Monday, December 18, 2006

BCS HIF report - The Way Forward for NHS Health Informatics

The Way Forward for NHS Health Informatics : Health Informatics Forum : BCS

The British Computer Society (BCS) Health Informatics Forum has produced a major new report which reviews the current state of Informatics in the NHS and suggests ways forward. Peter provided a link to this a couple of days ago but I've only just had a chance to read it.

The report suggests that the current problems facing the NHS's IT Programme require a realignment of the National Programme for IT.

According to the BCS Health Informatics Forum Strategic Panel, the NHS Connecting for Health (CfH) programme can still make a massive contribution to safer and more appropriate patient care and remains in full agreement with the Wanless report that 4% of NHS turnover should be spent on business led informatics.

"One of the fundamental goals," according to Dr Glyn Hayes, Chair of BCSHIF, "must be to support the diverse business processes that recognize local constraints and individual patients' values, and focus on delivery and implementation at Trust level. Instead of the current monolithic systems intended to meet most of the needs of users in a local health community, we need a range and choice of more innovative and agile solutions contributing to a common purpose, encouraged within national standards to deliver functionality in whatever way suits the users and suppliers. This should not be interpreted as ruling out adoption of local server provider (LSP) products where they fit the business requirements."

Key recommendations of the report include:

* The Provision of a business context for NPfIT at national and local level.
* A focus on local implementations at Trust and provider unit level, e.g. hospitals, diagnostic & treatment centres, community and mental health Trusts, practices. Providing specialty and service-based systems within provider units will encourage clinical involvement and give quicker benefits.
* There needs to be a major emphasis on standards to enable systems to interoperate effectively, rather than focusing on a few monolithic systems.
* The strategy should be evolutionary, building on what presently works and encouraging convergence to standards over time, rather than revolutionary.
* To adopt a truly patient-centred approach at the local health community level
* There are major issues about the sharing of electronic patient data which need to be resolved. These must not be hijacked by technical issues, and informed patient consent should be paramount.
* Transform NHS CfH into an open partnership with NHS management, users, the informatics community, suppliers, patients and their carers, based on trust and respect.
* The clinical professions, NHS management and informaticians should collaborate to provide clear and comprehensive guidance for all sectors on good record keeping and data management – clinical and other, and embed this in undergraduate and post graduate training. The NHS should facilitate the take-up of this guidance.

I feel the report contains a lot of good ideas, however in addition to the focus on managerial arrangements, current issues around information governance and ownership need greater emphasis along with the clinical benefits which should flow if the systems are put in place appropriately.

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