Monday, February 26, 2007

Calling all NHS Connecting for Health Project Managers

An opportunity for NHS Connecting for Health Project Managers to share experiences and learn from others...

Join the Project Managers Knowledge Cooperative
I am looking for Project Managers working with CFH to take part in a MEd research project to assess the value of blogging as a tool for learning, development and knowledge sharing.

The project will run from March to June/July 2007. Participants will be required to participate in a collaborative blog and take part in the review process on completion of the project.

The Project Managers Knowledge Cooperative
The research is designed to assess the value of blogging for Project Managers learning and development. To understand how blogs would be utilised in a real situation, limited guidelines on blogging content or structure will be provided to participants.

Participants will be provided with a secure log on to access and contribute to the blog, details of the functionality and “how to” guide to posting and commenting. From then, Project Managers are free to post, comment or to read posts as they see fit. The only requirement is that posts do not include any comments of a derogatory nature or anything that could be considered damaging to others.

It is hoped that a collaborative blog will enable Project Managers to learn from one another about all elements of project management, from how to solve a problem, to dealing with suppliers, to chairing project board meetings. However the content of posts is open to Project Managers to decide.

Potential Benefits
Project Managers talking part have the opportunity to share their own knowledge and experience, aiding other Project Managers to

  • avoid problems or issues
  • improve a process etc
    use colleagues as a sounding board for ideas
  • ask for help or advice on resolving problems
  • share “war stories” and “success stories”
  • build a network of Project Managers

Evaluation Process
The frequency, content and style of blogging activities will be reviewed by the researcher. A selection of participants will be interviewed, the outcome of which will influence the development of a questionnaire which all participants will be required to answer.

Anonymity and confidentiality
All participants will be anonymous when blogging, by using only their username. They should not divulge personal data making them identifiable to other bloggers during the project. The researcher will be aware of the names of those involved in the project, but will not be able to connect usernames to real names. Confidentiality is ensured in terms of interviews and other face to face data collection activities. Questionnaires will also be anonymous and administered online.

Dissemination of Results
Interpretation of data will be published within my MEd Dissertation. The results and conclusion section will be made available to all participants, with the full dissertation available on request. Results will also be made available to NHS Connecting for Health and the wider NHS to ensure there is awareness of the impact of blogging on learning, development and knowledge management as demonstrated by this sample of Project Managers.

If you would like to take part in the project, please complete the form at!Blogging

If you have any questions, please contact:
Helen Nicol
MEd Training and Development Student
Visioning and Readiness Programme Manager for NHS CFH

Thanks to Rod for signposting this blog....

Friday, February 23, 2007

Information Tribunal Hearing

I have just heard that the hearing of the Information Tribunal into my request for the report by Sir William Wells into the NHS University to be disclosed by the Department of Health, will be held on Weds 4th April at Procession House, 110 Newbridge Street, London EC4V 6JL.

Information Tribunal Ref: EA/2006/0094
Information Commissioner Ref: FS50070878
Decision Notice

Back story available on this blog - start at: NHSu report & Information Tribunal

If anyone has advice or guidance about whether I should be "joined to the appeal" or about the conduct of the hearing I would be grateful.

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Wednesday, February 21, 2007

Medical Informatics & The Internet in Medicine, 32(1) 2007

Medical Informatics & The Internet in Medicine, 32(1) 2007

The latest edition of this journal has just been made available and includes some interesting articles including:

Electronic health records: Is the evidence base any use?
Authors: S. Clamp; J. Keen

Using artificial intelligence to bring evidence-based medicine a step closer to making the individual difference
Authors: B. Sissons; W. A. Gray; A. Bater; D. Morrey

Progress towards automated detection and characterization of the optic disc in glaucoma and diabetic retinopathy
Authors: R. A. Abdel-Ghafar; T. Morris

Integrating health information: A case study of a health information service for thalidomide survivors
Authors: Martin Johnson

Addressing the need for adaptable decision processes within healthcare software
Authors: P. Miseldine; A. Taleb-Bendiab; D. England; M. Randles

Use of OWL-based tools to aid message development and maintenance
Authors: Tom Marley; Alan Rector

Using Unified Modelling Language (UML) as a process-modelling technique for clinical-research process improvement
Authors: P. Kumarapeli; S. De Lusignan; T. Ellis; B. Jones

Using XML and XSLT for flexible elicitation of mental-health risk knowledge
Authors: C. D. Buckingham; A. Ahmed; A. E. Adams

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Friday, February 16, 2007

Post number 500

This is post number 500 in this blog. The first was by Rod on 15 October 2004 - so we about two and half years old. Many thanks to Rod for setting up the blog in the first place, and for keeping it going. I have enjoyed contributing to it - I hope readers have found it useful and interesting. Here's to the next 500 posts coming thick and fast.

Peter Murray

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Cuba health informatics - reflections

Sitting here in the Hotel Nacional, watching the north wind whip the sea up and waiting for it to stop raining, is a useful pause point for a few reflections on the past few days. The conference has been well-organised and interesting; out hosts have done a great deal of work to proviede translation facilities for us lazy English who don't know any Spanish. We have had an interesting range of presentations, about developments in Cuba and other parts of the world; similar issues are being addressed in many countries, but, of course, local solutions differ with local circumstances.

Cuba is an interesting place to visit; we hope many colleagues will join us here for future health informatics events. The Cubans are great hosts and love having people from other countries visit them, to discuss and exchange ideas.

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Cuba congress - Bill Hersh presentation

It is Friday already, the final day of the VI International Congress on Health Informatics. The day's opening keynote presentation came from Bill Hersh, from Oregon Health Sciences University, and titled 'Training the health and biomedical informatics workforce: competencies and approaches'.

Bill began by quoting Nelson Mandela – 'education is the most powerful weapon [that] you can use to change the world'

He said that many of the issues in developing professional practice in health informatics are common to all countries. He sees the future as being bright for information technology in healthcare, as there is increasing recognition of the value of EHR (although he acknowledges that USA is by no means a world leader in the area), and of need for patient information to be available to all who need it. He noted increasing effort in the USA into translational research, ie moving research from the laboratory to the clinical areas, and he sees a large role for informatics in this.

He notes many challenges to using the EHR – issues of cost, integration with the clinical workflow in healthcare, interoperability and standards. There is also a necessity for well trained people to lead the implementation of systems, and this has received less attention than needed. He cited his recent work, (in JAMIA, March/April 2006) built on that of Covvey and others on categories of professionals in biomedical informatics practice. Medical informatics is more than just technology, and there is a need to understand how to use the technology in healthcare, and how healthcare organisations can make best use of the technology. He sees a need for an emerging breed of professionals who understand healthcare and technology, and also the organisational issues to lead implementation and change, as well as a need for academics in the field. Citing recent work on whether medical informatics is a profession, he suggested that it is not (yet) a profession.

The are approx. 25 programmes offering informatics degrees in USA, but due to the highly multi-disciplinary nature of the field, there is no standard curriculum or accreditation. OHSU has a broad curriculum, with tracks in health informatics and bioinformatics, but Bill sees the likelihood of more convergence between the two fields over time. He also sees a need to develop courses dealing with public health informatics.

Bill described some of the teaching modalities used within their distance learning delivery, including 'voice over powerpoint' presentations, threaded discussion forums, and virtual projects. He emphasised that interaction is an important component of the asynchronous distance education. In concluding, Bill sees one of the most important success factors for health IT as the skills and competencies of those working in the area.

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Thursday, February 15, 2007

Cuba congress - OHSU and education

The main afternoon session on Thursday was a round table lead by Dr William Hersh, from the Dept. of Medical Informatics and Clinical Epidemiology at Oregon Health Sciences University (OHSU –, USA, with several of his colleagues addressing issues from their experiences in health informatics education. He pointed out that there is a major interest in OHSU on global health research and education.

Steven Bedrick, PhD student at OHSU spoke about their educational programmes. Steven began with an introduction to Portland, pointing out that three major things it is known for are music, free software and craft brewing. The OHSU informatics training programme began in 1992, and reflects many aspects of health informatics, with much use of distance education (relying on Blackboard, which Steve describes as 'sort of like Moodle').

Nancy Carney talked about their research into clinical epidemiology and methods for teaching clinical guidelines. Misha Pavel discussed their work on technology for aging, based in predicted shifts in the increasing numbers of older people and decreasing proportions of younger people to support them (economically and in other manners). The situation in Cuba by 2020 is expected to be even worse than in many other countries. Holly Jimison focused on home monitoring and health coaching technologies.

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Cuba congress - IMIA, blogs et al

We start today (Thursday) with reports from yesterday, as I was too tired last night after a full day to try and post anything. Yesterday did not start over-well - we arrived early to hear Richard Stallman (as did many other people), only to find that her had been moved to an afternoon slot, ie the same time I was speaking. However, I hope one of our colleagues will provide a report.

My first presentation of the day was about IMIA, its Working Groups and Nursing Special Interest Group, and its Strategic Plan. I included materials and comments sent by Nancy Lorenzi, IMIA President, which were well-received and appreciated. The session was focused on how Cubans in particular, and people in any other country, can become more involved in IMIA's WG/SIG and wide range of other activities. Some interesting issues were raised in discussion, including how IMIA might faciliate links between individual researchers and research groups, how IMIA and health informatics organisations interact with bio-informatics.

My second talk was part of a 'round table' series of presentations on Web 2.0 issues. I focused on the work colleagues and I have been undertaking in blogging health informatics events ( - other presenters talked about the development of 'Infomed 2.0' ( - Otto Martin), digital identity management, and the development of the Brazilian 'Virtual Health Library' (Abel Packer).

For those whose Spanish is better than mine, there are some reports and news items about the event on the Infomed ( and conference ( websites.

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Wednesday, February 14, 2007

Cuba congress - education

The second part of Tuesday afternoon was a round-table devoted to various aspects of health informatics and education. It began with a presentation by Graham Wright titled 'Exploring the knowledge base for health informatics: the Otley duckfest and beyond'. He briefly discussed the background to the project, from the original 'Education Steps' project at Otley in early 2005, including the origin of the research methods used and the rationale for using Bloom's taxonomy for focusing on the cognitive, rather than psychomotor, aspects of health informatics.

He described the process of participants identifying the elements of health informatics and then grouping them, by use of post-it notes for smaller elements and tables for the larger themes, so that people could walk around and get a feel for the whole – not possible on a computer. Through a process of voting on terms and their inclusion or exclusion, a consensus was reached by the Otley participants. Graham emphasised that the process aimed to capture what subject experts thought were the main themes.

The next step of the larger project is now building on the Otley outputs, through a jointly funded project with IMIA and the British Computer Society. This project has two parts – to collect as much as possible of the electronic health informatics literature, and also to do a literature search with SCOPUS and PubMed (via Reference Manager) to see how many papers have been published under different domain names. From the literature base, author-defined keywords were extracted; this resulted in over 14,000 keywords. In parallel, desktop search engines (eg Google Desktop and Copernic) were used to index and search the literature database that has been gathered. Graham brought people up to date with a short description of the pilot workshop recently held in London to examine the outputs of the keyword/literature analysis, and also introduced the opportunity for others to become involved in further stages of the project, which is expected to include a consensus conference.

Following Graham, a number of Cuban colleagues presented papers on their development work in the production of educational materials in medicine, health sciences and health informatics.

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Cuba congress and IMIA-LAC

The Tuesday afternoon session began with a presentation by Dr Alvaro Margolis, from Uraguay, in his role as President of IMIA-LAC, the Latin-America and Caribbean region of IMIA ( IMIA-LAC was established in 1983, with representatives from Argentina, Brazil, Cuba (the Cuban Society for Medical Informatics, founded in 1970) and Mexico. He outlined the strategic objectives of IMIA-LAC for 2006-09, which include strengthening the network of societies in the region, through both the national societies and through universities and other institutions. He talked of the need to try and encourage the development of health informatics societies in the various countries that do not have one. Other objectives include identifying specific areas (and related groups) where health informatics might be developed or promoted, including developing clinical information systems and the development of health informatics education. He talked of several examples of projects in the region, including the Virtual Campus in Buenos Aires (, which is implemented in Moodle.

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Tuesday, February 13, 2007

Cuban health informatics congress opens

The VI Congreso Internacional de Informatica en Salud (6th International Congress in Health Informatics) began at 10:00 this morning (Tuesday, 13 February) in the Palacio de Convenciones de La Habana, Cuba (Convention Palace, in Havana). The opening session is well-attended, with about 100 people, and while the opening presentations have been in Spanish, there is also simultaneous translation into English.

The opening presentation, titled 'Informaticization en el Sistema Nacional de Salud de Cuba' (Informaticisation in the national health service in Cuba) was given on behalf of the Vice Minister for Public health, who is away in India. Are developing software systems for national health system. The presenter explained how in Cuba they are using free software for web services, eg the Infomed website (Health Telematics network – which connects institutions and other facilities such as virtual university and virtual library. Much of work is joint projects between Ministries of Public health and of Informatics and Communications.

Other projects include linking the national network of blood banks, to give realtime information on blood donor status and a national registry. A national network for imaging is also being developed, for transmission of a range of image types. First stages of hospital management systems have been developed, with a number of modules. The system is due to be rolled out to six hospitals in Havana. Other networks, including the national nephrology network, are being developed.

At present, projects are being used by technicians, for testing the development, with a view to moving towards use by health professions, and then by the general public in the later stages.

18%Cuba's GNP dedicated to public health.

One of the Vice Ministers, in response to a question comparing the business models of health systems in other countries, emphasised that in Cuba, health is not a business, but is a 'public good'.

More on the day later. Peter Murray

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NHS CfH Southern Cluster ETD day

Today I attended a study day organised by NHS Connecting for Health Southern Cluster Education, Training and Development (ETD) at Taunton Racecourse.

The day was chaired by Nick Jupp (ETD Lead, NHS Somerset Health Informatics)

The first speaker was different to the usual NHS "Men in Suits" when - Andrew Raynes (ETD Programme Manager, NHS CFH, Southern Cluster) appeared in his schoolboy outfit and used a high tech drum kit to illustrate points he wanted to make about working together, under the title of "NPfIT Skool of Rock". He achieved audience participation with the use of maracas and tambourines.
(I have video available for blackmail purposes)

The next (rather dry) presentation was on the Role and Benefits of Change Management within NPfIT by Steve Swift (Business Change Manager , Fujitsu NHS Services)

After coffee and some useful networking with colleagues from the NHS, Cerner and Fujitsu alliance, Phil Bolton (E-learning Development Manager, Royal United Hospital, Bath) gave a presentation about the issues they have experienced in training for their implementation of Cerner Millenium Release 0 which has been delayed for 14 months (so far) and demonstrated an elearning application they have developed rather than use the training domain provided by Fujitsu.

The final presentation of the morning was by Dr Roger Tackley (Chairman Southern Cluster Terminology Group SCCAG) who talked about the SNOMED CT terminology system as a concept. This seemed unfamilar to many of the trainers present and he emphasised the importance of this for clinical use of the Cerner Millenium system.

After a good lunch there were four parallel sessions:
• Table top challenge –Maria Scott (Clinical Benefits Advisors, NHS CFH)
• Professional Support and Development workshop - Di Wilson (ETD Networks Development Manager, NHS CFH) / Jackie Smith (Informatics Specialists Development Managers, NHS CFH)
• CIS Accredited Learning – Kamru Mohammed (ETD Systems & Platform Lead, NHS CFH)
• Implementing Training standards (What do you want out of the standards – A Case Study approach) – Jonathan Coe (ETD Standards Delivery Manager)

I attended the session on Professional Support and Development which involved teams using a variety of children's toys, sellotape, and modeling clay to represent what health informatics is and the knowledge and skills required - and the role of NPfIT (during which I got to do a bit of juggling!)

The day closed with a panel session answering (or trying to) some of the questions which had been put onto post it notes during the day by delegates.

An undercurrent to the day was provided by a report on the Radio 4 news this am which was carried by the Times as £6.2bn IT scheme for NHS ‘is not working and is not going to work’ with the comment that "A lack of vision and poor understanding of the sheer size of the task meant that the IT overhaul “isn’t working and isn’t going to work”, by Andrew Rollerson, an executive with Fujitsu. As I was sitting at a table with some of the staff from Fujitsu this caused some discussion!

Generally it was quite an interesting day - although obviously aimed at NHS ETD staff rather than me - and I did make some useful contacts and learn some bits I wasn't aware of.

I am assured that the power point presentations will be made available on the NHS Connecting for Health Southern Cluster Education, Training and Development (ETD) web site.

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He@lth Information on the Internet vol. 55 no. 1 (February 2007)

The latest issue of He@lth Information on the Internet (vol. 55 no. 1 February 2007) is now available.

It contains some interesting articles:

TI: Googling a diagnosis
AU: Childs, Sue

TI: GP Specialist e-Library
AU: Mulligan, Zena
JN: He@lth Information on the Internet

TI: Obesity
AU: Blenkinsopp, John

TI: Autism Data: a database of resources in the field of autism
AU: Taylor, Stephanie

TI: Medical images online
AU: Brown, Harry
JN: He@lth Information on the Internet

TI: Current literature
AU: Childs, Sue

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

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Monday, February 12, 2007

Nursing informatics in Cuba

This morning, Graham and I presented at the 3rd National Exchange in Nursing Informatics (3er Intercambio Nacional Informatica en Enfermeria). It was held at the Giron University campus in Havana, and was attended by about 50 nurses, nurse informaticians, and others. I gave a version of tghe presentation I will be making later in the week, on IMIA (, its Working groups and the Nursing Special Interest Group, and the IMIA Strategic Plan. The focus of the talk was on how nurses and others in Cuba can be involved in IMIA activities.

Graham spoke on clinical information systems in the UK, outlining some of the systems that have been used, some of the mistakes that have been made in the UK, and some of the issues around use, or non-use, of computer systems in health care in both primary care and hospitals. Both talks seemed to be useful and well-received.

Other speakers included a nurse from Spain, who mainly presented a Spanish nursing journal and its website.

The main health informatics conference starts tomorrow, and we will write some on-the-fly reports from sessions, to upload at the end of the day. We also hope to attend the open source and fre software conference later in the week, where Richard Stallman is the keynote speaker.

Peter Murray

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HIJ - Healthcare Technologies in Practice: 1 March 2007; Vol.

The latest edition of Health Informatics Journal is a special on: Healthcare Technologies in Practice: 1 March 2007; Vol. 13, No. 1

It contains some interesting papers.


Introduction to Healthcare Technologies in Practice
Jon Hindmarsh, K. Neil Jenkings, and Tim Rapley

Monitoring practice and alarm technology in anaesthesiology
Marcus Sanchez Svensson

Sound sight: seeing with ultrasound
Monika Buscher and Gloria Jensen

`You've got to take them seriously': meeting information needs in mental healthcare
Karen Clarke, John Rooksby, and Mark Rouncefield

Managing integration work in an NHS electronic patient record (EPR) project
David Martin, John Mariani, and Mark Rouncefield

Implementation, change management and benefit realization: investigating the utility of ethnographically enriched process maps
K. Neil Jenkings

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Sunday, February 11, 2007

From 'our men in Havana'

Greetings from Havana, Cuba. Graham Wright and I are here to participate in the Sixth International Congress in Health Informatics (VI Congreso Internacional de Informática en Salud -, which takes place from 12-16 February. The event is part of the larger Informatica2007 Congress.

We are staying at the Hotel Nacional de Cuba ( where we have wireless Internet access. We will try to post more or less daily reports at the end of the day.

Tomorrow (Monday) we have unscheduled presentations to make an additional nursing event that is being held locally.

Peter Murray

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Friday, February 09, 2007

NAO report on Dr Foster

The UK's National Audit Office has recently released the report of it's findings into Dr Foster Intelligence: A joint venture between the Information Centre and Dr Foster LLP

It describes how the Health and Social Care Information Centre (now renamed as the Information Centre) set up a partnership with a private company Dr Foster Ltd, which would publish the data from the Information Centre to the general public as Dr Foster Intelligence.

The deal is seriously critical of the failure to put the contract out to tender and the failure to get value for taxpayers money.

The report says:
“Although the department believes it acted as a market investor in negotiating a realistic price, we calculate that the IC paid between 33 and 53 per cent more than the advisor’s highest indicative valuation based solely on the acknowledged strategic premium of between £2.5 and £4 million.

“As the joint venture does not deliver any direct or measurable services to the IC, it is an investment in a private company for which the IC paid a strategic premium without gaining a controlling interest".

I first mentioned my concerns with this in a Feb 06 piece Frequent flyers' costing NHS £2.3bn a year and then in March Paying for data your taxes paid for and April Is NHS data there for any company - or just one? based on articles by Michael Cross in the Guardian.

It is nice to see some of these concerns being recognised.

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Enquiry into Electronic Patient Records

On 5th Feb 2007 the Health Select Committee announced the terms of reference for its inquiry into the Electronic Patient Record and its use. The terms of reference are available in their press notice of 5 February. The deadline for written evidence is Friday 16 March.

The inquiry will focus particularly on the following areas:

• What patient information will be held on the new local and national electronic record systems, including whether patients may prevent their personal data being placed on systems;

• Who will have access to locally and nationally held information and under what circumstances;

• Whether patient confidentiality can be adequately protected;

• How data held on the new systems can and should be used for purposes other than the delivery of care e.g. clinical research; and

• Current progress on the development of the NHS Care Records Service and the National Data Spine and why delivery of the new systems is up to 2 years behind schedule.

I feel this is a good individuals and organisations to ensure that issues that they feel are important are included in the inquiry.

These might include:
* The type, quality, specificity and identifiability of the information which will be routinely shared in the NHS (and possibly beyond), and the right of the patient to insist that their information is not included or is restricted.

* The mechanisms, both technological and human, for controlling and securing access to the information. The recent case of staff in an A&E department sharing smartcard access, because it took too long to log on and off the system, highlights the risks.

* The risks of sharing detailed patient information with bodies such as drug companies- even if attempts have been made to annonymise or pseudo-annonymise it beforehand.

* The causes of current delays in implementation & the importance of getting the NHS to "own, love and understand" the IT programme in a way that it has not done up to now as suggested by David Nicholson a couple of weeks ago(see Picture this: an NHS data project that everybody loves, Guardian 8th Feb). In addition, comments may be welcomed about the current debates relating to the balance between central control through NHS Connecting for Health and local health communities.

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NHSu report & Information Tribunal

Following the decision notice issued by the Information Commissioner in November about my request for the report by Sir William Wells into the NHS University, I have now received copies of the appeal by the Department of Health and the response to the appeal by the Information Commissioner.

The Department have argued that the Information Commissioner was wrong in his application of sections 33, 35(1)(a), 40(2) and 41 of the Freedom of Information Act 2000.

The appeal hearing is to be scheduled between 8th and 22nd March and the Information Tribunal and is aiming for a final determination by 22nd June 2007.

I am currently deciding whether I want to be "joined to the appeal" & will post further news wen I know the date of he appeal.

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