The Turing Way for Healthcare

[DocEd]

I have for quite some time wanted to tackle the issue of documentation based collaboration in healthcare. Let me set the scene:

In healthcare, there are a large number of internal documents that must exist to facilitate the delivery of safe, evidence based and locally appropriate care. This includes: guidelines, SOPs, policies etc. If we look at guidelines as an example, these tend to reflect the expertise and capabilities of a local department, translating current best practice from the more global context. While some hospitals are able to purchase cloud based solutions for document collaboration (like Microsoft 365 etc.) these are by no means ubiquitous. Coupled with a largely itinerant resident doctor population, and zero permanent office space, it inevitably leads to a number of issues:

1. Inefficiency: collaboration almost always falls to the lowest common denominator of emailing word documents around. Mailing lists may include upwards of 50-100 people. Tracking changes and manually managing this process is a nightmare.
2. Sustainability: Staff move on, and their project source files (again, likely word files) are sometimes lost, as is the document history and decisions around what was or was not included and why. Consider a guideline where an expert has stated a certain action should not be taken. It's easy to construct a situation where a later revision would include this undesirable action, because the expert advice was long since forgotten.
3. Duplication of Work: Hospitals are continuously writing what are essentially the same document up and down the country. Of course there are already areas where we collaborate and share work. But this is at best ad hoc and certainly not joined up across all disciplines.
4. Manual Curation: These policies continuously reference each other, but updates will ever propagate through the system (they are just word documents) and so every update is a slow process of manual curation as the documents come up for review. It's easy miss things.
5. Proprietary Lock In: There is an extreme dependence on MS word. Enough said.

There are many more examples, and I'm mostly just building the reasons for engaging in version control at this point.

I think the benefits of applying various aspects of TTW will hopefully be obvious to this community. Basing a workflow around plain text, git and GitHub could have a profound impact on healthcare. The above issues aside, the network effects could be multiplicative. Consider forking a guideline from a national referral service. Everyone could have the opportunity to access, modify, and locally apply guidelines that originated from world leading experts.

Moving on from the pitch, there is a major issue. There is a zero percent chance, that most healthcare workers will engage with this set up unless it is breathtakingly easy to do so. With that in mind, are there thoughts on how you would go about building a pipeline that allows for the benefits of working with git and GitHub, but is almost frictionless in terms of technical ability? Is this something that TTW would be interested in developing as an idea/extension?

Thank you in advance for your help, advice and thoughts on this topic.

[JimMadge]

Hi @DocEd, this sounds great.

most healthcare workers will [not] engage with this set up unless it is breathtakingly easy to do so.

Reminds me of @KirstieJane saying "We want to make reproducibility too easy to not do" 😄.
I think there would be community members interested in this, and we have some overlap with like-minded people in the NHS like the RAP CoP and the NHS R community.

[firstethicalai]

Happy to have a chat..on Zoom or Teams. Pls send me a message so that we can arrange.