The ‘Big Society’ is a concept introduced
delivered by the British Prime Minister David Cameron to describe a move towards increasing competition in the delivery of services. In particular the government is looking to open up competition to business and non-profit organisations alike. The concept is very simple but is supported by the government’s close attention to detail in specific areas. The Big Society website provides a lot of information on developments in the Big Society movement. However in this piece I want to focus on one area in particular – the reconceptualisation of service delivery to incorporate key features of sociotechnological developments – the Web 2.0. The interested reader will find further information on Web 2.0 in the Appendix but for those unfamiliar with the term it refers to the way that people have worked together on the World Wide Web in new ways by taking advantage of innovations in technology. It seems only natural that these developments should be considered in any discussion of how services are delivered because such developments offer valuable resources across many sectors. The focus here will be on health. One of the key features of Web 2.0 is the way in which collective intelligence is harnessed.
Elsewhere this has been divided into 3 broad categories
1. The use of human intelligence
2. The use of humans intelligence supported by computers for decision making – augmented intelligence
3. The use of artificial intelligence agents
All three scenarios have been tested and have proved successful across a range of services. Therefore if the ‘Big Society’ involves increased competition in service delivery it would be reasonable to suppose that successful approaches would involve some of the above solutions. If there is a reconfiguration of services in the UK then there is the potential to increase the available resources through such approaches including for healthcare delivery. Let us consider a project that made use of a very simple form of artificial intelligence – the SETI@home project or the Search for Extraterrestrial Intelligence @home. This project passes on astronomical data together with software to home computers so that a person’s desktop can process data from the project. The software runs in the background the computer is used for other activities – this is in effect an efficient use of resources (although perhaps not so straightforward). As of 8th November 2011 the SETI@home project had processed 2 billion results. At the time of writing the processing power being used was averaging 5,655.736 TeraFlops (Floating Point Operations Per Second). While direct comparisons cannot be made because of subtle differences in the architecture to get an idea of what 5,655 Teraflops means, consider the list of the top 500 supercomputers in the world. As of November 2011 according to the list the British Meteorological Office’s Supercomputers had a peak performance of 253.8 Teraflops.
The difficulty with using web based solutions including distributed computing platforms and artificial intelligence solutions is that for healthcare delivery they have to be relevant to patients. However the government has already published a draft consultation document on ‘Making Open Data Real’ and the interested reader can learn more about it here. Essentially this means that it is possible that in the future in the UK health related data will be made available online in a way which should protect patient confidentiality but enable improvements in service delivery of the type discussed above. Consider a few examples of how this might work
1. Areas where there are cases of rare illness may be identifiable. Using human intelligence through crowdsourcing, areas with people with these rare illnesses can be identified. This crude data can be used by clinical researchers to make contacts with local centres to build case registers.
2. Using a combination of researchers with software support antidepressant prescribing patterns can analysed by region and time period. This approach could be used to investigate the correlation of a phenomenon of interest with changes in prescribing patterns.
3. Artificial intelligence software running across a distributed platform could monitor health across the UK detecting changes in patterns of illness as data becomes available. Live monitoring of this data, assuming that data quality is reliable means that AI agents could alert epidemiologists to potentially significant patterns much earlier. Neural networks for instance might identify patterns in the data which wouldn’t ordinarily have triggered an alert through the usual reporting mechanisms. Although there may be false positives the open data paradigm might facilitate earlier detection.
If the NHS can make use of these resources on a global platform, critics might argue that it would have implications for employment with work being removed from UK employees. However healthcare delivery is primarily a service which involves the ‘physical’ delivery of care and these approaches would supplement this more direct approach. Essentially these resources would help to improve the quality of healthcare and would build an infrastructure that does not yet exist. On a distributed computing platform such a service would fit with the philosophy of the NHS – that it would be free at the point of delivery. The population of an augmented society would be reassured that their health was being monitored continuously by a distributed intelligent software system that supports the more familiary parts of the healthcare service. There is also the possibility that if this is successful in the UK, the NHS could facilitate the delivery of a similar healthcare service to other countries. With low and middle-income countries this would help them to build upon their healthcare infrastructure (providing the basic infrastructure was present). For high-income countries with different needs there is the possibility that a successful roll-out of this approach could provide the UK with the necessary experience to offer expertise in healthcare 2.0 improvement strategies. In summary there are many interesting developments underway with the potential to impact significantly on healthcare in the UK and there are many opportunities which results from advances in technology.
The Big Society
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