Bottom line: The parts informatics does not reach

I really must get on board the bus: there are many assumptions that people make, what a nurse does, the role of a social worker and such like. I'd assumed that the private health sector - in this case a provider of residential nursing care would automatically invest in administration and clinical information systems. Silly me.

I don't know if the home I visited is an exception or typical of this particular group, but the staff are not only struggling to provide the best quality care for their residents, they are struggling with paper. Where's the I.T.?

2007 heading fast towards 2008 why I.T.'s in plastic folders, pinned on the office walls, on the office desks, semi-scrunched into pockets.

There is nothing wrong with paper and after all these staff are expert in handling several types.

What I was told, is that when a home (or two) is acquired and there are examples of good practices in documentation these will be adopted by the new parent. That is good; nothing wrong with that, surely this is a key part of what acquisition is all about.

The problem is that amid these additions the whole documentation system is not reviewed and rationalised; so the paper-burden grows literally with the organisation. Conclusions:

1. There is a records management consultancy opportunity there for someone (race you!).
2. I did not have to wait to see and discuss my client. There were no clinical information system vendors cueing up to demonstrate their wares. So good news for clinical informatics suppliers: you have of course not yet covered the (w)hole market!
3. If this particular organisation is successful financially, how much more successful could it be if it embraced clinical and organisational informatics?
4. Does the Commission for Social Care Inspection (and other regulatory agencies) take informatics capability into account in their assessments? If the benefits of effective informatics are real then they must be represented in inspection reports: shouldn't they?
5. 'Success' what does this mean in a nursing home? Well, let's try marks out of ten -

• the bottom line in the Financial Times;
• the bottom line in the nursing home main office;
• the bottom line on that top floor with its residents, staff and relatives/visitors.

So, what is the real bottom line?

Out of sight....