Friday, November 24, 2006

eBrochan report - part 1

This joint meeting of the BCS Health Informatics (Scotland) and BCS HI (Nursing) groups was held at Glasgow Caledonian University on 24 November, attracting over 70 participants. Heather Strachan, chair of the Scottish group and Richard Hayward, chair of the nursing group, welcomed participants.

Brochan is Gaelic for porridge – so why does the meeting use this as its title? We will find out later and tghere is a competition for attendees to come up with ideas.

The first session provided an update on eHealth strategies.

Ian Herbert, Vice Chair of BCS Health Informatics Forum, was the first speaker, dealing with 'The English Experience'. He began by giving an overview of the English NPfIT; this included the NHS Care Records Service (including the summary and detailed patient records), and the NHS Knowledge Service (which, he noted, had been very quiet recently). He noted that patient information sharing is a mix of push (messaging) and pull (browsing patient data). He noted that, as far as LSP applications and services, there had originally been an intent to take a 'rip and replace' approach (including GP systems), although there were now moves to a more evolutionary approach, and a changing approach to patient records.

He noted there were several reviews in progress, including the second NAO report, review by NHS chief Exec. (including looking at local ownership), and internal technical review; this indicates there are a lot of concerns. Major issues around NHS CfH include that it is attempting change driven by IT implementation, not business need (which is generally held to be the wrong way around), NPfIT procurements are based on weak requirements specifications, rendered out of date by recent NHS reforms, a lack of local ownership of acute implementations, lack of explicit funding for local business change and service transformation, and huge issues around information governance and patient data confidentiality. Other issues include 'what is the NHS Care Records Service?' as it seems unclear (even after several years of work on it) as to what it is meant to be, there is not enough work on some key standards (eg whether there is a need for a common record architecture) to underpin all the work, and there is no partnership with clinicians, informaticians, large parts of the NHS, etc. Other general informatics issues, such as data migration, and providing coherent views of records also affect the likelihood of success of the whole project.

Heather Strachan, in her role as Nursing, Midwifery and Allied Health Professionals (NMAHP) Clinical Lead for eHealth with the Scottish Executive (which she has been doing for six months), provided an eHealth update from the Scottish perspective. She described the Scottish eHealth programme as being committed to\delivering an Electronic health record, but with NHS being as local as possible, support for people with long term conditions and reducing the inequalities gap. The eHealth strategy is about incremental convergence, as opposed to 'rip and replace', exploiting what already exists and filling gaps where necessary; she noted that there was top level commitment and the likelihood of funds to support developments.

Further report to follow.

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