How did I not know about this? – Answers on a (Digital) postcard by Susan Irving, Team Lead Physiotherapy, Children & Young People.

Those of you interested in digital health may remember my last blog, a summary of my experience about the journey of introducing digital technology in community children’s AHPs. Well……my journey has been on a very steep up hill direction over the last 4 months!

During one of my first sessions in the Digital health and leadership course back in 2018 we were advised – when you believe in something keep shouting, be (respectfully) disruptive and keep knocking on doors. Well after lots of talking (don’t think I shouted!) I was fortunate to be given the opportunity to work alongside colleagues in IT on the expanded community rollout of Morse in the Womens and Children’s directorate. 4 months in and I thought I would gather my thoughts.

It has been a steep learning curve, but one which I am enjoying immensely. I have learnt about back ends/front ends (a vastly different definition to what it might mean clinically!), datasets, configurations, licenses, permissions and now have a better understanding why somethings that, as a clinician, we just think is easy to get – is not that simple! I still have lots to learn.

As a clinician I am always keen to embrace digital health to benefit my work and make life a little easier – whether that be in efficiency in record keeping, using data to evidence service need or using technology to to make sure we can see our patients safely; but what this last few months has really brought to the fore for me is equity vs equality.

There is a tendency to treat everyone the same but we are not, neither in need or ability. The same equipment might work for one person/one team but not another. What one term means to one team might not mean the same to another. Clinic and caseload can mean different things to different clinical staff, never mind clinical staff and IT staff! A community therapist working in schools/away from the office all day (will that ever be a thing again? – that’s a question for another day!) will have very different needs than a predominantly clinic based therapist who has access to a PC all day.

In order to ensure we can gather consistent and comparable workload data we do benefit from using the same systems, with a shared understanding of terminology, to gather workload information and record patient notes (and lets face it if we all use the same systems it is easier to navigate and support each other) As an organisation the direction is clear for community services – morse is the tool they want us to use. But we don’t all need to use the same technology/ equipment to do it and we don’t always need the same data!

If we are to avoid just giving out technology and devices that end up in a drawer or not used to its full capacity or rolling out systems that clinicians don’t utilise we need to spend time with teams asking and understanding what they need.

Having been part of the children’s physio team for 22 years, I have a good understanding of what my team needs, what the people in the team need and due to good working relationships have been able to expand that to other children’s AHP teams too. I am fortunate to have a good understanding of what technology is available to staff because I am not afraid to ask questions. I enjoy spending time with people and understanding what they need, showing them how digital technology can help and supporting them to do use it, in way that is (hopefully) beneficial to them.

Over the last few months I have had to get to know other teams, other processes and understand what they need, not only to do their job, but what they need from me.

The project involves working alongside IT colleagues and clinical teams to introduce the product and sell its advantages, before teaching them to use it. To do that you need to spend time understanding the team – identifying the key players and understanding what the teams need and how they operate. In the course of doing that, I have had many corridor conversations about technology and equipment; and achieved the ultimate sense of satisfaction when one person said, “that will make such a difference to me’. Twice in one week the comment was made, ‘how did I not know that?’ – and for me that is the ultimate prize – we need to make this better.

The morse project currently also involves the development of additional functionality in the product in order to meet service needs, and being able to be part of discussions with the software developer is a great opportunity. I recently attended a webinar on ‘what is a digital leader’ where there was a crystal clear example of the importance of co-production of systems with service users. As a service user I feel this is something I can bring to my role working between IT and clinical teams.

As I said, this has been a steep learning curve, but spending time training and showing clinicians the potential of digital technology and how it can benefit their working life and then seeing the realisation of that makes it worthwhile. As adult learning theory highlights – everyone learns differently and one size doesn’t fit all. I have been fortunate enough to be able to listen to people and ask the question, ‘what do you need’ and more importantly ‘ how can I help’ whilst recognising it’s not just about how technology can support what we currently do but challenging people – how can services evolve to utilise the opportunities that technology brings.

That for me is the true benefit of being a clinician with a role in IT.

Susan Irving, Team Lead Physiotherapy, Children and Young People, NHS Dumfries & Galloway.

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