I spent a day recently working with colleagues at the Leading Edge Forum, helping the board of an NHS clinical commissioning group to think about the impact and the potential of Digital in their context.

I had done quite a bit a research into case studies that might help to ground the more conceptual stuff we were doing, give some anchors to the “real” world. But then something serendipitously popped into my Twitter feed – a mention of OpenAPS.org – a group of diabetes type one sufferers and associated geeks who, with a few bits of commoditized technology and a few lines of code, have created a closed loop artificial pancreas.

The hashtag for the project website is #wearenotwaiting. The whole thing seemed to have a fairly profound impact on the people in the room. It’s a remarkable project. It also flies in the face of traditional thinking about the natures of medicine, regulation and professional expertise.

The conversation for a while after introducing OpenAPS turned to whether providing training in “maker” technologies would be an appropriate use of NHS funds. You could see a few folk in the room were thinking “well, maybe…”

The thing with healthcare, though, is so often you are talking about matters of life and death. Most of business is nothing like as serious or important. Which gets me wondering… if a group of interested people can collaboratively band together to create a medical device that appears to have euluded the healthcare industry, what could a maker ethos do in most organizations?

What gets in the way? Well it’s tempting, particularly for technologists, to believe that what’s missing is skills. But I’d argue that far more likely barriers are the prevailing issues of management control that permeate most large organizations. We provide people with technology, and then systematically stop them from using it.

It’s easy to blame this on IT, but I’d argue that that is probably shooting the messenger. IT and IT policies are the physical manifestation of underlying cultures of control that are still so prevalent in large businesses. Sure we want people to innovate, but only in tightly proscribed ways that won’t rock any boats. The gap between innovation in most organizations and the creativity and invention of OpenAPS are the managerial attitudes that allow all of our technology to be locked down into uselessness in the names of efficiency and compliance.

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