gp’s on the line? information systems and the nhs plenary session professor frank stowell

GP’S ON THE LINE?

INFORMATION SYSTEMS AND THE NHS

Plenary Session

Professor Frank Stowell

IS or IT Failures?

Project Author

TAURUS DRUMMOND (1986)

WESSEX HEALTH AUTHORITY

KIRBY-GREEN (1993)

LONDON AMBULANCE

WASTELL AND NEWLAN (1996)

PATHWAY RANGER (2000)

SOCRATES MITEV (1996)

NATIONAL AUSTRALIA BANK

JOHNSON (1996)

ETC ETC ETC

HORRIBLE INTERFACE? (Morris and Travis, 2001).

“The commonest cause of It failure...is custom-made systems…

new business processes must also fit unmodified software and not the other way around.

(Economist, 2002).

“METHODS OF IS DESIGN FROM THE DATA PROCESSING ERA

ARE AS DEFUNCT

AS THE MONOLITHIC ENTERPRISES IN WHICH THEY RESIDE”

(ANGEL, 2000)

• NHS and Change

• Wales new structure (Dobson,2002)

• Scotland merger (Truland,2002)

• UK workforce development (Davis,2002)

• UK/IT 50% coverage by 2005 Economist,2002

Comment

Workshop Jan ‘03 £ but What is problem?

Vickers is relevant here any system to have stability .. “does not consist in prescribing one goal or even one series of goals; but in regulating a system over time in such a way as to optimise the realisation of many conflicting relations” (1983).

Systems and Information systems

Experience shows:

1. understanding from within

2. transfer of ownership

OWNERSHIP AND SUCCESS ARE SYNONYMOUS

AND

3. systems tools

4. client-centred –v- client-led

Appreciate

Depict

Define

Specify

SpecifyGap

Satisfy ISDEFINITION

Model

CLIENT-LED DESIGN

e.g. Black box diagram

eg RP’s, AIM, influence diags

Transparent

e.g.Root defintion, rates/levels diagram

eg Activity models, DFD’s, Object Models(Stowell and West, 1994)

client led information system creation(clic)

DESIGN SYSTEM TO BE

SERVED

DESIGNSERVINGSYSTEM

IDEASforACTION

APPRECIATE

IDEASintoPRACTICE

TO FACILITATE THOSE INVOLVED IN I.S. DESIGN IN NAVIGATING FROM THE CREATION OF IDEAS FOR PURPOSEFUL ACTION TO CREATING A LOGICAL SPECIFICATION FOR A SERVING I.S.

1.1ST PHASE OF THE INQUIRY - AN EXPLORATION OF THE SITUATION TO CREATE SHARED APPRECIATION (VICKERS,1983)

2. ONCE SOME SHARED AGREEMENT HAS BEEN REACHED MOVE ON TO CONSIDER IDEAS FOR ACTION THAT MIGHT BRING IMPROVEMENT

3.CONSIDER IDEAS FOR THE SYSTEM TO BE SERVED THEN IDEAS FOR THE SERVING SYSTEM.

4. BOTH CLIENTS AND DEVELOPERS CONSIDER HOW TO OPERATIONALISE IDEAS FOR ACTION - IDEAS ARE “CONTEXTUALISED” TO CREATE WHAT VICKERS REFERRED TO AS “A MORE DETAILED COMPLIMENTARY PICTURE”

TO DO THIS WE USE A CONVERSATION FOR ACTION MODEL

CLIC

Systems Tools for CLIC

Appreciation:Rich Pictures, AIM

Designing the Action to be taken(the System to be Served)

Conceptual Activity Models

Conversation Models

Designing the Information System(Serving System)

UML Collaboration Diagrams

Object Oriented Case Tools

APPRECIATIVE INQUIRY METHOD(West,1995)

Why attend an SPMC Workshop?

Learn about systems ideas

Hear about developments in NHS/IT project

Will it help to address workplace problems?

What time is available

IS Development scenarios

brownfield

development

greenfield

reform

renew

Navigating the Gap:

Using Systems Ideas to manage IS development

Discussant: Donna Champion

GPs on the line April 2003 SPMC Workshop

Client Led Information system Creation

1. Create a shared appreciation of the situation

2. Create some ideas for improvement

3. Express those ideas for taking action as a model

4. Think through the implications, creating more detailed models of how the action might work in practice. (The ‘system to be served’).

1. Use this learning to think through the requirements for the information system –ideas for the ‘serving system’.

GPs on the Line April 2003 SPMC Workshop Champion and Stowell

CLI C: Client Led Information system Creation

Appreciation

I deas into Practice

Design the System to

be Served

Design the Serving System

I deas for

Action


Systems Tools for CLIC

Appreciation:Rich Pictures, AIM

Designing the Action to be taken(the System to be Served)

Conceptual Activity ModelsConversation Models

Designing the Information System(Serving System)

UML Collaboration DiagramsObject Oriented Case Tools


An Example

Create an Activity modelExpressing ideas for action


An Example

Take each actor in turn and consider the ‘Conditions ofSatisfaction’ for each activity

Manager

IT

Manager


Take each role in turnand model all the conversations they willneed to participate in to complete the action.

1.

1.b

2.

3.

ActionStart

Finish

Conversation for Action Model

E.G. Manager


CLIC

In a practical sense, coherence is maintained by using activity-oriented models throughout.

In a theoretical sense, coherence is maintainedby following the same principles of inquiry throughout.


Summary

Developing IS in public services is difficult, failure is common.

The purpose of the workshop is to think about how Systems ideas might help.

The idea of ‘navigating the gap’ seems useful.

Any ideas must be useful in different conditions. For example, in new ‘green field’ design, or in ‘brown field’ reform approaches.



References

Champion, D. (2001) “Navigating the Gap between Purposeful Action and a Serving Information System”, Unpublished Ph.D. Thesis, Dept. of Information Systems and Computer Sciences, De Montfort University, Milton Keynes.

Champion, D. and Stowell, F.A., (2002) “Navigating the Gap between Action and a Serving Information System”, Information Systems Frontiers, Vol. 4, No. 3, pp. 273-285.

gp’s on the line? information systems and the nhs plenary session professor frank stowell

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