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Pritpal S Tamber

Pritpal S Tamber: Understanding what communities really value

7 Aug, 14 | by BMJ

There is nothing more convincing than someone citing research, and yet we often don’t know if what’s being cited is any good. Research can be bad if it’s poorly conducted or if the wrong evaluative method was used to answer the question. The methods we use in healthcare are often quite limited, especially when it comes to community interventions. This is why I have been working with the Institute of Medicine (IOM) to open up what we mean by evaluation. We’re holding a potentially groundbreaking meeting on 27 August: “Designing Evaluations for What Communities Value.”

The alleged gold standard in evaluation is the randomised controlled trial, so much so that one often hears people try to convince on the basis of “RCT evidence.” This lazy citing of a method is one sure way to detect that someone doesn’t know what he or she is talking about (venture capitalists, take note) because a randomised trial is not always appropriate for the question being answered. more…

Pritpal S Tamber: Health 2.0 and academia—reconciling experimentation and protectionism

11 Jul, 13 | by BMJ

This week I attended a Health 2.0 London event on mobile sensors. The title of the event asked if they were key to remote patient monitoring. I think the answer is an obvious yes; without them it’s not going to be possible. But I’m not sure the event was asking the right question. For me, the question is how we derive actionable knowledge from all the data that we might amass.

There were two accelerometer-based devices on display, Fitbug and Withings; one service that lets you pool all your accelerometer-based activity onto one website, Tictrac; and one mobile heart monitor, AliveCor. more…

Pritpal S Tamber: And so, it’s time for TEDMED

16 Apr, 13 | by BMJ

Regular readers of my blog will know that this week is TEDMED, the US based event that looks—with a multidisciplinary lens—at the future of health and medicine. I’m TEDMED’s clinical editor, one of the four person core editorial team that recommends topics and speakers to the curator, the ever curious Jay Walker. I thought I’d use my Heathrow-to-Dulles time to reflect on some of the themes of the programme that we’ve put together. more…

Pritpal S Tamber: Innovation, lazy commentators, and data Darwinism

25 Mar, 13 | by BMJ

One of the most common questions I have had since becoming the clinical editor of TEDMED is what’s the “next big thing.” When I started the role I actually tried to answer but as time has gone on I have resisted—and felt more and more disappointed with the people asking the question.

My disappointment has two dimensions. Firstly, having worked for an entrepreneur for almost a decade, I have learnt that even if there is the promise of the “next big thing” the only way it becomes a reality is through perseverance and adaptability. When I joined BioMed Central in 1999, we really had no idea that we were on the road to proving that open access publishing could become a commercially sustainable reality. These days there is much hype about the promise of open access and yet back then all our fearless leader believed was that with the advent of the internet there had to be a better approach to scientific publishing. more…

Pritpal S Tamber: We don’t know what the NHS is for

12 Mar, 13 | by BMJ

Last week the people of Leeds successfully halted the NHS’ plans to reform children’s heart services, which included moving surgery to a neighbouring city. It was a great victory for the citizenry. According to the High Court, the campaign group, Save Our Surgery (SOS), raised legitimate concerns about the decision making process by which the NHS had decided to move surgery. It was democracy in action.

The problem is their “victory” has probably doomed local children to poorer outcomes. For some time now it’s been known that specialist surgery needs to be done in dedicated sites to increase the likelihood of better outcomes. So how is it that good democracy appears to be incompatible with good clinical outcomes? more…

Pritpal S Tamber: How digital health will humanise care

5 Mar, 13 | by BMJ

I have always been troubled by the “disconnect” between clinical practice and real life. Clinical evidence recommends a standard intervention, according to research, but it often flounders in the messy heterogeneity of the real world. This week I found myself worried about replicating this “disconnect” in the online world, especially with the addition of gamification, whilst strangely hopeful about the untested promise of natural language processing. more…

Pritpal S Tamber: The fallacy of user interfaces and big data

25 Feb, 13 | by BMJ

I’m lucky enough to spend my workdays around the kinetic kids in Google Campus, London. From what I can tell, they sit about hacking code to see what they might make possible. Occasionally they have flat whites, crack jokes, and look around them, but, in general, hacking is what they do.

For reasons that are not always clear to me they’re repeatedly taken with the idea of creating consumer health apps. A few of them know that I’m a doctor so I get the occasional question about medical “facts.” I always answer with my usual rant about not hard-coding knowledge, and then point to NICE guidance or something. They’re usually fascinated with the idea of soft coding but less interested in NICE’s 160 page PDFs. more…

Pritpal S Tamber: Why “paperless” is meaningless

22 Jan, 13 | by BMJ

The National Health Service (NHS) of England is enduring the enthusiasm of a new health secretary. As he gets to grips with his £110bn toy he is, as you’d expect, eager to make the right noises about the future of healthcare. One of his promises, though, is to make the service “paperless.” This only illustrates his complete lack of understanding of innovation.

Why should NHS England be “paperless?” What has paper done that necessitates its complete extermination from the service? It seems paper’s crime is that it’s not digital. The information it holds, as ancient ink absorbed onto its surface, cannot be extracted, aggregated, and analysed without expensive and slow processes that endanger patient confidentiality. Becoming paperless would, as a by-product, also enrich the NHS with much needed data, its bigness being the panacea to our inadequate research information and unjustified variations in performance. more…

Pritpal S Tamber: It’s time for a few good punch-ups in the NHS

6 Dec, 12 | by BMJ

The National Health Service in England needs a goal, and a plan on how to get there. Its local leaders should be appreciated more, not constantly pilloried. Primary care is on the brink of failure and needs to truly understand its role within integrated care. And we all need a few good punch-ups to get the right kind of debates going.

So say senior figures of the NHS who met at the exclusive Cambridge Health Network’s Christmas Event. Four of the senior figures were challenged with offering a “short, fun, little ditty—their Christmas wish for the health sector in 2013,” as Pam Garside, one of the founders, described it. The audience was then invited to comment and ask questions. more…

Pritpal S Tamber: The time is right to put patients at the heart of healthcare

29 Oct, 12 | by BMJ

The clinical data collected by hospitals in England is almost completely useless. So says Tim Kelsey, the recently appointed National Director for Patients and Information. It’s so bad, he believes, that National Clinical Directors charged with commissioning services simply cannot do their job because there is no useful data to base their work on. more…

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