Friday, November 24, 2006

eBrochan report - part 2

The second session addressed engaging with technological change. Janette Bennett, Senior Clinical Advisor with BT Health Executive (although speaking from an NPIG – Nursing Professions Information Group – perspective), looked at issues from a health professional perspective, and Liz MacDonald, from the Scottish Consumer Council, from a citizen perspective. Janette distinguished between communication (some of which CfH had been doing, generally one-way and top-down) and engagement (which requires two-way dialogue between equals), which CfH had been poor at doing. She discussed the development of 'switch on cards', due to be published soon, which provide brief overviews of aspects of NPfIT (eg the NHS CRS, staff access to patients' records, and where a patient wants to limit access to records). Liz talked about some research from summer 2005, and lack of patient/citizen involvement in moves to development of electronic health records. She noted the possibilities for inaccurate information being held, and needs for ensuring confidentiality. The research was based in eight focus groups drawn from NHS users, patients with chronic conditions and informal carers, and explored attitudes to a single electronic health records. Findings were in line with much of the existing literature, including little awareness of how records are held, stored and shared; people want to have choices about their information and records, and want to be properly informed. There was general support for electronic records, and little wish for full opt-outs from a system, but concerns about levels of access. She highlighted issues of access similar to those being addressed in NPfIT, and concerns about security, confidentiality and access, and the need for some kind of patient records guarantee.

The third morning session focused on telemedicine, telehealth and telecare.

Frances Mair, Professor of Primary Care Research at University of Glasgow, spoke about 'Telehealthcare: current role and future challenges'. She defines telehealthcare as 'synchronous and asynchronous information and communications systems used for clinical information sharing', which range widely in use of technologies, and some of which are based around promoting self-care based in personalised systems using, for example, mobile phones and PDAs, as well as promoting equitable services, for example to remote and rural areas. She saw potential for transforming model of care from reactive to pro-active care delivered by integrated teams across time, place and conditions, with self-management support. She sees telehealthcare as a useful tool, along with many others, and not as a 'magic bullet', but there currently exists a lack of evaluation of services.

Colin Jervis, from Kinetic Consulting, spoke about Five ways RID might improve healthcare', covering identification, tracking, alerting and triggering, recording interventions and sensing.

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