FROM: A community mental health context TO: Acute EMR/EHR and other ...

or: Will 21st Century health and social care informatics truly begin on Sunday 10 10 10 ?

I've been a nurse AND info tech / informatics enthusiast since 1981. As an advocate of info-tech as a means to improve the quality, effectiveness and safety of health care - I must confess; I feel I have let down those colleagues purely there to 'nurse'. .

After 20+ plus years the nearest we (the team and I) got to a system that answered our questions was a small PICK database and a later MS Access database. These focused on referrals and data capture - demographics, problems, interventions (WHO and what) and outcomes. Although the number of data items was not great, no more than 30 the insights we could glean from queries was surprising. People versed with databases, datasets and research readily appreciate how even small datasets, carefully thought out and planned, can answer a diverse range of questions (and generate countless new ones too!).

I noticed in the mid-1980s to mid-1990s the development of customer management software and recognised that clinicians have a need: caseload management.

Even now the requirement of 'X' visits per day, the number of information systems and lack of integration (health - social care) mean that in many instances there is still no readily accessible caseload manager for the individual practitioner. This is an outcome and amid all the talk around 'engagement' (with a 'E').

Perversely, ironically, paradoxically (take your pick) at a time when Lean is (presented and) needed, there are scarce resources to do the things that should now be embedded (routinised) into the life history of the professional. This includes what the professionals do WITH the patients, carers, data, information ...

I speak to student nurses (and other disciplines) regularly as a nurse mentor and sign-off mentor. Their exposure to health care informatics to me is minimal, adhoc, and when it has happened it has signally failed to strike a cord. A very small (and so non-significant*?) sample admittedly.

Informatics remains an academic 'must do'.

Perhaps 21st century informatics only begins on Sunday -

101010

Whatever:
as it stands informatics is a management pursuit.

Slippage is a fact of project management, but words present their own challenge when target driven 'secondary' uses become 'primary'.

*surely not.

[A version of this post first appeared on the Healthcare Information and Management Systems Society HIMSS group on LinkedIn.]