BIG ICT - BIG Society: The big society and HI professionalism

I have a question for you - is there any irony in the matter of a BIG ICT project that was in embryonic form a decade ago - and the emergence now of the UK government's BIG Society?

Well before the 2010 election NHS IcT policy makers recognised once again the importance and value of locally based IcT management and solutions. Over the past decade the NHS has achieved a national infrastructure at great cost. I always wondered about the extent to which a 'national solution' supports innovation and creativity. Having a market, local scope and flexibility, innovation and creativity depends on standards which we can now benefit from.

There is a very timely and interesting article in the BCS's Health Informatics - HI Now newsletter:

The big society and HI professionalism

Professor Stephen Kay and Dr Glyn Hayes discuss how the government’s Big Society programme might affect the state of UK health informatics and look at how BCS and UKCHIP promote professionalism in complementary ways.

Like the dichotomous axes of the health care domains model you wonder whether:

BIG - small : GLOBAL and local

- can co-exist?

Of course they do. In the socio-economic-political realm we now have 'Glocal' stressing the global times we live in - the constancy that is the bigger picture; and as noted above the NHS has re-discovered the mantra of 'Bsmall'.

My role like that of many colleagues is a mixed-bag. Nursing Home Liaison plus training staff in HoNOS and shortly STORM. I have numerous informatics related conversations with students and managers, but for the time being I've let my UK Chip registration lapse.

Having a professional body in occupations with ethical dimensions, safety, accountability and other essential qualities is vital. Amongst many definitions professionalism means important things are anchored; lifting that anchor and subsequent movement needs to be debated, justified and agreed.

Idealism will count for little though if health informatics professionals are tied to the back-office. A chorus that rang out in Trust Boards, project groups in the early-mid '00s was clinical engagement. We can learn a lot now from the background echoes of all that noise. If the reach - risk management of the more adventurous informatics individuals only sees them reach the middle-office; then change in the hyper-contextual-multidisciplinary-person-centered clinical front-office will be difficult and hard to visualize (whatever technology you throw at the problem).

It seems clinically in a great many areas that health informatics has done diddly-squat in terms of non-informatics personnel understanding data, information and knowledge and the relationships between. Little difference in reflecting the questions that clinician's would ask of their case load, wards and department. Yes, with mention of 'dashboards' staff may realise they are all in the same vehicle; but they may not know whether they are in a 2, 4, 8 or 16 wheeler. [A strange and scary phenomena this - when the staff DO know that one or more wheels are in the process of falling off.]

Furthermore, the destination may not be shared, or even identified. Yes, there are centers of excellence and award winners; but there are information deserts out there in the community, public mental health, the nursing homes. You have to ask where exactly are we bound?