Future - History: Information Systems or Care Records

Brian Warboys Professor of Software Engineering at Manchester University has stated that clinical staff lack the skills to make working information systems should leave it to IT professionals. A consultant physician and cardiologist at Bloomsbury and Islington agreed, the HSJ quote as saying:

"The fault lies not with the IT experts but with ourselves as clinicians. If we do not tell them what we want, how can they come up with the answers? ... There is a case for evaluating every IT solution available now and scrapping some of them". p.8.

Health Service Journal, 101:5259, 4 July, 1991.

'Coroners have warned the NHS on dozens of occasions that its record-keeping is so poor that patient's lives are at risk, an investigation by The Times has found. ...

Coroners have issued 62 warnings since 2013 in which they identified failings in record-keeping that could lead to the deaths of other patients.' ...

 'Simon Eccles, of NHSX, which is responsible for improving digitalisation, said that all of England should be covered by digital records by 2024 so staff could access the information needed to provide patients with the best possible care.'

Greenwood, G. Lost notes and illegible records 'risking lives of NHS patients'. The Times, October 2. 2019. p.16.

3rd Healthcare Digital Technology Congress: Manchester

I greatly enjoyed Convenzis's Congress in Manchester at etc.venues. The early train journey (as 'us' Northerner's know very well) was not pleasant. Upon arrival I worried I might behave like a sardine in the lift up to the 8th floor. The venue is very convenient near Oxford Road and Piccadilly (I got off early at O. Rd). Manchester and Liverpool are well served for conference venues.

The journey was quickly forgotten, with a welcome coffee and breakfast. Networking started immediately thanks to a 'clear' twitter profile picture and some 'homework' with tweets the night before. Despite breakfast the exhibitor stands whetted the appetite for information at the breaks to follow.

These events are not just a help keep up-to-date #HealthIT #DigitalHealth wise, but a way to try to maintain some sense of balance as things are read while not experienced first-hand. Digital health is diverse and a reference during the day to juggling and its architecture was quite apt.The balance comes in countering the social media bubbles that (as users) we inhabit and are influenced by.

I'm not going to do a blow-by-blow account but Richard Price set the digital tone referring to technology development through the course of NHS's history:

- and The Topol Review (February 2019) and the digital future through Dr Eric Topol and a video:

As a scholar of literacy in its many forms I appreciated Richard's slide on the digital form. (Is this the same as 'information', or informatics' even?) This is interesting in being person-centred which at an individual level is not necessarily the same thing. Hopefully any e-careplan is formulated and constructed based on this, with time for data entry and practitioner-patient(person) engagement?

My thoughts or social media concerns here are based on tweets I have read which are often politicised and tied to related policy and the NHS Long Terms Plan. Health and Healthcare IS political, as previous posts have indicated. In contrast days like this and technical evangelism are a great experience for the optimism, technology, skills, problems solved and ongoing progress.

There was a question at the end of the day about AI artificial intelligence and how perhaps its role can be proven in less clinically applications. I was going to reply with the case of 'robotic process automation' which is gathering pace in other 'industries' such as insurance, recruitment and document management. Having experienced in the past new starters from universities have to retro-learn old applications and operating systems I was surprised to hear mention of 'Windows XP'. History - future all rolled up together.

In March I noticed a tweet andwell before I attended RCN Congress for the first time:

1 in 40 doctors participating in research compared to 1in 1, 000 nurses says Lord Willis @councilofdeans @JessicaCorner @KingsNursing @theRCN what can we do /enhance access and participation?

— anne marie rafferty (@annemarieraffer) March 13, 2019

Also on twitter I've wondered about wards, clinical teams having a 'research question' sitting on the shelf, if not a 'live' research project. Perhaps a ward could have three proposed questions that are revisited and even picked up by students. This could be part of the introduction to the placement and help raise awareness on several levels. At this event I spoke to InPhase and within the 'single assurance system' which was demonstrated to me there would be scope to incorporate such an initiative. Beyond this though ward managers, matrons and senior managers can have the tools such that 'data' about wards and even individual practitioners is available. While crucial (think CQC), this data turned into information and intelligence should not just be inspection fodder. There must be a clinical and research dividend to routine records. Also noted previously is the need for practitioners to manage their cases, their caseload.

A representative for Checkware explained their approach of patient involvement through self-reporting, self-management and long-distance follow-up. In terms of low-hanging fruit for computerisation this has long been one of them. The original box-ticking exercise that now seems to define the success or otherwise (mere completion?) of activities that it really shouldn't. After discussing copyright, patient engagement and the company's background I thought of Hodges' model (of course). I wanted to ask "What is the most general assessment tool you have?" There are many possible responses, but I didn't.

As a registered nurse I've always been defensive about patient data and what happens to it (IT). Consequently I've paid interest to data protection and public initiatives for e-records over the decades. It may be me, but I picked up a sense that a consensus within the public may be emerging? It's not even that the public were represented as such, just a sense from what was said. I may be wrong... and any optimism regards the maturity of the public's attitude to health e-record, does not equate to the maturity of the technology?

Hadleigh Stollar from NHSDigital explained the progress and plans of the National Record Locator Service, it’s success so far and benefits! This is pivotal for the experience of people with mental health problems in crisis and ambulance services. This is just the start. There was a phrase, LHCRE (which became 'lycra') that's "Local Health Care Records Exemplar" sites. There was a lot more with the Personal Health Record, a key example, as the event website indicates. The offerings of PureAV go far beyond the prompt for me to use video. Clinical Emergency Medicine Books - CEMbooks brought back some nursing memories. This was a very well organised, clearly well-planned Congress, informative, practical, with time for the exhibition and networking. Leaving at 1610 I even had a much better return journey.

Thanks to the Convenzis Team and etc.venues.