Do we need a StackOverFlow or Quora for the NHS?

When I first taught myself to program the iPhone there were several websites that had great tutorials but when i had a question i went to stack overflow. its a brilliant  Q&A website that programmers use. gamilasation to build reputation. presumably this helps in their careers. some do it for kudos. it uses tags. so you could ask IOS questions or android questions or c# questions. you could obviously use more than one tag. but it helped make sure the right people saw the right question. people would follow tags and be notified if anything came in on their favourite tag.

the point of the site was not to be a forum with endless discussions that ramble on but to be a q&A. people would put answers to the questions and both the asker and others would rate the answers and choose the best one. before asking a new question you were encouraged by the crowd to make sure you had looked it up to make sure it wasn’t already asked and there were all sorts of punishments for asking an already asked question – from having your question shut down to loosing rep points.

there are other sites that do the same – but perhaps in more general terms e.g. Quora.

i’m wondering if we need a version for the NHS?

we ran a version locally in south cheshire for a while and we learnt lots of lessons and do wonder if its worth revisiting/re laughing the idea with those lessons learnt.

our idea was – who do you ask for help? in a large practice – our registrars ask their trainers or whoever is in the common room. juniors ask seniors. even seniors ask others. but sometimes there is no one around to ask or no one knows. in a small practice it must be harder as there are less people to ask. now i’m not talking about referrals here per se. A whole host of stuff.

we got 250 users fairly quickly. we found and deployed an open source clone of SO. it had a lot of the same features. we made people log in by authenticating with a NHS net mail account as we didn’t want it open to the public.

we allowed experts to join and to subscribe to tags. e.g. a friendly consultant ENT surgeon watch the ent tag and a gastroenterologist several GI ones. etc. they didn’t have to log on they got emailed when a new question appeared and could reply to the email. it worked well.

as we weren’t locked down completely – we didn’t let people post PID and this did limit some questions. though as stated this wasn’t a referral vetting centre.

we quickly found that people were posting several things. 1. info about educational events and almost using the answers as RSVPs, 2. job adverts – we let admin staff join as in theory the questions didn’t need to be clinical they could be where do i get toner cartridges from. we found pms would advertise locum’s but also vacancies. 3. nes items from the ccg/gp federation which often got a lot of comment more than Q&As. and some people posted questions.

we think – being named didn’t help and if doing it again we would take a leaf from Quoras book and allow people to go covert. we wonder if being seen as the person asking the dumb questions all the time put people off. we had one registrar once who wasn’t very confident and he cleverly never asked the same doctor twice in a day but at the end of a week we all twigged he’d asked us all about 5 times each = about 100 asks.

the gamilsation meant nothing to people – while it might make programmers happy – it did nothing for local GPs. core users were small. there were some core people who replied a lot – whether they had more time, more knowledge – more It literacy more desire to be seen to be knowledgeable who knows but even with 250 registered users it could go very quiet for a while.

interestingly seen a version in the USA where the questions are open to the public. the doctors build reputation which they use in advertising their private services. I do wonder if some form of crowd sourced opinion might be popular – over paid video consults with docs though would need to understand why docs would answer questions? a lot would worry about giving bad advice?

this all leads to some thoughts.

does each area need a forum/job board? would a Q&A site be popular – would it be better at a national level? perhaps using tags to localise it – so i might tag stuff as Cheshire when asking about local things. Is the NHS workforce IT literate enough – a group of highly IT skilled programmers can perhaps cope with the Q&A rules? but i guess we are all more and more social media aware.

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