Informaticopia

Wednesday, March 28, 2007

ECDL module for health

The British Computer Society recently announced a new module to be added to the European Computer Driving Licence (ECDL) specifically for healthcare staff, and developed in conjunction with Connecting for Health.

It aims to "provide candidates with an understanding of the key principles and policies relating to healthcare information systems and the practical skills needed by users. As well as enabling users to read, retrieve, update and store patient records accurately, the unit also provides candidates with a thorough understanding of the key issues regarding patient confidentiality and data security."

It has been piloted with 100 staff quite successfully but it will be interesting to see if this is rolled across the NHS and whether it is seen as a high priority for managers and useful for individual staff.

For More info:
BCS develops ECDL for NHS from Kable
BCS Develops New ECDL Health Unit for NHS from eGov Monitor


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Tuesday, March 20, 2007

HC2007 - Strategies and technologies

The day closed with two good presentations. Justin Keen, Professor of Health Politics, Institute of Health Sciences, University of Leeds, posed the question 'Is an IT strategy possible?' He began with the premises that IT programmes have myths surrounding them, that are often not examined in a systematic way until things go wrong; they persist because we have so little rational evidence, but are often based in gut feelings. Some of the myths he posed are that electronic services will save money, improve patient safety, will enable joined up government, and that they will transform healthcare – but he says we have no evidence base to support any of these. He asked why this keeps happening, especially in regards of IT in healthcare. Among possible explanations we could consider, which may or may not be correct, he suggests, might be that the sector is immature, or that the research community is useless and cannot produce the evidence, or that the government has some kind of dastardly plan. Alternatively, he asks, does the status quo still suit too many groups?

In looking at what might be done, he suggests, as part of a move towards an evidence-based debate:
1.need for a sophisticated response to wider NHS policies
2.need to account for ways in which services currently work, so what might be transformed (eg how exactly does patient participation work?)
3.to ask what are alternatives to current government policies.

In answer to his question, he says 'yes' – if we generate evidence to puncture myths, if we are seen to develop plausible alternative policies, and if we remember that the world was not perfect before NPfIT.

Jonathan Kay, Professor of Health Informatics, City University, London 'Using everyday technology to challenge clinical boundaries'. In a thought-provoking session, he asked some of the 'blindingly obvious' questions that the health services seem not able to address. He asked why do we not pick up on common everyday technologies, such as entertainment and commerce? The technology of ecommerce involves personal computing devices, web architecture, email architecture, enhanced telephone technologies, and barcodes (for autoidentification). These technologies work because they are mature commodities, often non-proprietary (but based in standards), and have easy entry, low training ans switching costs, and high rate of change of functionality – but often same technologies for multiple purposes. But in healthcare there is often slow adoption, resistance to adoption, and structural bias in ICT departments against new technologies. He suggests there are far too many gateways and firewalls in the NHS, and too much use of proprietary implementations. He demonstrated benefits from his work in Oxford on barcode systems to ensure correct blood administration to patients. He suggests that patients and staff are familiar with uses of mature technologies, and that their use in healthcare could provide the same benefits as are seen in other domains, including trapping and preventing errors, instead of simply recording them.


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HC2007 - More on exhibitors

A couple more honourable mentions to exhibitors who are doing a good job of seling their wares, not just to those who they think might buy, but doing a broader good promotional job. Being registered as press for HC2007, I have over the past 10 days or so had a deluge of emailed press releases; most quickly got deleted, but sometimes the PR people seem to hit the hooks just right.

AxSys Technology's (www.axsys.co.uk) release talked about real life examples of their systems, in particular in Scotland and in cancer services - and they had an invite to their Monday evening reception. They put on a good spread, even if not too many people attended, and were helpful and honest in their discussions of their products. Their 'Excelicare' system for collaborative work looks interesting and worth having a further look around.

The people at WebVMC/RemoteNurse (http://www.hometelehealthltd.co.uk/)were also very helpful in talking about their system of integrated telehealth devices (a real life example of the sort of interoperability that David Whitlinger was talking about this morning). They also have Age Concern involved with their developments, and seem to have some real life case studies of benefits deriving, although maybe haven't yet answered the question about whether it is cheaper than hospital care, or just offset/hidden costs.

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HC2007 - BCS Nursing Specialist Group session

The annual satellite session organised by the British Computer Society's Nursing Specialist Group (www.nursing.bcs.org/) took place on Tuesday moring, and was titled 'Challenging boundaries or grappling with fuzzy edges?' There were 4 short presentations, followed by discussion. Richard Hayward, NSG Chair, opened the session. The first speaker was Janette Bennett, Senior Clinical Advisor with the BT Health Executive; she quoted Florence Nightingale as saying 'I look forward to the abolition of all hospitals ... but it is no use talking about the year 2000'. In looking at boundaries and challenges, and making changes in practices, she looks at professional issues, education issues, the research needed to inform decisions, and finally the management aspects, including roles, skill mix, etc. The shift to care in the community does not seem to be providing that kind of thinking, and this causes Janette concern. There need to be radical changes to the ways of working (eg virtual support services), and these have radical implications for the nature of education needs. She sees possibilities for new online environments, such as MySpace, for modelling new ways of working, learning and thinking. Underlying infrastructures, rather than technologies, she suggests, are what provide the real boundaries to be addressed.

Rebecca Randall, from City University, talked about computerised decision support systems (CDSS, eg as used in NHSDirect) pushing the boundaries of nursing roles. Her talk was based in the work undertaken in the recent Department of Health funded study into nurses' use of technology. She says there is a blurred boundary between supported and unsupported decision making, and whether CDSS directly supports decision making. Helen Sampson talked about the challenges in the workplace for frontline staff, as nursing roles change, and working at the boundaries of health and social care. She says that nurses now do know what kinds of information they want to record about care – but that elements of the National Programme are dictating what can be done, and this does not always match with what nurses want. Peter Murray presented some thoughts on boundaries between everyday life and education, and of the real boundaries being cultural, and also discussed scenario planning as a way of thinking about possible futures and emerging boundaries. A wide ranging discussion followed the presentations, with concerns being expressed about the ability of information systems to support the real needs of the clinical end users.

The satellite was followed by the Annual General Meeting of the BCS NSG.


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HC2007 - Personal telehealth and Continua Alliance

I decided that I couldn't stand to listen to any more Microsoft propaganda, so skipped the first session of the morning, which was John Coulthard, Director of Healthcare, Microsoft talking about the 'Common User Interface'.

However, I did go to listen to David Whitlinger, Director of Healthcare Device Standards and Interoperability, Intel Corporation, talking about 'Personal health'. The exact title of his talk was 'Fostering independence through personal telehealth solutions' and was focused around the Continua Health Alliance (http://www.continuaalliance.org), of which he is President and Chair of the Board of Directors – so not really what was advertised. Continua started in June 2006 and brings together a large number of organisations (including medical device companies, technology and consumer electronics companies, pharmaceutical and healthcare provider companies, and the NHS joined in January 2007).

He cited the mission as being 'to establish a marketplace of interoperable personal health systems that empower people and organisations to better manage their health and wellness' – a focus on chronic disease management through devices and services.. He talked of the enabling of a 'personal health eco-system' where products from different vendors could be combined. Part of the rationale, as illustrated by one his slides, seems to be cost, with moves from high cost acute care (with possible low quality of life) through to a 'personal telehealth space' where quality of life is higher, and cost of care per day in lower (at least, in theory). Part of the shift is seen as being behavioural change. However, much of what he was saying was not new; he talked of the kinds of telehealth applications, home chronic illness and elderly monitoring, that we have been talking about and which the European Union has been finding research into, for the past 10 years and more.



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Monday, March 19, 2007

Healthspace strikes again

This, I have to share - it demonstrates the reality of NHS IT systems (in particular, 'a service provided by NHS Connecting for Health') that they want to encourage us all to use. Following my previous post about NHS Healthspace, I thought I would just try it out again, as they have a whizzy new interface. So, I put my ID and password in - error message says they cannot be found. So, I enter some other details to try and retrieve the ID and password - same response. Saqme again to trying to upgrade from the older healthspace.

Oh, I thinks - typical, they've upgraded and managed to lose all my details. let's try and register again for a new account. So, I enter all my details as previously used and - yes, you've guessed it, the message now is that there is already a user with these details. Que?

So, let's see how long it takes them - if ever - to reply to a query about this on their feedback form. I'm not going to hold my breath.


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HC2007 - Do exhibitors not want publicity?

You know how it is; you're just composing a blog post and something happens to disprove your theory and your nicely crafted words. After spending some time wandering around the HC2007 exhibition this afternoon, I was coing to the conclusion that most of the exhibitors were not interested in talking to the press. They look at your press badge and look away, or are not as interested in talking as they are if you have a badge that indicates you might have some money to spend.

A couple of honourable exceptions, though - two exhibitors who are here for the first time were happy to talk, so I will give them a mention. Remind Patients have a text and voice messaging system to remind patients to attend appointments - I hope it works better than NHS Healthspace (https://www.healthspace.nhs.uk/), which certainly does not seem to work in this way in my experience - and they don't even have the decency to reply to emails. Another newcomer this year to the exhibition is SpectrumITech (www.spectrumitech.co.uk) with their 'ViewPortal' document and records management system. Finally, an honourable mention to Devlin Mobile Computing, who actually wanted to talk to a media person about their new healthcare keybaord, a fully sealeed unit aimed at contributing to reducing infection risks (www.devlinmobilecomputing.co.uk). Thanks, people, for taking the time. maybe tomorrow I'll name names for the exhibitors most blatantly ignoring the media.

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HC2007 - Mobile clinical assistant

Wandering round the exhibition, it seems very quiet. One piece of hardware that caught my attention was on the Intel stand, and their 'new mobile clinical assistant platform and Motion Computing's C5 product' (http://www.motioncomputing.com/products/tablet_pc_c5.asp). At first glance, it looks very neat, but a short play with it revealed that there is still a lot of work to do on it (IMHO).

It is advertised as 'the first point of care solution that was designed for clinicians with clinican input' (according to the text of their launch invitation); looking at tghe functionality, I'm wondering just how much clincian input there was. The device itself seems pretty much like a standard tablet PC, although with a few tweaks. My first issue is with the weight of it - my Toshiba Portege is lighter. The handwriting recognition for data input seemed to work well for simple things, like temperatures etc. - but I was concerned that the demo device accepted an obviously spurious temperature. Patient checking is by either barcode reading or RFID tag (why both?) - and it took a long time to read the RFID tag even when it was held against the device.

The look and specs seem to be trying to move towards the sort of device that anyone who has attended any of his talks recently will recall Mike Bainbridge, from CfH, saying is needed - but the limited poke around I had with this device seems to show it has a long way to go.

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HC2007 - Lord Hunt speech

Lord Hunt of Kings Heath OBE, Minister of State for Quality, Department of Health has responsibility for IT in the NHS, and for patient safety. Those who were expecting any significant new announcements were disappointed; as far as I could see, he did not say a great deal that was new, but focused on an overview of some of the benefits to date from NPfIT.

He says his number one issue is improving care and reducing errors. The NHS needs national standards for treatments of conditions, regulation to ensure local provision is to satisfactory standards, and money – and supported by the IT system.
The biggest challenge now is local ownership of NPfIT – engagement with local NHS organisations is where energy needs to be put. The creation of NHS Local Ownership Programme (NLOP) aims to fully engage chief executives and trust boards. The challenges to future delivery include refocusing efforts on the most important components – electronic prescriptions and prescribing, Acute Trust Patient Administration Systems (PAS) and integrating primary and secondary care. A 'charter of requirements' is being drawn up.


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HC2007 - Opening keynote, Nigel Shadbolt on the semantic web

Steven Kay opened the conference, which has the theme of 'Challenging Boundaries', by outlining the range of boundaries that may challenge us – social, organisational, political, national, economic, technical etc. He said that we need to make the computers fit for the health service, and that we need to challenge the boundaries of silo mentalities that many people have been working in. He closed his opening remarks with a quote from Bertrand Russell - 'In all affairs, it is healthy to hang a question mark on the things you have long taken for granted'.

Prof. Nigel Shadbolt, President of the British Computer Society (BCS) and from University of Southampton, whose field is AI and knowledge technologies (http://www.bcs.org/server.php?show=ConWebDoc.4551) gave the opening keynote, titled 'The Semantic Web and e-Health'

He began with a short overview of the BCS, which is 50 at the end of May 2007, has 60,000 members, and is determined to be professional, independent, interdisciplinary and forward-looking.

In giving an overview of the reality versus myths of the semantic web, saying that one myth is of a future of smart software agents, while the reality is more prosaic and mundane. The semantic web is about equipping content with rich metadata (information about information), and metadata organised into ontologies, which then means accessible data, with implications for interoperability.
Structured markup languages (such as HTML and XML) are taking us some way down the route we need to go, but other emerging semantic web functions will go even further, eg RDFs (resource description frameworks). He suggested that the semantic web is about sharing meaning through ontologies, an ontology being a shared model of conceptualisation of a domain; they are real and support communication and interoperability. This allows for network effects of information on the web, which gives serendipitous use of data and information. The semantic web, he said, is about sharing meaning, reducing ambiguity, making explicit what is implicit, and providing information spaces. However, the modern information fabric is about people, not just information and technologies; social issues of trust, privacy and governance and personal digital information entitlements.


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HC2007 starts today

The HC2007 conference and exhibition begins today. The Press Office is set up - and like a sauna as usual - but at least I have managed to connect to their wireless network. The event programme is at www.health-informatics.org and I will be reporting from a range of the conference sessions and the exhibition. The opening session is supposed to feature Nigel Shadbolt, BCS President, talking about the semantic web and e-health, and a ministerial speech by Lord Hunt - will be interesting to see if he actually turns up, given ministers' previous attendance records.

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Friday, March 16, 2007

1st uploads from GP to national spine

The first upload of GP patients records to the NPfIT national spine are about to start.

Bolton has been selected as the pilot site and two GPs practices in the town will begin uploading GP records as part of the "summary care record" which will contain containing details of name, address, medication history, serious illnesses and allergies. These will then be accessible to the out-of-hours provider and A+E department.

Letters and leaflets explaining the programme will go out in the next few weeks, and local residents will have the option to "opt out". This long fought for opt out will have three possible options. The first is a total refusal for their records to be uploaded. The second option is to limit the people who are able to access it and the final options is that particular details - such as an abortion or being on HIV medication - must not be uploaded (the so called and long awaited sealed envelope). However, very few details of how this will be achieved have yet been made available.

It will be very interesting to see how many people take one of the options to restrict the use of their personal and sensitive information.

Further information is available from:

* The Guardian 15th March First test launched of NHS's controversial 'Spine' database
* E Health Insider Starting gun fired for Summary Care Record roll-out

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Monday, March 12, 2007

Blogging HC2007

HC2007, the 24th Annual Conference and Exhibition, takes place in Harrogate, England on 19-21 March, 2007 (http://www.health-informatics.org/). The Conference is organised by British Computer Society Health Informatics Forum (BCSHIF). The exhibition at HC is organised by BJHC Ltd., and exhibition details can be found on their website: http://www.healthcare-computing.co.uk/hc2007/exhibition/index.html


We will be blogging the event, and would like to hear from anyone else who will be blogging it, or who would like to contribute posts here about or from the event.

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Baltimore Summer Institute in Nursing Informatics

The University of Maryland School of Nursing (in Baltimore, USA) will be holding their 17th Annual Summer Institute in Nursing Informatics (SINI) on July 18 - 21, 2007, with pre-conference sessions on July 16 - 18.

This year's theme is 'Skills and Systems for Today and Tomorrow'. The deadline for submission of abstracts has been extended to March 23, 2007. Full details of the SINI can be found at http://nursing.umaryland.edu/informatics/ and of the call for abstracts at http://nursing.umaryland.edu/informatics/abstracts/index.htm There are also scholarships and cash awards available (even if you live outside the USA).

To give you a flavour of the event - probably the largest annual nursing informatics event - some blogs of previous SINIs can be found at http://www.differance-engine.net/SINI2006blog/ and http://differance-engine.net/SINI2005blog/

I have attended for several years - and will declare and interest as a member of the Scientific Programme Committee - and think it is well worth attending. we will be blogging it again this year.


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Thursday, March 08, 2007

Doctoral Studentship - E-learning and Health Informatics @ UWE

Doctoral Studentship - E-learning and Health Informatics (HSC/DS2)

This doctoral studentship in E-learning and Health Informatics has just been made available & will be appearing in the Times Higher Ed this week.

Proposals should relate to one or more of the following areas:

- Use of e-portfolios/ evaluation of e-portfolios

- Online Communities of Practice supporting professional working

- Application of handheld/mobile technologies in health and social care practice/education

- Technology based learning across further, higher education and health and social boundaries

- Measuring attitudes of health and social care staff to the use of IT

- Evaluating practice change resultant from of the use of electronically available health information

- Impact of technology on management/ education in the health and social care arena


The closing date is 23 April 2007 & further details are available from Deb Joy (contact details on the linked page)

Wednesday, March 07, 2007

Health websites need personal testimonies

The BBC News is today reporting an ESRC funded study by Northumbria University under the heading 'Personal' health websites sought, which found "People searching online for health advice often reject sites giving high quality information in favour of those with a human touch".

The findings showed users did not like adverts & didn't trust drug company web sites, but looked for those with personal stories to which the reader could relate.

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Interesting PhD Studentship

An interesting PhD studentship about "The expert patient: how the public make use of the Internet and electronic information sources in making choices about their health and treatment regimes" has just been made available by Bournemouth University.

Application forms etc are available from the universities Institute of Health and Community Studies and further information is available from: Dr Carol Bond Senior Lecturer, Health Informatics.

This looks very interesting and if I wasn't already doing my DPhil & could afford to pay the mortgage from the 3 year bursary of £12,900 p/a + fees, I would consider applying for it myself.

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Sunday, March 04, 2007

Health Information and Libraries Journal 24:1 (March 2007)

The latest edition of the Health Information and Libraries Journal 24:1 (March 2007) is now available. It has some interesting papers including:

The emerging Web2.0 social software: an enabling suite of sociable technologies in health and health care education
Maged N. Kamel Boulos, Steve Wheeler

Effectiveness of information skills training and mediated searching: qualitative results from the EMPIRIC project
Alison Brettle, Claire Hulme, Paula Ormandy

Evaluating the impact of library user training programmes across Thames Valley Strategic Health Authority in the UK
Valerie M Trinder, Geoffrey E Fleet, Anne E Gray

Growth in biomedical publications and scientific institutions in the Emirates (1998-2004): an Arabian renaissance?
Karen Neves, Wim J. E. P. Lammers

National Vocational Qualifications: the candidates experience
Susan Isaac

Teachability: creating accessible learning and teaching in information skills
Margaret E. S. Forrest, Anne E. Simpson

Who will appraise the appraisers?-The paper, the instrument and the user
Andrew Booth

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