor don’t get to decide if that’s what’s on the ward when you arrive for your shift. The NHS has for very good reasons made this available free of charge to all staff because the benefits of always having such an important ‘essential’ reference document is obvious. It also saves them a heap of money if medics help them do away with the need to print and distribute new books and collect/recycle old books across all of the NHS’s buildings/wards every few months.
It clearly takes Mobile First thinking but I’m confident that in 2017 you shouldn’t be allowed to practice medicine without a smartphone loaded with high quality up to date content because clearly access to this information on a device you are familiar with using is critical to being able to do your work safely and to the best of your ability.
I think the thread also highlights the urgent training need there is because so many even young Doctors (yes even those who already use Twitter and have experience working for a ‘management consultancy firm’ that specialises in IT) have become wedded to the paper based processes that they have been trained to use.
The aviation industry has shown us it’s not sufficient to blame mistakes and deaths on fatigue when there are processes in place that haven’t been thoughtfully designed. All Doctors but especially Junior Doctors deserve better working conditions and their training and examinations urgently need to be modernised to ensure that they are capable of working with the tools of our time because it’s safer to be using a quality smartphone (perhaps with a mophie power pack if you need to work long shifts away from a power outlet?) than hoping the hospital ward you are working in has a poster on the wall or a printed book that hasn’t been thrown away/misplaced/recently updated or even (as we’re seeing since Friday following what’s being labeled as the ‘NHS cyber hack’) a PC that has been patched for known security issues and is working/available.
Get in touch if you face these challenges in your Medical School, Hospital or Clinic and would like us to run the accredited mHealth course we developed because such an investment in your staff can help ensure you don’t fall victim to easily avoidable malware attacks and your Patients will benefit from being cared for by Professionals who are confident using the incredibly powerful supercomputers that they already carry in their pockets.
Click here to download a copy of the BNF’s essential reference book app for your smartphone.
If you attend a Medical School that still doesn’t give you mHealth tools the data now shows that they are failing you (Feb, 2013)
Has your Hospital replaced error prone paper based Observation Systems with mHealth Apps? (Oct 2014)
Why do we blame Pharmacist Fatigue when fatal errors are originating from poor design & outdated tools? (Dec, 2016)
UPDATE 13:00HRs 16 May 2017
I tweeted a link to this post and Dr Kunal Kulkarni came back to say I was just “scaremongering to sell IT” and that how he or colleagues use their mobiles “has absolutely NO link” to his clinical acumen.
I think this is very interesting because I’ve only encountered it once before when training medics and it was a point of view held by another newly qualified Doctor. More senior Doctors absolutely love the energy that mHealth adds to a consultation (eg. a Paediatric Cardiac Electrophysiologist who pulls out an Alivecor in an outpatient consult, or an orthopaedic consultant who launches the 3D4Medical app and shows their Patient exactly what they’re talking about before adding their anoted images to their Patients records, etc.) but the young Doctors have got to be really skilled in their use of mobile technology and how they communicate what they are doing because otherwise some Patients/Carers may think they just don’t know what they’re doing:
I think it’s clear twitter isn’t working for this debate (and find it very odd that a Junior Doctor in 2017 is claiming that they don’t benefit from the superpowers a smartphone gives them especially when many NHS facilities have had to close today or have cancelled appointments because of malware that would’ve been easily avoided if staff had been using smartphones or even just had been trained to properly use the old IT the NHS prescribes them) so I offered him an invitation to join me on a mHealthTV hangout and hope he takes me up on the offer (I’ll then update this post with that video discussion and readers can make their own mind up):
Margaret McCartney: The NHS needs big, firm IT pants
UPDATE: 27 May 2017
Medics in the NHS are so obsessed with the value of printed drug reference books that they think it’s charitable to ship their old (dirty) copies to the BNF to colleagues working in lower income regions of the world. Why not just send them your old mobiles or use the money wasted on shipping heavy books to pay for inexpensive SD cards (that could be loaded up with the LATEST content) and send them out there in an envelope?