From the consulting room on six degrees of separation
This article first appeared on Microsoft’s NHS Resource Centre on 11 December 2008 (site now defunct; ).
Anyone in the world can be related to anyone else in just a few steps. So why can’t computer systems tell Dr Neil Paul which of his patients are related to each other?
There is a concept called six degrees of separation that says any two individuals on the planet can be linked together by mutual acquaintances and that, on average, they are separated by just six steps.
In theory, a peasant in a paddy field in India and the president of the United States may be linked by only a few jumps. Having heard that the president sent 875,000 Christmas cards this year, I can’t help thinking that it may even be less in his case.
Bringing home the Bacon Number
Mathematicians have devoted serious thought to this concept. More light heartedly, it has also spawned the Bacon Number. After watching several films starring Kevin Bacon, some students created a new game where they tried to link people to him in the shortest number of steps.
He counted as 0, anyone that had appeared with him was 1, someone that had appeared with a 1 was a 2; and so forth. Using the Hollywood database, they were able to calculate every actor’s Bacon Number. Very few are more than a 7.
It was then decided to do some analysis into whether Kevin Bacon was the most connected person in Hollywood by calculating the average Bacon Number of every actor in the database. Interestingly, he turned out not to be the most connected. Other actors - including at one stage Dennis Hopper - have a lower average number.
What got me thinking about this was an invitation that I received from a website called LinkedIn. This is a social networking site for business and it allows people across the globe to share information such as current posts, education, likes and skills – and, most importantly, contacts with recommendations.
“In a previous column, I wondered about an NHS wiki where people could share their ideas and projects. Perhaps we also need a NHS version of LinkedIn?”
You start by putting in your own data and then you can either surf your contacts’ contacts or look up someone that you might want to do a deal with to see if there is a link between you and a path by which you might get introduced.
Interestingly there seem to be very few NHS managers on LinkedIn, which seems crazy in today’s climate of tendering and procurement. Surely good information links and networking with industry is what the NHS needs?
In a previous column, I wondered about an NHS wiki where people could share their ideas and projects. Perhaps we also need a NHS version of LinkedIn? Perhaps it could be part of the NHSmail programme?
Finding suppliers – and relatives
I know that locally, one of our primary care trust’s objectives is to publicise our commissioning priorities and needs in the hope that new providers will come along and deliver those services. We are setting up a website for our consortiums to do this.
I believe that a NHS website has been created for a similar purpose - www.supply2health.nhs.uk - though I haven’t had time to look at it. If so, it’s obviously trying to solve a big problem. I was recently speaking to a large private healthcare company that would like to get involved in delivering NHS care; so far, it seemed to be working on word of mouth and accidental introductions.
“The stories I could tell about people having affairs and secret love children – it’s no wonder I don’t watch soaps.”
To give this column a more clinical focus, the subject of relationships also came up as an IT need at a recent PCT meeting I attended. It was argued that with the breakdown of the traditional family unit, it was very difficult in general practice to keep track of who was related to whom.
I have often had a revelatory moment - as have many other GPs - when I have realised that a patient I had been seeing was another’s daughter or relative or even spouse. Things suddenly made a lot more sense.
The stories I could tell about people having affairs and secret love children – it’s no wonder I don’t watch soaps. The practical point is that computer systems really need a built in pedigree system that takes into account temporary liaisons, as these can also be difficult to track.
Of course, issues of consent and access to notes shouldn’t be overlooked; but surely relationship information could be expanded in our systems and handled in a way that doesn’t smack of big brother.
In Emis, there is a household button that shows you everybody at an address; assuming it has been typed in correctly. It can be out of date and is a good way of finding people that haven’t deregistered. I don’t know if any of the other suppliers have similar, good functionality built in. Perhaps social services or other agencies have a system – I would be interested to know.
About the author: Dr Neil Paul is a full time GP working at the Ashfields primary care centre in Sandbach. He sits on his primary care trust’s professional executive committee and has a lead role for IM&T and Payment by Results.
Tags: commissioning, nhs it, nhsmail