Friday, November 24, 2006

eBrochan report - part 3

After lunch, Kirsty MacLeod, eHealth consultant with the Scottish Executive, talked about the Scottish Emergency Care Summary (ECS) Programme. Three evaluations have been done of ECS, following the original pilot with two NHS Boards and two Out of Hours (OOH) services, in relation to links to NHS24, and with A&E at two hospitals. ECS is accessed via web browser, and one of the main problems was the need for new log-in as opposed to it being integrated with other systems. ECS is now being integrated with the OOH systems, and work is ongoing to integrate it with NHS24 and Scottish Ambulance Service systems.

The main afternoon session featured four speakers. Derek Hoy and Ian McNicol, from Glasgow Caledonian University, kicked off the session with a talk titled 'Clinical templates: how to make babies'. Ian begain by reiterating the need for standards in order to get interoperability between computer systems. Traditionally, people see terminologies as providing the answers; but these are essentially labels, and are static; these are models of real world entities and do not model clinical processes, and so terminologies are not enough and do not provide sufficient context for clinical records. Clinical forms are the beginning of attempts to deal with the issues; these are made up of 'clinical fragments' (small chunks of clinical information). Templates (equal to clinical forms) and archetypes (clinical fragments) are attempts to address the problems. This leads, Ian suggests, to 'flexible standardisation' which can address issues of local ownership, meet innovation and differences of opinion and requirements, and have managed extensibility. Derek talked about a 'national library of clinical templates for community nursing in Scotland'. The templates are developed from a mix of expert groups, standard tools and 'grey' content; using open source development model to get as much input as possible and get use, testing and buy-in. The website is supposed to be – but I could not access it this afternoon (nor the url returned by Google). [Correction 25 November - both work fine when accessed from outside GCU - some kind of configuration problem with the servers when trying to access internally - thanks to Derek Hoy for the correction.]

Dickon Weir-Hughes, from the Royal Marsden Hospital, talked about 'NANDA's contribution to standardised nursing communication'. Margaret Hastings, NMAHP Clinical Lead for eHealth, Clyde Division, talked about Allied Health Professionals (AHP) and a project to look at where AHPs deliver services and how they interact with patients. There are as many AHPs in Scotland (8,000) as there are community nurses. From a study of 40,000 case summaries, 58% of AHPs' patients are seen in clinics; an AHP summary dataset, with 19 items, has been produced, to help provide information about AHP cases. The final speaker was Ann Wales, NES (NHS Education Strategic Framework) Programme Manager for Knowledge Management, speaking about strategic developments for managing knowledge and linking this to supporting all stages of the patient journey. Among resources mentioned were the elibrary ( and its various components (eg shared spaces such as the 'remote and rural'), the 'Get involved' website (, and specialist elibraries for defined staff groups

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