Informaticopia

Saturday, February 26, 2005

Nursesandtechnology.org

Nursesandtechnology.org

This is a project web site for a Department of Health funded study "How do NHS nurses use Information Technology?" being undertaken by the Universities of York, Southampton and Loughborough.

The press release says:
A team of researchers from three universities, led by the University of York’s Department of Health Sciences, is studying the role of information technology (IT) in the decisions nurses make about patient care.

The new two-year research programme, which is backed by a £250,000 grant from the Department of Health, will involve surveying NHS trusts across the country to establish how a range of health care professionals use IT in delivering patient care.

The research will identify areas where there are innovative projects and four will be selected for closer study.

Programme manager Dr Dawn Dowding said: "We will select four locations to look at how they have introduced the technology and how it's impacting on decision-making and consultations."

The aim of the research will be to assess how the technologies have been introduced and whether trusts have provided sufficient information and training. It will track where nurses are using PRODIGY -- a decision support tool commonly used by general practitioners when prescribing -- or similar technologies.

Dr Dowding added: "Very little is known about what types of system are in place at local levels. None of them have been developed at a national level and so there may be considerable differences in the types of equipment that nurses use.

"We will identify which systems are the most efficient to introduce and work best in practice."

Friday, February 25, 2005

National Knowledge Grid for Health

DLnet: National Knowledge Grid for Health

There seems to be discussion on various health librarians lists about an advert in this weeks British Medical Journal advising readers to sign up (through Athens) for access to the NHS National Knowledge Grid for Health. This is a new phrase to add to the National (electronic) Library for Health, National Knowledge Service etc - no wonder users can get a bit confused with this blossoming of new electronic knowledge services to support healthcare. I wonder what this particular service offers?

Thursday, February 24, 2005

Nursing Informatics of Tomorrow

Nursing Informatics of Tomorrow
This article by Marion Ball in Healthcare Informatics examines nursing documentation and makes the case for the role of IT. It would be nice if the role of nurses in other aspects of health informatics received a similar treatment.

What Is eHealth ?

What Is eHealth (3): A Systematic Review of Published Definitions

This article from the Journal of Medical Internet Research reports the results of a systematic review of published, suggested, or proposed definitions of eHealth.

Call for debate on privacy issues in e-NHS

Call for conference to debate privacy issues in e-NHS

This report from EHI Primary Care outlines a call from several doctors for a conference to debate the privacy issues surrounding electronic patient records.

I would like to add my voice to the calls for a wider debate around these issues - although I'm not sure putting a BMA badge on it & having the usual collection of the "great & good" is necessarily the right way forward - the issues affect all healthcare professionals & most importantly the wider public.

Sunday, February 20, 2005

Blogging HC2005

Blogging HC2005

Peter Murray and I have set up a blog for reports, comments and interaction surrounding the HC2005 conference.

Please feel free to visit and add your own comments, whether you are attending the conference or not.

Saturday, February 19, 2005

FOI talk to NHS Modernisation Agency

FOI talk to NHS Modernisation Agency

This link is to a online meeting/talk given to staff of the NHS Modernisation Agency by Laura Ladd about the Freedom of Information Act. It is delivered via Webex which requires the use of their "training manager" plug in. (The security certificate on the download showed up as out of date on my version!).

A link to the presentation is available from the MA's Virtual Conferencing Centre from a page headed "Staff Portal" - which makes me wonder whether I should have been able to get access to it, without any sort of password - or whether it will remain available for long? Alternativley this could represent an encouraging move towards openness as the Modernisation Agency and NHSu move towards the creation of the NHS Institute for Learning, Skills and Innovation.

The presentation contains some useful advice about the implementation of the Freedom of Information Act and the MAs progress towards it. Several items struck me as key - that there should be a presumption to disclose, that embarrassment of an individual or organisation is not grounds to withhold information, and to "think of disclosure before exemptions - A nil response may reult in a complaint". A final recommendation is to be prepared to remove individual identifiable material rather than refusing to disclose.

Friday, February 18, 2005

FOI request - NHSU Wells report - review request

Following the letter I recieved yesterday from the Department of Health (see Thurs 17th Feb ), refusing to publish the Wells report into the NHSu, I have today sent the following letter requesting a review of the decision.

Your Ref: TO6011201

Ms Jill Moorcroft

Freedom of Information

360C Skipton House

80 London Road

London SE1 6LH

18 February 2005

Dear Ms Moorcroft,

Further to my request for the publication, under the Freedom of Information Act, of the Wells Report on the NHSu, I received a letter dated 14th February stating that:

The Department has decided not to disclose the information you requested. The information is being withheld as it falls under the exemption in section 33 of the Freedom of Information Act 2000. A number of other exemptions apply to a lesser extent. In applying this exemption, we have had to balance the public interest in withholding the information against the public interest in disclosing the information. The attached annex to this letter sets out the exemption in full, as well as the factors the Department considered when deciding where the public interest lay."

I wish to request an internal review of this decision.

The department took considerably longer than the 20 working days allowed under the act to respond.

My understanding is that for section 33 to apply, the department needs to demonstrate that;

(a) disclosure is likely to prejudice the authority's auditing functions, and

(b) the public interest in avoiding that prejudice is greater than the public interest in disclosing the information concerned.

I do not feel that the Annex to the letter I received demonstrates this and suspect that the request has been refused as it may cause embarrassment rather than a genuine belief that information release may be harmful, particularly as the establishment of the NHSu was a significant pledge in the 2001 Labour manifesto.

The fact that John Hutton the Minister of State indicated on 9th November 2004 (Your Ref: PO5005693), that the Department intended to publish the information on the departments web site, indicates a strong public interest in disclosure and throws doubt on the suggestion that publication would be harmful.

Transparency in the way in which a large amount of taxpayers’ money is spent is surely in the public interest, and I would hope that publication of the report would be able to inform the establishment and management of future departmental bodies and enhance scrutiny and accountability.

I also do not understand the significance of statements in the Annex to my letter that:

“It is also a relevant factor in favour of disclosure that not all of the Report consists of comments or opinions which can be traced back to particular individuals.”

And the opposing view that:

“There are arguments as to why it might be inappropriate to disclose only some parts of the Report, which might give a misleading impression of its contents; and that the publication of any part of the Report might undermine the policy of encouraging candour.”

I would be happy if any names or comments which could identify an individual were removed.

For the above reasons I request that you review the decision not to disclose the contents of this report.

Yours sincerely,

Rod Ward

Thursday, February 17, 2005

FOI request - Wells report on NHSU - response

Following my request to the Department of Health under the Freedom of Information Act for the publication of the report by Sir William Wells into the NHSU (previosuly detailed on this blog: 9th Feb 05, 31st Jan 05, 31st Dec 04, 16th Oct 04 ) I today recieved a letter of reply dated 14th Feb (Reference No: TO6011201).

The letter says that:

"The Department has decided not to disclose the information you requested. The information is being withheld as it fails under the exemption in section 33 of the Freedom of Information Act 2000.A number of other exemptions apply to a lesser extent. In applying this exemption, we have had to balance the public interest in withholding the information against the public interest in disclosing the information.The attached annex to this letter sets out the exemption in full, as well as the factors the Department considered when deciding where the public interest lay."

And the full reasons set out in the Annex are:

Section 33, entitled "Audit functions", provides as follows:
(1) This section applies to any public authority which has functions in relation to -the audit of the accounts of other public authorities, or the examination of the economy, efficiency and effectiveness with which other public authorities use their resources in discharging their functions.
(2) Information held by a public authority to which this section applies is exempt information if its disclosure would, or would be likely to, prejudice the exercise of any of the authority's functions in relation to any of the matters referred to in subsection (1).

Factors for disclosure
The exemption under s. 33 is subject to the public interest test in s. 2(2)(b); that is, it applies if the public interest in maintaining the exemption outweighs the public interest in disclosing the information.
There is a public interest in disclosure of the information contained in the Report as disclosure could enhance the scrutiny and accountability of a public body.

It is also a relevant factor in favour of disclosure that not all of the Report consists of comments or opinions which can be traced back to particular individuals.

Factors for withholding

The Secretary of State has the function of examining “the economy, efficiency and effectiveness with which other public authorities (e.g. NHSU) use their resources in discharging their functions". Therefore, s. 33 applies by

The concern that publication of the Report would endanger the co-operation of individuals with future investigations, fails squarely within s.33(2).

That view is confirmed by the Department for Constitutional Affairs' Guidance on the exemptions contained in the Act.

The Department must consider whether and to what extent its policy of maintaining the effectiveness of future investigations is threatened by the disclosure of those parts (perhaps the majority) of the Report which consist of general comments or criticisms originating from sources which are not identifiable from the Report itself.

There are arguments as to why it might be inappropriate to disclose only some parts of the Report, which might give a misleading impression of its contents; and that the publication of any part of the Report might undermine the policy of encouraging candour.

Reasons why public interest favours withholding information

These are matters for the Department to weigh up. There is no judicial authority on the application of the public interest test.

The Department considers that disclosure of the Report would damage the Department's capacity for conducting, or procuring the conduct of, effective investigations in the future.

The force of the latter point is enhanced by the fact that the Report is not a routine or run-of-the-mill investigation, but a one-off project which has been commissioned, in effect, by Ministers so as to enable them to take a particular policy decision, regarding the future of NHSU.

The importance of maintaining the effectiveness of special projects such as this, which are central to good decision-making by Ministers, can be argued to be greater than if it were only the more general investigative capacity of the Department which were at issue.

Confidential Report

Applicable Exemption

Section 33 - Audit functions

A number of other exemptions are relevant but to a lesser extent:

Section 40 - Personal data

Section 35 - Formulation of Government policy

Section 41 - Breach of confidence

I am not a solicitor or lawyer, but take this to mean that if a report involves audit (ie consideration of the financial situation of a public body) then it is not in the public interest to be able to see it. To my mind this goes against the spirit of the Freedom of Information Act which is supposed to let people know how well taxpayers money is being spent.

I also understand this to mean that from the report any "whistle blowers" might be able to be identified - and this may discourage others from giving evidence to such an inquiry. I would be very happy for anything which identified an individual to be removed.

I also wonder why in his letter dated 9th Nov 2004 (Ref PO5005693) John Hutton Minister of State at the Department of Health could say that "it is our intention to publish our findings shortly" and yet on 14th Feb 2005 the Department consider it is not in the public interest to publish them?

I will be writing to the Department's Freedom of Information Unit complaining that it took longer then the 20 working days allowed by law to respond and requesting an internal review of the decision. If anyone has advice about what to put in this request or the best form of words to refute their reasons I would be very interested in hearing from you. I will publish my letter to them here.

Wednesday, February 16, 2005

Practices could get £6,000 for Choose and Book by June

EHI-Primary Care - Practices could get £6,000 for Choose and Book by June

This story form E-Health Insider: Primary Care "reveals what practices and primary care trusts in England will have to do to earn their share of the £95 million of the Department of Health incentives for Choose and Book".

It will be interesting to see whether "money alone" is enough to get GPs to buy into this system? I wonder whether similar inducements will be made available to other sectors of the NHS to get them to implement electronic referral and appointment systems?

Wednesday, February 09, 2005

The Potential Use of “Blogs” in Nursing Education

NursingCenter - Library - Journal Issue - Article - The Potential Use of “Blogs” in Nursing Education

This paper in the current edition of CIN: Computers, Informatics, Nursing provides some useful insights into the use of blogs in educational provision & makes specific recomendation about their use in nursing and healthcare education.

FOI request - DoH - Wells report on NHSU

I have still not received any response to my request, under the freedom of information act, to the department of health for publication of the report by Sir William Wells into the NHSU.

I therefore phoned again, and now have a reference number. I'm not satisfied with the response and have sent the message below to the department's Freedom of Information Unit as specified in their publication schedule.

To: FreedomofInformation@dh.gsi.gov.uk

Cc: Jill.Moorcroft@dh.gsi.gov.uk

Subject: FOI request - Wells report on NHSU

Jill / FOI unit,

Ref: TO6011201

I submitted a written request to the department of health for publication of the Report by Sir William Wells into the NHSu on 1st Jan 2005. I understand that under the act you are supposed to respond within 20 working days.

I had not received anything by 31st Jan and phoned. I spoke to Veronica Fraser who told me my letter had been stamped as being received on 12th Jan (although I posted it on 31st Dec) & suggested it had got delayed in the Xmas post - and that I should receive a response by 8th Feb.

I have still not received anything & phoned again today. I was informed of the reference number of my application and told that DoH was aware that my request had not been responded to. It would be useful if at least an acknowledgement could be sent with the reference number.

If it is of help in your investigation I have a letter signed by John Hutton to my MP dated 9th Nov 2004 (Ref No: PO5006593) which stated that this report would be published shortly.

I am not satisfied with the way the department has handled my request and therefore, in line with your guidance on the DoH web site I am now contacting you.

I would appreciate receiving either publication of the report or an explanation of why this has not occurred.

I will be placing a copy of this email on my blog Informaticopia at: http://www.rodspace.co.uk/blog/blogger.html which contains the full text of my original letter to the DoH & updates on progress if you are unable to find any of the relevant correspondence.

Rod


Calls for proposals in eHealth

Calls for proposals

This page includes several calls for research rpoposals from the NHS Service Delivery and Organisation (SDO) Programme which include several interesting ehealth areas, as set out below.

I'm currently looking at these with some colleagues & if others might be interested in a collaborative bid please gte in touch.

e-Health

Ref: EH93 ‘Harnessing the internet as an effective health information tool to empower patients, carers and members of the general public.’ Funding of up to £300,000 is available for this project which should take no longer than 3 years to complete and start in December 2005.

Ref: EH94 ‘The attitudes of health care professionals to e-Health technologies and services, and the identification of strategies to support increased uptake.’ Funding of up to £300,000 is available for this project which should take no longer than 3 years to complete and start in December 2005.

Ref: EH95 ‘A study of the use of e-Health solutions in the management and treatment of disease and in facilitating change in the organisation and delivery of services.’ Funding of up to £300,000 is available for this project which should take no longer than 3 years to complete and start in December 2005.

Tuesday, February 08, 2005

Documenting sickness on the internet

SocietyGuardian.co.uk | Health | Documenting sickness on the internet

This article in today's Guardian describes how web blogs are being used by individuals as part of their therapy, the latest in a long line of examples of the "union of health and the diarist".

The key example given is Ivan Noble's Tumour Diary following his death last week.

Perhaps a free blog from the NHS, as part of a comprehensive package of care for those with chronic or terminal illness, is an application Health Space should consider?

Doctors fear 6bn pound IT project will be a fiasco

SocietyGuardian.co.uk | Society | Doctors fear �6bn IT project will be a fiasco

This item from todays Guardian reports a survey of doctors attitudes to the NHS National Programme for IT (NPfIT), revealing how they now have less confidence and enthusiasm than they did last year.

Monday, February 07, 2005

10% of NHS staff signed up for ECDL

One in ten NHS workers now training to use computers - Press Release - NHSIA

According to this press release from the NHS Information Authority (NHSIA) 100,000 NHS staff are now working towards the European Computer Driving Licence.

This is extremely encouraging, however the completion rates are still much lower. My suspicion is that those who already have reasonable computer skills will be the first to sign up for ECDL & get recognition for what they can do. Those with less IT skills are more likely to delay signing up & are those are the people who are likely to have more problems as increasing use of IT systems in clinical practice become the norm.

Thursday, February 03, 2005

MORI survey uncovers major new trends in web use in the UK

Common Information Environment | Projects | Audience research

A major study undertaken by MORI & published today, has examined internet usage and patterns in the UK & what they find "trustworthy" (or not) on the Web. It shows a growing "digital divide" and has important implications for an information society, particularly in relation to "piublic service".

It was commisioned by the Common Information Environment Group which is "all about public sector organisations working together in order to make the online experience more educational, entertaining and enriching than it is currently".

A summary of findings from the JISC press release :

* Most of the population is aware of the Internet to some degree, with just under half of all respondents (49%) saying they know at least a fair amount about it
* 92% of Internet users say that reliability of content is an important factor, including 63% saying it is very important
* Home is the place from which people most commonly access the Internet, with 80% of current users saying that they go online most often from there
* 53% of all respondents go online at least once a week, including 30% who do so every day
* 3% of users access the Internet via mobile phones or GPRS as their preferred means of access.
* Over half of all current users (54%) of the Web use it as their preferred information source. In addition, some 59% of all those surveyed are confident about Internet use, and three quarters of respondents say that they find it easy to get access to the Internet.

In addition,

* With the potential of the Internet as a learning tool, the survey also reveals the public’s attitudes to lifelong learning. Encouragingly, the overwhelming majority of people surveyed agree that it is important for adults to continue to learn as they get older (94%). Importantly most see a role for the Internet in learning new things (83% class the Internet as an important learning tool). 59% of those who have ever used the Internet search for specific information in connection with a hobby or interest, while 40% have done so in connection with their own education, and 25% in connection with their own children’s learning.

The survey also points to a growing “digital divide”, a gulf between different groups of users based on gender, employment, class and educational attainment. Men, people aged 16-54, who work, come from social classes ABC1, and have a formal educational qualification are more likely to be Internet users, the survey finds, than women, people aged 55+, those not in work, from social classes C2DE, and people who do not have a formal educational qualification.



At the same time, findings from the survey suggest that use of the Internet may be prone to lapsing as people move from education and training (where learning providers supply the means of access for those without ready access elsewhere) into work. Once again, the implications for the wider agendas of lifelong learning, e-Government and active citizenship would appear to require concerted political action.

Wednesday, February 02, 2005

Future Health Bulletin - Jan 05

Future Health Bulletin - Jan 05

The latest edition of Future Health Bulletin has just been published in PDF.

The January edition includes items on:
- News that one of the UK's leading GP technology advocates thinks £95m is not enough to save 'choose and book'.
- The immediate plans of the NHS's new digital television service.
- Our readers' views on the biggest challenges for NHS IT leaders
- A new section with the top IT vacancies in the NHS and its suppliers