Occupational Therapy and technical skills

Photo by Vanna Phon on Unsplash

Originally written for The OT Magazine (Jul/Aug 2020)

Modern healthcare and (to a lesser extent) social care are hugely augmented by technology. We can provide people with the longest, healthiest lives ever lived by humans because we are able to combine clinical expertise and human empathy with the muscle of computerised information processing. Humans and computers are good at fundamentally different things, so there is no concern about one replacing the other. As Clive Thompson (one of the most eminent writers on technology and its impact on the world) and Garry Kasparov (Chess Grandmaster widely acknowledged as the best chess player of all time, who has played both with and against machines) have said, people working collaboratively with technology are far more effective than either people or technology on their own.

During COVID19, a multitude of services have moved to remote-friendly or remote-first operations where possible (video or telephone calls, webinars, virtual appointments unless urgent). Microsoft Teams has been used for over 100,000 meetings by NHS services in a little over 3 months, with over half a million messages sent every day. It feels like ten years’ worth of technological growth in health care services (a sector which never saw the tech growth that finance did, for example, despite health being central to human life) has happened in under half a year. During this time, I have been hearing from OT friends how their services have been stripped back, digitised, and potentially changed forever; but I wonder sometimes whether we could change the narrative to something more positive if we were more empowered to do so. Compared to diagnostic health, allied health professions and therapies like OT have not seen the funding or tech innovation that the rest of the medical world has done.

Transferrable skills

My case is perhaps a little at one end of a spectrum of things that an OT could do to grow their tech skills. I’m very interested in the digitisation of public healthcare. I stopped working as an OT and retrained in three months at a full-time coding bootcamp with delayed fees repayment. As anyone who is familiar with the OT PGDip knows, accelerated learning is no walk in the park, so if you are considering this option I’m happy to share my experiences, please do get in touch. I qualified as a very junior software developer and thought: “oh no… what am I going to do now? How do I convince a tech company to hire me?

It turned out that the bootcamp themselves thought I was magical — a bit of life experience, proven skills communicating with a diverse group of people, and an encouraging manner (the OT’s bread and butter) — and gave me a job immediately until I found an elderly care tech company I wanted to work for. The takeaway from this is that digital skills are just another string to your professional bow. You already have a powerful set, and if you’re interested in growing further in this direction (which I appreciate not everyone will be) you will only get stronger.

For our professional development

The title of this article is intentionally vague: tech skills can mean lots of different things (for a start, technical or technological). This doesn’t have to be yet another hoop to jump through to feel like you’re hitting the minimum professional bar, and it certainly isn’t a competition. As someone who has spent the last couple of years actively building out various digital skills, it could mean:

  • Learning how to organise and host a successful webinar
  • Learning how to leverage your network of contacts without having to (or being able to) physically go to meet ups or conferences
  • Learning a programming language or the basics of computer science
  • Learning how to build an app, or understanding how they get built in general
  • Keeping abreast of digital health movements and organisations through eg Twitter or e-newsletters
  • Being able to share updated best practices (or new research) digitally, to people wider than just your immediate professional network

These small steps could be the beginning of a new branch in your career; it will doubtless be an interesting personal experience, whatever the outcome. I see it as bringing multiple benefits — not just meeting the standards for and moving beyond Health Education England’s “Digital Ready Workforce”, but also potentially innovating the way services are delivered, and growing a profession made up of curious, creative, caring, intelligent individuals.

For our patients and clients

There are two broad categories in my mind when I speak about OTs having technicals skills: those who work as OTs and increasingly weave technology and digital health into their practice, and those who leave patient facing work to do the inverse; weave OT into increasingly digitised health and care services.

For numerous reasons, I decided to leave the NHS after studying for two years and working for two more in London’s biggest Trust. I was not sure then (and am not sure now, to this day) whether I will return to patient-facing clinical practice, but I remain convinced that I will use those skills: as an informal carer to my loved ones who will need increasing levels of care, by volunteering in my community, by coaching other women and OTs who want to transition to that second group of “OTs working in health tech”, and in any other professional work I do.

I now work for a company which is digitising social care notes and how care workers record and deliver care. As any OT who works in the community can confirm, social care is years behind health care in the technological sense. We don’t have cool AI or flashy startups. A lot of notes are either handwritten, siloed from other systems, or both. With huge pressure on hospitals and secondary care, care in the community and keeping people happy and healthy in their own homes is a priority for everyone. I adore and have huge faith in the NHS, and I do not want to actively encourage OTs to leave clinical service— I know we need all the help we can both give and get to keep public services running. However, it has been incredibly rewarding for me to use my skills in a different setting. As well as helping build the software, I am now able to influence the product that the company makes in very visible, positive ways, such as working with the designers to ensure our copy and tone are person-centred, pushing for full accessibility features as a Must Have, not a Nice To Have, and using my clinical expertise of working with older adults, plus NICE guidelines and other research, to inform how things like our Falls Assessment is built.

For the majority of OTs, seeing patients every day, there is still much scope for these digital or technical skills to flourish. Digital literacy is a big part of life (technology’s reach is inescapable) and a really basic example could be: if a patient has an Amazon Alexa or a smart doorbell system or similar tech which they aren’t quite confident with, I can use my knowledge to upskill them in the same way I would upskill someone not able to reach their toes how to put on a sock with the mighty sock-grabber. If this sounds mundane, then you’re already well on the way to more complex tech understandings and explainings.

For ourselves

There is a lot of evidence around how having a broad skillset brings more rewards than you’d expect. Nobel Prize winner and highly celebrated theoretical physicist Richard Feynman discussed many times how his eclectic hobbies (playing Brazilian music, lock-picking, sketching) helped him be better at physics, instead of distracting him from it. Perhaps watching some YouTube videos on how algorithms work or getting the newsletter from the HealthTechNewspaper will, in some very small way, contribute towards you being an even better OT in the future.

If nothing else, I hope this inspires just one OT to take the step towards building that app or service they think the world would really benefit from, or following up on that Python lesson they took a while ago and enjoyed. You don’t have to build an app by yourself, but it is also very possible for you to given the right support — and a bit of encouragement and inspiration can often be the first step. I have heard it said many times (and agree) that it is genuinely easier to teach health people tech (programming, in my case), than to teach tech people healthcare. You’ve already done the hard part! I know there are ways health services can be improved, or even totally re-invented or re-imagined, using technology, and I really believe OTs should be part of this as we have such a wealth of knowledge and unique professional insight to contribute.

You don’t need to rebuild RIO or EMIS or PACS to make a difference. You don’t have to know how every health app works to be helpful to your patients (a good thing too, because there are over 318,000 of them, according to recent data). Building out your digital skills could be something as small as starting an online journal club with OTs from different trusts who share your passion or special interest area, or doing a bit of research on whether you’d like to trial a certain app in your service. Even though the NHS is stretched, we are lucky to be working in a time when entrepreneurship is encouraged, and digital tools are available freely on the internet. The NHS has a specific training program for entrepreneurs and the National Institute for Health Research offers flexible fellowships and funding opportunities. Many free online courses for programming, data science, data visualisation, UI/UX (user interaction/user experience design) and more can be found via Coursera, Udemy, Khan Academy, and others.

Building the future of OT

As Fleming and Mattingly famously said: “therapists think in more than one way” and one of the super powers of the OT has always been, in my opinion, the ability to draw multiple, often quite disparate, strands of experience and knowledge together to inform their decisions and practice. By growing your digital skillset — either your understanding of tech or your ability to implement it — you become an OT primed and ready for the brave new world of health and social care. No one really knows what it will look like yet, but this is a chance to help construct it.

In my opinion, building personal skills in the tech domain is something OTs should take into their own hands (bottom up approach), at least to begin with, rather than waiting for professional bodies to encourage it (top down approach). This is for two reasons. The first is that, though the Royal College of Occupational Therapists is positive about technology being at the heart of innovation in OT, pushing for systemic change in how a profession operates is not an easy or quick process. Despite some parts of health being very well funded, it’s still early days for tech in allied health professions. The second reason is I’d love to see people grow skills and ideas that they are passionate about — as we all know, meaning is at the heart of engagement.

If you’d like advice or just a friendly hello, I can be reached on LinkedIn, Twitter, and email.

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Lucy Mitchell

Lucy Mitchell

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Technical Writer. Former NHS OT and software developer in health tech. I like bikes and plants. www.ioreka.dev