Joe’s View: Betting on the 1% Open Digital Challenge Fund

  • 3 August 2017
Joe’s View: Betting on the 1% Open Digital Challenge Fund

Greetings from Berlin where I am recovering from Summer School and from my failure to get a slot in the Rockeoke band. Never mind – there’s always next year.

As usual, Summer School fell on my wedding anniversary and to make it up to my better half I organised a trip to Berlin afterwards. Well, actually, Fiona did all the organising because seven years back, on our 20th anniversary, we turned up at a posh hotel in London only to discover I had actually booked the hotel for the week after. It was London Fashion Week, and so there was not a room to be had. We spent the big night in Kings Cross Travelodge. I am now no longer trusted with organising wedding anniversaries – or anything else for that matter.

Fascinating place, Berlin. Almost everything is new because of the devastation visited upon it at the close of the second world war. Anything that isn’t new is cratered with bullet holes. The city is dominated by one of the relatively new buildings – the TV tower built in the 1960s.

Monzo mobile banking beta

An appropriately modern city to try out my new international banking solution Monzo. Monzo is an online bank which shamelessly describes itself as being “in beta”, and its smartphone app advises me that I should also carry a card other than my Monzo in case the technology fails.

Refreshingly honest. The reward for signing up is commission-free foreign exchange transactions and instant notifications to my phone of any activity on my account. Does it work? You bet it works.

Checkpoint Charlie does surf

At Checkpoint Charlie, the infamous crossing point standing in what was the Berlin Wall, there is now an artificial beach. Yes. A beach. With palm trees and sand and deck chairs and a choice of three beach bars. It was 27 degrees in the shade and so we were thirsty. I ordered two beers and paid with my Monzo card.

Before the barman could tear off my receipt and hand it to me, my phone buzzed. I looked at it and saw the message: “You spent 7 Euros at Charlie’s Beach”. Wow. Beta? Real time alerting as to the use of my bank account.

Even more interesting was the sign-up process. I downloaded the Monzo app to my phone and the app informed me I was 25,446 in the queue to get a Monzo account. If I wanted to climb that queue I could nominate friends to receive information about Monzo – the more I nominated, the higher up the queue I would go. I didn’t nominate anyone. After two weeks I reached the front of the queue and Monzo texted me an activation code to open my account. Something I have and something I know – two factor authentication. So far, so good.

Selfie video for verifying ID

How do they verify someone’s identity, though? Easy – the app requests a photo of my passport and I have to shoot a five second “selfie video” during which I have to say: “My name is Joe McDonald and I want a Monzo Account.” Minutes later I got an email asking me to transfer £100 pounds from my existing bank account to deposit in my Monzo account. All done.

I can get statements broken down into different categories of spending (eating out/household bills etc). This is banking transformed rather than transferred from paper to electronic. Surely it must have taken an army of people to craft such a bank and its apps and automated ID solution?

In fact, Monzo is a company of just 110 people in East London who aret together building the “Bank of the Future” and who only got their banking licence this past April. Their app is powerful, fast and beautiful. Amazing what a passionate, knowledgeable but small team can achieve when they get a little space to think beautiful thoughts. Could we do similar for health?

The need for customer focus

Sitting in the Berlin sunshine half way through my second beer, I am filled with hope from three sources. Firstly, Juliet Bauer’s passionate presentation at Summer School and the fresh perspective she brings to the party from another industry. Some welcome fresh eyes on the problem and real customer focus.

Secondly, Monzo seems to have solved the whole ID/authentication piece in an elegant and usable way. It’s not just doable, it’s done. My feeling of beery wellbeing is completed by my memory of Tony Shannon and Ewan Davis’ presentation at Summer School. Their proposal for the NHS to reserve 1% of its IT spend for the development of an open platform approach to NHS IT is brilliantly simple.

Now’s the time to back NHS of the future?

I would go further, though. An internal review was critical of NHS Digital’s ability to deliver “thought leadership” and to genuinely transform healthcare. There is an opportunity here for NHS Digital to get behind Shannon and Davis’ vision and passion in the way that Monzo’s backers got behind their vision for the “Bank of the Future”.

I believe the NHS should take a punt on the 1% Challenge – not just with money but with 1% of the headcount at NHS Digital. In his opening to the internal review report, NHS Digital chairman Noel Gordon rightly points out the organisation has done great things (EPS and Spine to name two) and has some great people. He states: “We are reinventing the culture of NHS Digital to become more flexible and responsive to the very dynamic environment in which we operate.”

Time for a digital leap of faith

NHS Digital has been at its best when it has been at its boldest, taken a leap of faith and backed a bright idea to the hilt. Shannon and Davis are two of UK health IT’s most knowledgeable and passionate experts and have one of the brightest idea around. What have we to lose except the expensive chains which bind us to a dwindling number of system suppliers who we are struggling to make interoperate?

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10 Comments

  • summary:
    makes sense … IF 1% of budget is also put in to a project to develop a NATIONAL person portal so that ALL can access THEIR data on an equal footing (this is in my mind is the priority) IT should be a leveler and right NOW the service needs to be re-leveled because over time because of the significant variation in NHS leadership it’s become very VARiable !

  • I suggested to Dr Tony Shannon at an event where he was presenting that they should crowdfund OpenEHR – I’d certainly chip in, as unless it gets into the GDE funding pool a really, really good idea (and probably the best chance of pulling off interoperability in the NHS) could be lost.

  • i think someone has said it before but we need to clone Joe and just shake up everything , before we end up with nothing 🙂

    • Yes we could have lots of cloned Joe’s – but only as long as I can have Joe 90
      (anyone under 40 probably wont get this!)

      • Too kind, Steve. Thank you.

  • Monzo is kool.
    KIDZ luv apps, apps are the future for health.
    Dashboards are needed NOW bi NHS management so they can work out wotz going on.
    IT is the future for efficiency and when in the hands of good people there should be no cause for concern.

    • lol.
      😉

  • That sounds pretty similar to how SMARTonFHIR apps work but without the centralisation.

    I’d hope we have the first smart apps within a year.

  • As usual, another great but pertinent story …

    IMHO, the only way the NHS will solve the issue of data/access is to define a patient data record and have it sit in a walled garden/ vna – if new data doesn’t fit the format, it doesn’t get in (and people won’t buy those systems – right?). Note, this is a storage layer, not a presentation layer) Then, with open API’s a slew of entrepreneurs will develop apps for various user cases -actually,apps competing for the same functionality. There will (of course) be the Patient app- and that will allow them to control access to their data. There will be GP apps which will poll info they need/ ask for, there could be diabetes apps, breast cancer/ any clinical condition, physio, A&E practitioner apps etc etc . Users may use multiple apps for various scenarios, and of course they will be available for various platforms, including web based.
    As things currently stand, the only real prospect of getting anything close to this is portal type functionality and that remains a very distant 2nd choice to the nirvana I describe above.

    • Good points. This is exactly what openEHR provides (www.openehr.org). It separates structured clinical data from applications similar to what PACS systems do with images, basing the data on open, published and free to use models. And it is being used in this way in projects in Moscow, Norway, Slovenia and recently in Genomics England, Plymouth and Salford Royal!

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