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Wireframer could save NHS from gung-ho developers argues Thoughtonomy

There are many ways that hospital patients could be protected by machines, but Nick Booth warns that we have to make sure these systems don’t fall victim to developer impatience

Ten days observing operations in Croydon University Hospital has been a fertile breeding ground for ideas to improve the patient experience. I hero worship anyone in scrubs - as both my parents and two of my sisters were either doctors, nurses or anaesthetists. Which means I spent 10 days enthusiastically quizzing them. They were probably relieved when the anaesthetics kicked in.

As a result of this intelligence gathering we can now propose some new apps. My view from a series of beds, trollies, wheel chairs and operating tables gave insight into potential ways to improve patient outcomes. They could be done cheaply too.

But will they be good long term prospects? Process automation expert Thoughtonomy has recently issued a stern warning about developers cutting corners. These lessons should be heeded by our code cutting readers as they begin their projects with impossible deadlines. We will save Thoughtonomy’s verdict to the end - first let’s describe the apps. Then we can find out how they could go wrong.

Here’s a proposal to improve the patient environment. Patient’s in Accident and Emergency, Intensive Care or surgical wards are often already in distress. The hospital trolley experience makes them feel even worse. Busy, distracted nurses - for whom patient moaning is the norm - can be immune to suffering. So the patient can find themselves on a trolley directly under a neon light while a ceiling heater roasts them into dehydration. As I found out. Meanwhile there’s an aural bombardment of multiple monitors going BING at full volume, in a disjointed rhythm that would drive even Jazz lovers to tears.

This sensory torture could be avoided if we planted a series of monitors of temperature, moisture, sound and light. These would report back to a management system, which might warn the nurses that the patient in Bed 5 is suffering cruel and unusual torture.

Sometimes, the patient’s worst enemy is other inmates. Some patients and their entourage of visitors treat the hospital like a playground, with no regard for the staff, whose views should be sacrosanct, let alone the patients in the other beds. In a 6 bed ward it’s possible to find yourself with at least one neighbour showing complete contempt for doctors, nurses and the rules of the hospital. Meanwhile the bed to your left could be occupied by an aggressive drug addict who assumes he’s a client of the NHS. As ‘the Customer’  this narcissist really thought he was king.

This misconception gives even Deluded Junkies a massive sense of entitlement to their heroin substitute. Hence they expect it delivered on time or, heaven forfend, they’ll go and buy some privately. Which, he announced in an endless series of loud mobile phone broadcasts, he was happy to finance by stealing.

Bit of patient feedback. This sort of noisy neighbour can put you off your painkillers. The resulting lack of sleep is not good when you are recovering from surgery. But who could relax with an acquisitive crack fiend - with proven robbery convictions - ready to spring from the bed next door to them?

In response, here is a patient safety and security proposal from James Wickes, CEO of data view specialist Cloudview. An achievable app would be CCTV surveillance of the ward, with automatic alarms if certain individual wander into areas they are not authorised to enter.

Analytics, coupled with Artificial intelligence, could protect more vulnerable members of society. Cameras could also detect self-harming or suicidal behaviours and monitor individuals to ensure they are being well treated.With appropriate permissions this could also monitor unruly room-mates and visitors in a hospital.

Another problem hospitals face is the logistical problem of transporting patients between wards, scanning centres and operating theatres The self driving hospital trolley is a long way off though. Too many double doors to negotiate for one thing.

But the problem of lost trolleys and wheel chairs can be tackled now, says Wickes. One solution is to have many designated points where several wheelchairs can be left, so they are close at hand rather than in a central store. Staff could find them using RFID tagging combined with an app that can show where the nearest wheelchair is located.

When a wheelchair is no longer needed, it can be left in the nearest designated location. The management systems already exist, and are being used to run cycle hire schemes. In the large and complex hospital environment, where need is often immediate and urgent, Cloudview’s visual data could quickly locate the required item.

The control system would always know where all the wheelchairs are, so less of this expensive stock would get lost or stolen. The visual data could be used to spot chairs that need repairs. This is a potential money saver for an IoT developer.

“The IoT can unlock a vast amount of data from a patient, monitor it and analyse it and use machine learning to improve each outcome from treatment,” says Tim Stone, a venture partner at European IoT investor Breed Reply.

However the NHS has terrible luck with IT suppliers. In the current climate there is huge pressure on developers to complete their coding assignments and move on to the next lucrative contract. This is enforcing errors and encouraging terrible habits, according to process automation expert Thoughtonomy.

Thoughtonomy recently warned Microscope that automation often achieves the opposite of its intended purpose: it acts as a problem accelerator and complexity multiplier.

Why and how? Because application development is too hasty too often, with not enough attention to details such as standards, accreditation and verification, warns Thoughtonomy CTO Danny Major. Thoughtonomy has produced a framework, Wireframer, which forces developers to declare all the variables that, in future, system maintenance people will need to provide continuity. How good is it? Don’t ask me, I’m just researching the apps.

This was last published in December 2018

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