A waste of money?

Top-down or bottom-up?  What is the best way for new technologies to be diffused throughout an organisation?  Of course, it depends on the technology, the organisation and what you want to achieve.  Some recent dealings I have had with the NHS have made me think more carefully about this.  Having spent quite a lot of time with a sick relative in various hospitals over the last few months I am astounded that despite more than £5 billion being spent on the NHS IT Programme, the effective sharing of patient records between hospitals and GP’s does not seem to be working.  We have been taking photocopies of medical documents with us to appointments as the various specialists we have seen do not seem to be aware of tests that their colleagues in other hospitals have carried out. I thought the NHS IT Programme was supposed to do away with all that – but then the computer was supposed to result in a paperless office.  So the top-down approach does not seem to be working very well for the NHS.  What about the bottom-up approach?  For me, this is the interesting part.  Before Christmas I ran a 5 day training programme on Web 2.0 technologies for 15 NHS librarians and information professionals.  I really enjoyed their enthusiasm for learning about new services like Twitter, Delicious, YouTube, blogs and wikis.  As an example of a NHS librarian using a blog for professional purposes we looked at Sue Jennings’s blog for the Lancashire Care Library and Information Service.  I interviewed Sue to find out more about the blog, why she set it up and what the benefits have been.  Sue, who had never posted to a blog before she set this one up, told me that the blog had allowed her to promote her unit’s services to their clients in a way that would have taken years to do without it.  Visit the blog and you’ll see the types of information she posts.  The blog is hosted for free at Wordpress.com and the only investment is her time spent posting updates on new information sources she thinks her users would be interested in.  This is a  great example of a low-cost/free Web 2.0 technology that is making a difference to healthcare provision.  I’m not naive enough to suggest that Web 2.0 holds the answers to all the problems of the NHS but there must be some lessons to be learned here.  Perhaps one of the first lessons is, don’t try to control everything and everyone.  Despite the enthusiasm of my NHS students, most of them had to carry on their experiments with Web 2.0 at home – many of the IT service managers in their NHS trusts blocked access by default at work to blogs, wikis, YouTube, Twitter, Facebook etc.  We still have a long way to go.

(Photo courtesy of YoNoSoyTu)