Hive Health

As Helen and I drove down the M6 in the rain yesterday, something struck me…..

In 1996, I travelled – I had no email, no mobile phone – my family got a postcard every couple of weeks

In 1997, I started at university – they gave us a clunky email that resembled an MS-DOS screen – we thought it was great

In 2000, I did a PGCE – for the first time I used the internet for research – my paper on health education for behaviour change was largely in debt to online publications

Here we are in 2009, not a huge number of years later, and Helen and I were driving down the M6 after meeting the Head of the Pharmacy School at Keele University. What he showed us was mind blowing!

They have developed the virtual patient – an avatar called Shirley who walks up to the pharmacy counter, coughs, snuffles and waits for you to start the conversation. Depending on what you, as the pharmacist, chose to say or do, Shirley will respond. The prototype is using text input, but the future masterpiece version will use voice recognition.  It’s ingenious and totally captivating!

The consultation scenario that Shirley demonstrates is based on a decision tree algorithm – an interlinking set of questions, answers and decision points that dictate what Shirley will say and do. These algorithms are incredibly complex to build, we know, because we have just completed our first set for the alli launch that has been used to train pharmacists across the land. We’re very proud of the work we’ve done so far, but I can’t help wanting to take scenario training to the next level.

In the city of Portland, Oregon, ‘Mrs. Smith’ has invited Intel Corp to equip her house and its contents with hi-tech sensors. These sensors map Mrs. Smith’s movements through her home, and measure her average stride length. They note the volume at which she speaks, and the amount of time it takes her to recognise her granddaughter on the telephone. They keep track of her nocturnal activity, including bathroom trips, midnight snacks, and ‘romantic encounters’. Urgh.

Researchers at Intel Corp will translate this data into a ‘behavioural baseline’ for Mrs. Smith. Any deviation from the norm could be a signal that something is amiss. Although research is at an early stage, it is hoped that the technology will eventually be able to recognise the patterns of behaviour that are characteristic of certain early-stage diseases, like Alzheimer’s.

It would currently take many years to determine if Mrs. Smith was developing dementia, and this technology shows promise to shorten this timeframe considerably. Early diagnosis translates into improved outcomes, and so intelligent houses may become an efficacious (although expensive) healthcare intervention. However, as with all nascent technology, many people are worried about the potential for abuse. You’d be worried too, if you’d seen Demon Seed.

Having hit the brand planning season, with flipcharts and by post-it notes a weekly occurrence I met with a strategist mate who suggested with much mirth that informed dictatorship is by far and away the best way of coming up with battle plans.

He is a military strategist, quotes Von Clausewitz  a lot, and never had to work in primary care – so I am sure he doesn’t know what tough is!

These conversations always get me thinking, our terminology is military, our challenges (resources, prioritisation, superiority) pretty similar, perhaps we have something in common. In his world having non-strategists risk being the rate limiting step to your campaign success is a fear well founded. The use of strategic development time to drive interdepartmental buy-in made him visibly nervous, and prompted him to suggest we should settle on a good old game of Rock, Paper, Scissors when approaching “strategy by consensus”.

His tips were as follows;
1. Play paper first. Rookies tend to lead with rock, so paper is the safest opener. (A savvy opponent will try the same, causing a tie.) If you win, claim victory; if not, start the next throw right away, because of course it’s two out of three.
2. Exploit copycats. Casual players often switch to the object that just beat them. You can encourage them to do this by shouting, “Paper wins!” when you defeat their rock. Then throw scissors on the next round.
3. Watch for doubles. People rarely throw the same hand three times in a row; if they play scissors twice, your next move is paper. Also, keep up the pace so they have less time to think and instead fall into patterns.

So that’s all solved then!

My friend Kate sat in my kitchen looking through a pile of papers. Then she laughed a short, scornful laugh:

“Wikipedia? Why would you print anything off Wikipedia?”

Silence.  A loose ball of cat hair tumbleweeded past.

I stirred the tea and hung my head. Why can’t I get into good debate with Kate? She makes me feel dumb. Nevertheless, I had to talk to someone about my thoughts on Wikipedia.

Unlike a real life Encyclopedia you need two hands to carry, Wikipedia is generated and edited by its users. There’s an article for just about every search term out there, and it’s often the first link on the search results page.

What came first, Wikipedia’s popularity or its accessibility?

Anyway, thousands of iterations by users shape a package of apparently relevant, well structured content, updated into real time. But with any piece of information plucked from the net, you should fact check your finds against your own research.  

For very casual research, I don’t have a problem with Wikipedia. It is fairly obvious to see which content has been approved by a substantial body of readers. And we know that scientific rigour is based in sample size. 2 approvals – not very rigorous, 200 approvals – much better. However, it’s true that we don’t know what these people are agreeing upon. I have never really checked out the references (not called references but “Notes” – suspicious).

Obviously Wikipedia was never made to fly with academia. There is also this satirist who calls Wikipedia an example of “truthiness” – the repurposing of “gut feeling” as equivalent to hard evidence.

Then again, Wikipedia is a soft target because it’s such an annoying buzzword. It’s high street, common, unfashionable. It’s in the distressing realm of the hyper-real (Wiki isn’t a real word). It symbolises our separation from what we were… think of the massive encyclopedia clutched to the chest with tiny child hands…the effort of finding the page we wanted.

But it should be fashionable for at least a couple of reasons – it’s free, it doesn’t make any money, it’s community-led.

People wanna get their facts straight!