Mmmmm – NHS Web colour palette

Intranets like porridge

A problem like porridge preference presents itself when considering intranet solutions that might work for member practices across a CCG.

GP practices need to store and share information within their organisations, and also need to pull and push data or documents with their parent Trust (soon to be CCG). Local intranets coupled with connections to secure pages dishing up comms and content from the parent are often suggested, as existing networks are usually quite low-tech.

The smaller practices don’t have the resources to employ dedicated IT support or staff with the kind of competencies to populate and maintain an intranet, despite the advantages it could bring.

Larger practices are much more likely to already have existing intranets, well used and populated by a dedicated member of staff with IT skills, Microsoft accreditation or an active interest in web technologies.

So when it comes to thinking about intranet solutions that might suit the information needs of GP practices across a whole borough, we’re left with a problem like Goldilock’s particularity with her porridge.

You can offer up an intranet solution to all the GP practices and invite them to run with it. However the larger practices may be reluctant to adopt, given their investment in, and familiarity with, their existing solution.

Smaller practices may balk at the time and expertise needed to develop an intranet space that adds value to their business.

Too hot or too cold – there probably is an intranet solution that offers the functionality and customisation to make it mind-bendingly easy for lay users to start adding and managing content, whilst offering serious features and migration options for bigger practices to buy into the benefits of a switch.

Why bother about this? The introduction of commissioning poses some serious challenges to communication and information management between CCGs and their member practices. Lots of documents, specifications, and data is swirling around, and practices could do with strategies and solutions for organising and sharing this content.

All clinical medicine in as few categories as possible

I’ve been pondering how to condense all of clinical medicine into the shortest list of categories possible.

There’s a page on the Camden GP Website which lists a large number of referral forms. They have no file naming convention, so a simple alphabetical list is of little use. Presently, forms sit under headings corresponding to existing service pages on the site, which makes more sense, but leaves us with a very long, unwieldy yet quite popular page.

I’ve been searching for a suitable set of broad categories that can serve to group these forms into a small number of sets. I want to re-use if I can, and I want a medical expert to be able to glance at these categories and quickly guess where the relevant form is likely to be. I came across:

http://www.cks.nhs.uk/clinical_topics

These NHS Clinical Knowledge Summaries are neatly organised into 27 groups which encompass pretty much all of clinical medicine.

That’s good. It has proven surprisingly difficult to find a decent set of categories like this, which is surprising given their utility in organising all sorts of content, documentation or other information in medical contexts. So it goes.

1. Allergies
2. Cancer
3. Cardiovascular
4. Child health
5. Drugs and devices
6. Ear, nose, and throat
7. Endocrine and metabolic
8. Eyes
9. Gastrointestinal
10. Haematology
11. Immunizations
12. Infections and infestations
13. Injuries
14. Kidney diseases and urology
15. Men’s health
16. Mental health
17. Musculoskeletal
18. Neurological
19. Oral health
20. Palliative care
21. Poisoning
22. Pregnancy
23. Preventative medicine
24. Respiratory
25. Sexual health
26. Skin and nail
27. Women’s health

My meta-human ability would be eating all Mini-Eggs

Been reading some terrible mind-trash replete with mutants, Nazi killer robots, fire angels and one of those ex-military special ops ninja hobos that crop up from time to time, and yes – I have thoroughly enjoyed it

Secret World Chronicle, Book 1: Invasion by Mercedes Lackey et al.

I’d like to summarise the plot but I can’t. Its bonkers. Some of the best bits though involve dialogue written in a Russian accent (‘vussian aaccent’), one of the old ‘I’m down to my last 10 bucks and just wanna drink me some liquor and dammit, Nazi stormtrooper robot things with lasers have goddam RUINED MY DAY’ and some real cheesy stuff where the anxiety disorder mage has got to get over her problems to lay the sorcery smack down on some no good voodoo spirits.

No seriously, it’s really good fun. The end of each chapter mocked me to continue, and I did. I’m still undecided on my meta-human ability. Based on the quantity of Mini-Eggs I’ve eaten recently, it would most likely involve eating lots of Mini-Eggs.

I’d only be useful if there were an equivalent villain who threatened to drown the world in Mini-Eggs. He’d be pumping them everywhere, and I’d be scoffing them up, real fast and smooth.

Done

The classification of gene products in the molecular biology domain: realism, objectivity, and the limitations of the Gene Ontology (PDF, 3.5MB)

Thesis (nearly) finished, like the Half-Life alter-dimension

After how ever many years, my PhD viva done and final corrections pending approval, I’d say we’ve reached that nearly finished bit.

I’m reminded of the game ‘Half-life’, where you get zapped to the alien dimension and everything has gone a bit weird and you’re thinking: this game is totally nearly done. I mean, where the hell are you going to send Freeman next?

As to next things, I’m working at the London School of Hygiene and Tropical Medicine weekends and evenings, plus I now do some work for the NHS on a Camden website for GPs called – go on, can you guess? – the Camden GPs website.

No translation or comprehension necessary. There’s an information transfer for you. I’m tempted to re-brand the site to something thoroughly obscure and hip, like ‘Bentham’s Knee’ or ‘The Pancrasian Electro Doc Shop’. Something jazzy and unintelligible.

I’m off. To. Riff.

Thoughts on bias are biased, so become a hardcore epistemological realist?

I’m pretty sure there is a reality.

If there isn’t, then what is not reality is so damn convincing, I’m not bothered either way.

Yet one can choose to commit to realism, or the belief that there is one really real reality in which all our observations, perceptions, language, theories and beliefs, have their referents.

And somehow, we can know this reality free from all prejudice – we can know the universe as an unbiased, neutral observer.

Critics of scientific knowledge have claimed that subscribing to realism is bonkers, because bias exists in everything we see or think and believe. Since bias is ingrained into human nature – even that part of human nature which sees itself as scientific and objective – then epistemological realism is a pipedream. We must accept that every theory, even the the fundamental ones that seem to be entirely free of prejudice are, somewhere along the line, polluted by bias.

The author of the paper below,Ingvar Johansson, describes a view of biasism he terms Myrdal’s Biasism which claims the following:

“…we cannot know truths and that we should therefore speak of research results as being true-for-certain-valuations instead of being just true”

Johansson criticises all forms of biasism with several logical arguments, including the paradox that biasism itself would surely be biased, if we were to accept the version above.

Can we biased and align ourselves with epistemological realism? I don’t see why biased research programmes cannot lead to truth. The problem is when our biases blinker us from better truths than what we have now. We can be biased AND appreciate the kind of movement towards more ‘truthlikeness’ described by Karl Popper and explored by Johansson in this same paper.

I see this sort of productive research bias in Thomas Kuhn’s view of science. The interesting part is when the scientist realises these biases are untenable in the face of new evidence, though the process by which one truth is superseded by a better truth is a fascinating one to try and understand.

Revolution? Inspiration? Logical necessity?

dx doi 10.1016/j.jbi.2005.08.005 and FULL TEXT