Informaticopia

Monday, January 30, 2006

Blogposium

For the past few weeks amongst bloggers in the field of health informatics there has been discussion of the possibility of having a Blogposium - expressions of interest are now open.

Shahid Shah at Healthcare IT Guy has been kind enough to set up a registration process that will help us organize the HIT Blogposium project.

The process also allows you to include your thoughts and ideas on what topic, issue or piece of work the Blogposium should take on, as well as anything else you want to share on how we should approach this collaboration.

Ultimately, we hope to have some kind of voting or selection process so that the Blogposium focus will be chosen by consensus.

Once you register, you can see the rest of the list, and people's ideas.

More information on this project is available on Jack Masons HealthNex blog

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Friday, January 27, 2006

iSHIMR06: 11th International Symposium for Health Information Management Research

iSHIMR06: 11th International Symposium for Health Information Management Research

This conference with the theme: "Advancing Health Information Management and Health Informatics: Issues, Strategies and Tools" will be held 14-16 July 2006 in
Halifax, Nova Scotia, Canada

A call for papers for this conference is currently available for research which meets the scope:

"iSHIMR 2006 aims to bring together people who are carrying out, or are interested in, research in the general area of health information management and health informatics technology, and to provide a forum for the presentation and discussion of their research activities. iSHIMR 2006 is a response to identifying opportunities and challenges regarding the application of modern information management and informatics technology to provide technology-mediated solutions to healthcare practice and delivery issues faced by all stakeholders--i.e. healthcare professionals, managers, planners, patients and the public. The multi-disciplinary field of healthcare is a massive generator and user of information and knowledge. Effective management and exploitation of this critical resource is fundamental to the effectiveness of all groups and individuals in this field, at strategic, management and operational levels. We therefore welcome paper submissions and delegates from the international healthcare community, particularly those with teaching/research responsibilities in health information management and health informatics, with clinical responsibilities, and those involved in provision of information and knowledge services."

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Web cast 'Health Informatics and Developing Countries'

Today I "attended" while sitting at my desk & doing marking! a web cast by Prof. Peter Drury describing his work developing ehealth in Kenya (& other developing countries).

He structured his talk around five components – the 5Cs. Firstly there is the Context of poverty, meeting the Millennium Development Goals and the role ICT can play to support health workers. Then, there is the Content of health information provided to health workers and how it can be migrated from being paper-based to a digital format. Providing wireless Connectivity within and between health facilities that supports the transmission of health knowledge and management information provides an entry-level health information infrastructure. Over such a health facility-based wireless infrastructure it then becomes possible to build workforce Capacity as well as support Community development, via the delivery of information to enable better individual and community decision-making in health and other development issues.

Further information and an overview of the current work is available from the Interactive Health Network Site

The webcast was organised by the University of Plymouth, started on time and was of a good quality (although one or two of the graphics were a little unclear where I was sitting). Viewers we able to interact by sending questions via email, which Peter responded to towards the end of his talk.

Dr Peter Drury. Peter is a Visiting Professor with the Faculty of Health and Social Work, University of Plymouth. He used to be head of the NHS IT Strategy group and now works as an independent consultant in Kenya (PD Consulting Ltd).

The webcast is anow available:

These are the direct links:

56k Modem

http://video.plymouth.ac.uk/tvb/27-01-06EHealth_56k.wmv

ISDN

http://video.plymouth.ac.uk/tvb/27-01-06EHealth_isdn.wmv

Broadband


http://video.plymouth.ac.uk/tvb/27-01-06EHealth_bb.wmv
(recommended – best quality, esp. for slide text)


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Wednesday, January 25, 2006

He@lth Information on the Internet - Volume 49, Number 1, February 2006

He@lth Information on the Internet - Volume 49, Number 1, February 2006

The Feb 2006 edition of the He@lth Information on the Internet journal has just been made available - as ever it looks as if it has some interesting articles:

TI: The Internet is good for you
AU: Childs, Sue

TI: Critical appraisal
AU: Blenkinsopp, John

TI: NHS Direct Wales: Specialist Health Informatics Learning Package
AU: Johnstone, Alison

TI: Research-based information for public health
AU: Glanville, Julie; Powell, Geoff

TI: View from the front line: What is happening with PDAs?
AU: Brown, Harry

TI: NLH launches 'For Librarians' pages
AU: Hadley, Sharon

TI: What's new?
AU: Williamson, Laurian

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Health Informatics Journal -- Table of Contents (March 1 2006, 12 [1])

Health Informatics Journal -- Table of Contents (March 1 2006, 12 [1])

The March 2006 edition of the Health Informatics Journal has just been made available & from the table of contents it looks as if it has some interesting articles:

Health information management: a retrospective account of a decade of iSHIMR events and highlights from iSHIMR2005
Panagiotis D. Bamidis and Barry Eaglestone

Supporting information technology across health boards in New Zealand: themes emerging from the development of a shared services organization
K. J. Day and A. C. Norris

Personalizing web information for patients: linking patient medical data with the web via a patient personal knowledge base
Asma Al-Busaidi, Alex Gray, and Nick Fiddian

Working towards the informationist
Kathleen B. Oliver and Nancy K. Roderer

An examination of the levels of confidence that consultants have in routinely collected clinical information
Caroline E. Brook and Peter A. Bath

Using geographical information systems and spatial microsimulation for the analysis of health inequalities
Dimitris Ballas, Graham Clarke, Danny Dorling, Jan Rigby, and Ben Wheeler

Quality labelling of medical web content
Miquel Angel Mayer, Vangelis Karkaletsis, Phil Archer, Pau Ruiz, Konstantinos Stamatakis, and Angela Leis

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Monday, January 23, 2006

Swicki added to HC2006 blog

We have added a swicki to the HC2006 blog. It will be an intriguing further addition to the ongoing experiment of developing conference blogs and trying to encourage collaboration and interaction.

See the HC2006 blog website for further information - http://differance-engine.net/HC2006blog/


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Personal data for public good: using health information in medical research

Personal data for public good: using health information in medical research

This report from a working group of eminent individuals, under the auspices of the Academy of Medical Sciences, has just been published. It argues that there is an urgent need to reform regulations governing personal medical data to improve public healthcare.

The report claims that research has been inhibited by confusing regulatory guidance, stifling bureaucracy and unnecessary constraints on researchers’ access to health data.

"The large numbers treated by the NHS and the use of electronic records should allow the UK to lead the field in analysing health data to allow better understanding and tackling of disease. Instead it has been hidebound by bureaucracy" according to the authors of the report.

Medical confidentiality and appropriate consent are important entitlements that must be protected by an ethically sound regulatory framework. Technological developments in database management present ever more sophisticated research opportunities. It is crucial that measures to preserve confidentiality and ensure appropriate consent adapt rapidly and in ways that allow research to proceed effectively, providing an appropriate balance between the rights of the individual and potential benefits to society.

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Saturday, January 21, 2006

Putting CfH at arm's length

According to a news release on the Connecting for Health website, 'as part of the review of the structure of the Department of Health, NHS Connecting for Health will have its status as a body which operates at arms length from the Department formalised this summer'.

The release goes on to say that 'the precise nature of the organisation and of the associated governance arrangements is being finalised' and says that 'no change will occur in the senior leadership of NHS Connecting for Health or, broadly, its modus operandi as a result of the review'.

What I found particularly amusing was the statement that 'continuity of leadership has been a feature of NHS CFH and the National Programme for IT'.

You can read the full statement on the CfH website at: http://www.connectingforhealth.nhs.uk/news/dh_reorg_statement


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Friday, January 20, 2006

Ofcom investigation into the price of making telephone calls to hospital patients

Ofcom Website | Ofcom own-initiative investigation into the price of making telephone calls to hospital patients

Ofcom, the independent regulator and competition authority for the UK communications industries, has published the results of it's investigation into significant concerns about the level of charges for incoming calls to hospital patients by Patientline Limited ("Patientline"), Premier Managed Payphones Ltd ("Premier"), certain NHS Trusts.

Users of the services, which allow patients to be in contact with family and friends directly from their hospital bed, are required to listen to a recorded message each time they call.

Inbound calls cost an average of 49p during peak hours and 39p off peak per minute, but there is currently no option to skip through the recorded message.

They conclude:

"that it would not be appropriate at this stage to continue with this investigation. Ofcom considers that the best outcome for consumers would be achieved by:

* the submission to the Department of Health of OfcomÂ’s concerns regarding the basis on which bedside communications and entertainment services are provided in major NHS hospitals; and
* the Department of Health and providers entering into discussions to examine whether services can viably be provided on a basis that does not involve charging high prices for incoming calls."

For many patients the opportunity to stay in touch with friends and relatives while they are in hospital is an important part of their recovery/treatment & the bedside units which enable this and other entertainment services, can be a real benefit - however excessive profits made at their expense do not seem appropriate, and hospital bans on the use ofmobile phones may come under greater scrutiny.

I hope that the discussions between the companies concerned and the department of health will be able to find a way to overcome these worries.

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Book Review - Nurse's Internet Handbook: a guide for nurses in primary care

I have just reviewed this book which provides a beginners guide to the Internet aimed at nurses in primary care in the UK. It provides a clear description of the Internet and how to use it with lots of links and descriptions to medical web sites with a focus on childhood immuniation, travel health and the like. It concludes with a chapter discussing the quality of health information on the Internet.

The links to sites mentioned in the book are available from http://www.rsmpress.co.uk/bkkiley5links.htm and the book is available from Amazon.




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BCS NSG meeting with Barbara Stuttle, London 1st March


BCS NSG meeting with Barbara Stuttle, London 1st March

The British Computer Society, Nursing Specialist Group will be holding a meetig with Barbara Stuttle CBE, one of the two nursing leads within NHS Connecting for Health, at the Holiday Inn, Bloomsbury, London on Weds 1st March 18.00-20.00.

She has said that “The fact is that the technology is coming and if we are to make real strides forward in patient care, nurses need to be asking for the same access to tools as GPs. They need to be pro-active about coming up with ideas and asking their PCTs for investment in order to deliver the benefits.” & will be updating members about progress within NHS connecting for Health.

I'm sure this will bean interesting evening & further details & booking information is available from the BCS NSG web site at http://www.bcsnsg.org.uk/londonmar06.htm

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Thursday, January 19, 2006

The nine projects at the heart of NHS IT

The nine projects at the heart of NHS IT

This series of articles from silicon.com provides an overview of major projects in the NHS NPfIT and their progress towards implementation targets;

# NHS Care Records Service

# Choose and Book

# Electronic Transmission of Prescriptions

# N3 national broadband network

# Picture Archiving and Communications System (Pacs)

# The Spine

# The Quality Management and Analysis System

# GP2GP record transfer

# Contact - a central email and directory service for the NHS

The individal reports are brought together in a leader article: NHS IT - now the real work begins which suggests "Soon demands to justify the £6.2bn spend will begin."

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Wednesday, January 18, 2006

NHS Connecting for Health announces its first conference for the nursing professions

NHS Connecting for Health announces its first conference for the nursing professions

NHS Connecting for Health has announced that it's first conference for the Nursing Professions will be held in London on 28 March 2006.

Speakers at the conference will include Chris Beasley, chief nursing officer, Jonathan Asbridge, president of the Nursing and Midwifery Council, Susan Osborne and Barbara Stuttle, joint national clinical leads for the nursing professions for NHS Connecting for Health, and two guest speakers from the University of Kentucky Medical School who will share their experiences of implementing clinical IT systems.

The follows various consultations etc with the medical professions and I hope will kick start nursing involvement. I hope that there will be an opportunity to question and comment in addition to "an excellent opportunity for nurses and midwives to hear about the work of NHS Connecting for Health".

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Tuesday, January 17, 2006

Medical Informatics and the Internet in Medicine Volume 30, Number 3, Number 3

Medical Informatics and the Internet in Medicine Volume 30, Number 3, Number 3

This edition of the journal has just been made available and the table of contents appears to include some interesting articles:

TI: An image-analysis system based on support vector machines for automatic grade diagnosis of brain-tumour astrocytomas in clinical routine
AU: Glotsos, D.; Spyridonos, P.; Cavouras, D.; Ravazoula, P.; Dadioti, P. Arapantoni; Nikiforidis, G.

TI: Completeness and accuracy of WWW-based catalogues of medical E-learning modules
AU: Stausberg, Jurgen; Bludsharpat, Kevin; Geueke, Martin

TI: A systematic approach to medical decision-making of uncommon clinical pictures: A case of ulcerative skin lesions by palm tree thorn injury and a one-year follow-up
AU: Corrao, Salvatore; D'alia, Roberto; Caputo, Salvatore; Arnone, Sabrina; Pardo, Giovan Battista; Jefferson, Tom

TI: A novel approach for incremental uncertainty rule generation from databases with missing values handling: Application to dynamic medical databases
AU: Konias, Sokratis; Chouvarda, Ioanna; Vlahavas, Ioannis; Maglaveras, Nicos

TI: A patient-identity security mechanism for electronic medical records during transit and at rest
AU: Chao, Hui-Mei; Twu, Shih-Hsiung; Hsu, Chin-Ming

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Monday, January 16, 2006

Adding a Swicki

I've just been playing around adding a "Swicki" to this blog (you can see & use it in the right hand column below the list of contributors). A swicki is another of the WWW2.0 applications which seem to be emerging everyday at present. The idea of this one is to create your own search engine which learns by the searches which people into it & shows a buzz cloud of those terms which are most popular. Because it is focused on particular topics (in this case health informatics and elearning) is aims to get more specific results than a general Google search. Why not give it a go & comment on whether you find it useful?

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NHS C4H Update on Recent Service Issues

Update on Recent Service Issues - NHS Connecting for Health:

NHS Connecting for Health has today released a statement about interuptions to national services over the last few weeks which have been reported by E-Health Insider and Michael Cross in the Guardian amongst others.

It starts by reiterating the size and complexity of providing the "National Spine" and some of the services and then by explaining the need for updates, to improve privacy and protect patient confidentiality.

It appears to highlight problems with specific software which, presumably, wasn't tested adequately before being installed, and possibly still ins't resolved:
"It is regrettable that our suppliers were unable to maintain full availability without interruption during the integration of the multiple systems that took place following the upgrade. It is also regrettable that the solutions do not yet appear to meet the exacting standards we require for systems to support continuous working 24 hours a day and seven days a week."

It also includes the statement:

"As a result of this experience we will be seeking further assurance from our suppliers over how they intend to make their systems more robust and how in future we all ensure their systems interface with each other seamlessly."


If this does happen then it will be positve - with problems being experienced before the majority of records are uploaded to the spine, however it has been a very public "problem" for Connecting for Health, and may have affected the views of clinicans and other staff towards the programme.

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Sunday, January 15, 2006

A net score approach to the Medix UK NPfIT survey and some other thoughts

I thought the following commentary would be better as a separate item, rather than buried as a comment, but it refers to Rod’s earlier post about the latest Medix UK survey (Doctors views of NHS IT programme, Weds. 11 January).

In the analysis and discussion of the latest Medix UK survey of doctors’ views on and attitudes towards NPunfIT and Disconnecting for Health, I am a little surprised that neither Medix UK (as far as their published results) or any of the many media commentators have undertaken the simple ‘net score’ approach to the surveys, which often throws up interesting ‘headline’ results (I have to admit, though, I have not exhaustively read all the commentary to date).I refer to the type of net score (taking the net difference between the positive and negative scores) that has been increasingly used by MORI and others in surveys of politician popularity and such (see http://observer.guardian.co.uk/politics/story/0,6903,1651767,00.html and http://www.mori.com/polls/2005/mdi050228.shtml for examples).

(And by the way, if anyone wants to now take up the idea, I will expect a hefty consultancy fee for suggesting it!)

Not all the items in the survey readily lend themselves to this type of analysis, due to many not having crisp, clear and unambiguous mid-point items to the questions (for example, is ‘satisfactory’ as a mid-point neutral, or actually positive? – is ‘vaguely aware’ a neutral point or positive towards awareness?). However, I have done the analysis on a few of the items from the publicly-available version of the survey results, and the following net scores show up. A positive (+) net score shows the degree of agreement, importance, etc. while a negative (-) shows disagreement or lack of support/importance.

Do you agree or disagree with the statement “NPfIT is an important priority for the NHS”?
GP agree +2 Non-GP agree +37

How do you rate the NPfIT services?

a Choose and Book:
GP important -41 Non-GP important -12
b Care Records Service:
GP important +46 Non-GP important +62
c Electronic Transmission of Prescriptions:
GP important +37 Non-GP important +53
d Picture Archiving and Communications System:
GP important +24 Non-GP important +73
e IT support for GPs (QMAS)
GP important +70 Non-GP important +52
f email and directory service (Contact)
GP important +45 Non-GP important +53

Do you agree or disagree with the statement “There has been adequate personal consultation with me about NPfIT”?
GP agree -80 Non-GP agree -79

Do you think that the advent of the NHS Care Records Service is likely to mean that the confidentiality of patients’ records will be more or less secure than it is today?
GP secure -63 Non-GP secure -31

NPfIT started in 2002. How do you rate its progress so far?
GP -74 (if ‘satisfactory’ is taken as a neutral point) (or -66 if ‘satisfactory’ is taken as positive)
Non-GP -62 (if ‘satisfactory’ is taken as a neutral point) (or – 55 (if ‘satisfactory’ is taken as positive)

Do you agree or disagree with the statement “The expenditure of over £6bn on NPfIT is a good use of NHS resources”?
GP agree -53 Non-GP agree -31

What is your level of support for NPfIT?
GP - support -17 Non-GP - support +20

In almost all the items, non-GP’s are more positive about NPfIT and its services than are GPs, this despite the fact that there is a skew towards lower ratings on ‘how much information have you had about NPfIT’. This could be taken to suggest that the positive attitudes are to an ‘in principle support for systems that could deliver these things’ as opposed to support for what services and systems NPfIT says it will deliver. Possible support for this interpretation also comes from the disparity in ratings between the various ‘NPfIT services’ as the survey calls them, which generally have positive ratings, and the degree of support for NPfIT and its abilities to deliver, consult, etc. Interestingly, the most negatively-rated service (‘Booze and Chuck’ as it is known by many) is the one that there seems to have been most publicity about, while the other items, which have been less widely reported and discussed in the popular and medical press, seem to be more highly rated.

Perhaps not too surprisingly – the one item on which GP support is much higher is the QMAS system. As this is the system by which their ‘financial rewards’ (to use the official C4H term) are determined, this may not be too surprising.

Finally, from the ‘Department of Joined-Up Thinking’, perhaps one of our readers from the primary care community can explain the following: the Choose and Book system is (supposedly) all about expediting referrals from GPs to hospitals; the C4H website describes the QMAS system as providing ‘a positive incentive for GPs to treat patients in the community rather than referring them to hospital for treatment such as diagnosis or minor operations’. Am I the only one that cannot see those two things being fully congruent???

Peter Murray


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Saturday, January 14, 2006

Blogging HC2006

Blogging HC2006

I am part of a team led by Dr Peter Murray involved in a series of acivites related to bloggin health nformatics events - details at the Health Informatics Blogs Portal.

This blog has just been set up and will beused for the Healthcare Computing conference HC2006 to be held in Harrogate UK on March 20-22.

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The "impact factor" revisited

Biomedical Digital Libraries | Full text | The "impact factor" revisited

Having previously considered the role of impact factors for [nursing] journals, particularly in relation to the UKs Research Assessment Exercise (RAE), I was interested to see this paper (Dong, P., Loh, M. & Mondry, A. 2005 The "impact factor" revisited Biomedical Digital Libraries 2005, 2:7 doi:10.1186/1742-5581-2-7) which explains how the Impact Factor (IF) is calculated, how bias is introduced into the calculation, which questions the IF can or cannot answer, and how different professional groups can benefit from IF use, in the light of the growing volume of scientific journals.

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IT-adoption and the interaction of task, technology and individuals: a fit framework and a case study

BioMed Central | Abstract | 1472-6947-6-3 | IT-adoption and the interaction of task, technology and individuals: a fit framework and a case study

This interesting paper (Ammenwerth, E., Iller, C. and Mahler, C. 2006 IT-adoption and the interaction of task, technology and individuals: a fit framework and a case study. BMC Medical Informatics and Decision Making 2006, 6:3 doi:10.1186/1472-6947-6-3 )presents a case for the FITT framework ("Fit between Individuals, Task and Technology") which builds on earlier work eg technology acceptance model (TAM) of Davis as extended by Dixon into the Information Technology Adoption Model (ITAM).

They studied the implementation of nursing information systems in five different areas of a German Hospital and tried to examine the factors which influenced the "success" of the new systems.

I feel that the model they propose could be useful in understanding how the different factors ie "attributes of the individual users (e.g. computer anxiety, motivation), attributes of the technology (e.g. usability, functionality, performance), and attributes of the clinical tasks and processes (e.g. organisation, task complexity), could be useful.

However, I find one of their general conclusions that "that from an epistemological point of view, it may be difficult or even impossible to analyse the complex and interacting factors that predict success or failure of IT projects in a socio-technical environment", worrying as it forms the basis of several of my current projects which aim to examine individual attributes and motivation towards Information Technology in healthcare settings.

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Friday, January 13, 2006

Nursing Informatics 2006 in Korea



I heard today that a paper “A Study of ICT Use and Developments in Supporting Pre-registration Students in Practice”, which I co-authored with my coleague Pam Moule has been accepted for the Nursing Informatics 2006 conference (11th to 14th June) in Korea.

Will any other readers of this blog be attending?

Rod


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Thursday, January 12, 2006

MCI Contract for SuperJANET5

MCI Contract

The United Kingdom Education and Research Network Association (UKERNA), which manages the JANET network used by educational institutions in the UK for the Joint Informartion Systems Comittee(JISC) (part of the Higher Education Funding Council for England (HEFCE)), has announced that it has placed a contract worth £29 million, with MCI for the new network which will see an increase in network capacity from 2Gbit/s to 10Gbit/s, eventually rising to 40Gbit/s.

This development is an important step in dealing with the massive volumes of data traffic between universities, colleges and schools, and willhelp to keep the UK ahead of it's competitors, however it is also important that we have access to the software applications which enhance the education and research processes currently underway and being developed for the future.

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HealthNex: The Blogposium Explained

HealthNex: The Blogposium Explained

Jack Mason from IBM, writing on his blog HealthNex, has suggested a blogposium in which several health informatics blogs would participate to consider an issue from various perspectives to try to arrive at some sort of consensus amongst the geographically disperate participants. Please see the post on his blog for more informaton on the idea and how it might work.
I'm thinking of involving Informaticopia and would welcome your thoughts.

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Wednesday, January 11, 2006

Possible legal challenge over privacy of electronic health records

Dr Paul Thornton has written a paper entitled "Why might National NHS Database proposals be unlawful?" in which he makes a strong case that "carry grave & imminent risks for both civil liberties and public health", and that "the legal justifications used to substantiate their proposals are untested in the courts and require independent judicial clarification".

He argues very convincingly that the NHS Care Records Guarantee doesn't provide sufficient safeguards. The acceptance of implied consent to the placing of patient records in a national database, rather than requiring individual and explicit patient opt-in to the sharing of their information is seen as contravening both the Data Protection Act and Human Rights legislation.

The plans outlined by NHS Connecting for Health for a "sealed envelope" to hold sensitive information which the patient feels needs be have restricted, are now beginning to look less secure. The fact that the sealed envelope will not be available for the very first release of the NHS Care Record Service and upload of data to the national database, as previously reported on this blog, is complicating matters!

Dr Thornton makes many good points in his paper but I think his case is weakened by the use of very emotive language in one paragraph suggesting "The abuse of medical information contributes to the transformation of democratic societies into totalitarian regimes. Privacy and consent prevent us drifting into Stalinist psychiatry and the preventive medicine of the Third Reich."

A summary and comment on the paper is available from E-Health Insider and further information on confidentiality and security issues relating to electronic health records and the wider context are available from Ross Anderson's page

I would hope that the arguments in the paper will apply to all interactions between patients and health professionals not just the GP record. I understand the paper is to be considered by the BMAÂ’s General Practitioner Committee and I would like to see the issues raised discussed much more widely by all professional bodies and royal colleges for health care staff and by patient groups. I would also be interested in some sort of comment or ruling by the Information commissioner. I do not know if a judicial review is appropriate (I don't know enough about the criteria and process involved), but I do feel that wider public debate of these issues is needed, and needs to be integrated with consideration of current government ID card proposals.


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Doctors views of NHS IT programme

Yesterdays Guardian carried an article Doctors have little faith in new NHS £6bn computer system and editorial Doctors in deficit based on the results of a survey carried out by Medix-uk.com commissioned by E-Health Insider, bjhc&im, Computer Weekly, Financial Times, Guardian, GP and Hospital Doctor, and also reported by E-Health Insider.

A total of 1329 doctors‚– 604 GPs and 725 other doctors – answered the survey between mid-December and early January. The survey showed that only 1% of the doctors surveyed felt that the NHS agency Connecting for Health was making good progress with the National Programme for IT, with 68% saying ti was poor or unacceptable.

A major issue is about the way in which doctors have been informed and consulted about the programe with 56% saying they had received little or no information and 6% saying they had never heard of the programme. A range of concerns were raised by respondents, particularly related to Choose and Book and potential risks to patient confidentiality, and other security issues.

Connecting for Health has also issues a response to the survey which, which accepting some of the criticism implied in the survey results highlights the more positive aspects of the findings, and suggesting that this "dip in confidence" is normal in the early implementation phase of IT change programmes.

It will be interesting to see whether the information campaign which is due to get nderway early in 2006 (aimed at the public) will influence the views of doctors. It would also be useful to find out if anyone is going to fund a repeat survey along the same lines of nurses and other NHS staff (which form a much larger proportion of the workforce than doctors) would produce similar results.

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Monday, January 09, 2006

Patient data errors created by iSoft's iPM system

Patient data errors created by iSoft's iPM system

E-Health Insider is reporting that "A flaw has been identified in the iSoft iPM patient administration system being provided as the standard solution to NHS trusts in the North West and West Midlands that can corrupt patient data creating suspected clinical risks to patients" supported by an email from an e-mail from the NPfIT regional implementation director Paul Charnley. The documents state that patient data may be incorrectly displayed and recorded to the patient's record if what should be routine functions are used – either clicking the Referral View icon or Referral View option from the Context Screen of iPM.

If the errors highlighted are found to be replicated more widely the potential risks of misidentification and clinical care being based on someone else's data are extremely worrying.

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Sunday, January 08, 2006

Patient Opinion - Website

Patient Opinion

I previously commented about the pilot of the "Patient Opinion" website and I'm pleased to say this had it's launch nationally last week. It is an independent website where patients can do exactly that. It represents a revolutionary exercise in public feedback on health services that takes free-form patient stories about their experiences and creates structured data that can drive service improvement. So a patient being referred to a particular speciality can review what previous patients at a range of hospitals thought about the services – for example did they think the wards were clean? And they can add their own experience to help future patients.

Patient Opinion’s founder Sheffield GP Paul Hodgkin says:
“Although our start up funding comes from the Department of Health and South Yorkshire SHA, Patient Opinion is structured as an independent, not-for-profit social enterprise and we generate income by selling collated themes and reports to Trusts and PCTs. Subscribing Trusts also get the ability to direct data feeds of interest to relevant managers and clinicians.” He added it has been developed in support of the NHS Choose and Book programme in order to help patients decide where they want to be treated. It complements official NHS statistics and star ratings and as well as being independent, it is confidential and free to patients.

Livio Hughes, director of Headshift, the UK’s leading social software internet consultancy says: “We were determined to avoid turning the Patient Opinion site into yet another token 'patient' website. Instead, the communication model uses a range of social software tool and techniques - from patient weblogs to feed aggregation
- to create reliable patient-generated reputations for individual departments and services, and shares these with prospective patients at the point when they are choosing a provider.”
The site’s system is simple, easy to use and requires patients just to tell their story in their own terms - it uses a specially-designed social tagging system to learn from the informal language used by patients, rather than forcing them to use official medical and healthcare terminology. Patients are given a treatment diary and the system will help them prepare for consultations with doctors. It is also the first major application to achieve real-time web service integration with NHS.UK to ensure information is up-to-date and relevant.

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Wednesday, January 04, 2006

NHS Connecting for Health Appoints New Nursing Clinical Lead

NHS Connecting for Health Appoints New Nursing Clinical Lead

NHS Connecting for Health today announced that Susan Osborne CBE from St Mary’s NHS Trust in London has taken up her post as the new national clinical lead for the nursing professions.

I wonder what changes this will lead to (and whether she will be in post longer than the previous encumbant)?

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Google health? - or medicine?

An interesting idea is reported in Health-IT World (see tmlr.net/jump/?c=17378&a=296&m=3463&p=924513&t=164) It reports the suggestion that 'Google should consider creating a medical portal. Call it Google Medicine; design an interface with medical filters and better algorithms; lead to the best evidence (just don't forget to consult with librarians about where the evidence is located). This kind of all-purpose tool is badly needed in medicine, particularly for developing countries.'

The idea is originally put forward in a BMJ editorial (bmj.bmjjournals.com/cgi/content/full/331/7531/1487) over the Christmas period and draws comparisons with the successes (and problems) of Google Scholar.

An interesting idea that merits at least some discussion.

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essentials of nursing informatics - review


essentials of nursing informatics - review

I've just written a review of the new (4th) edition of this book by Virginia K. Saba and Kathleen A. McCormick which I've been reading over christmas.

One of the chapters is written by Peter Murray who also contributes to this blog so he may wish to comment? If anyone else has comments about the book or my review please feel free to comment.

This book is available from Amazon



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