Health informatics and health technology solutions for the NHS Prof Jonathan Kay Clinical Informatics Director NHS England

Transcription

1 Health informatics and health technology solutions for the NHS Prof Jonathan Kay Clinical Informatics Director NHS England

2 Complex things Implementing an EPR in a multisite academic hospital Using computers to make clinical decisions Accumulating and understanding aggregated data across the NHS

3 Things that should be simple Knowing that the report of an investigation has reached the right doctor Giving the right dose of a drug to the right patient Contacting other mobile healthcare professionals Gathering data from existing instruments Communicating between organisations quickly with the right content being sent

4 Computerisation Can improve patient safety Reduce discontinuities Within organisations Between organisations Can reduce unit cost of processes Remove tasks from humans Reduce waste

5 Computerisation Can reduce unit cost of processes Can increase safety But Ignorance of unit costs of processes Passive approach to safety management

6 Technological opportunities Networked fixed computers Networked handheld computers Cloud services Autoidentification

7 Organisational opportunities Clinical Commissioning Groups Chief Clinical Information Officers Young healthcare professionals The shortfall in funding

8 Junior doctors access to the net at work My assumptions The survey

9 Unofficial NHS Staff WiFi Survey 2013 Online survey of WiFi availability for frontline NHS staff run by NHS Hack Day community, with support from HANDIHealth, Tactix4, and opengpsoc 650 responses so far, survey is still live at:

10 Headline: just 23% have NHS free WiFi The rest are either denied access (even when WiFi networks do exist) or are having to pay for it.

11 "It would mean we could demonstrate ebooks, Pubmed information on ward rounds, BNF and much, much more. Clinicians would get the information they need at the time they need it." "It is frustrating that although 'agile working' is the Trust's agenda, staff are unable to access the Wi-Fi. This is made worse by the ban on memory sticks so that staff without Trust access are unable to transfer their work to their own machines. Free web services are blocked." "I do clinics in the community where we have no computer access at all, let alone WiFi." "Staff do not have any wifi access across the trust but there is access available exclusively for medical students. The library service purchased a small number of ipads to loan (for meetings, grand rounds, study etc. ) but the IM&T department has blocked this trial. Unfortunately, I do not foresee an imminent change in trust stance on wifi access."

12 But there is hope... "I am lucky to have free access to fast wifi provided free to all staff at my Trust. It is rated Number 3 in the worlds top centres of excellence and the wifi is a major contributor to that - we all use it for patient databases, checking ebnf, journals, NICE, specialist guidance etc etc etc It is invaluable and a major contribution to outstanding care. It is secure and run well by our superb in house IT team. All our iphones and laptops were connected by IT at Induction day. They are the best IT Department I have ever come across and as a result of that, we have some incredibly well set up and supported electronic systems for tests, scans, results, admitting, letters etc - utterly incredible facilities"

13 What did I learn from that? I don t know enough about what s happening We need to treat staff better We may have a problem doing simple things well

14 Why would we not do simple things well and everywhere? Don t understand users needs Silo behaviour Technology not available Resources not available We don t know what works We don t do lateral transfers

15 NHS England

16 NHS Mandate Every year, the Secretary of State must publish a mandate to ensure accordance with the Health and Social Care Act The current Mandate sets 24 objectives and the following 5 priority areas identified by Government

17 Furthering economic growth, including supporting people with health conditions to remain in or find work Priority areas in the mandate Improving standards of care and not just treatment, especially for older people and at the end of people s lives The diagnosis, treatment and care of people with dementia Supporting people with multiple long-term physical and mental health condition particularly by embracing opportunities created by technology, and delivering a service that values mental and physical health equally Preventing premature deaths from the biggest killers

18 How does a commissioning body influence anything? Mandatory elements in contracts Funding projects National Local Transfer of good practice Galley of examples Awards Do once and share Influence by influence

19 NHS England: Big projects Informatics-led, eg Technology Challenge Fund ( 260M) Digital Primary Care care.data GP Systems of Choice Informatics-supported Urgent Care Review Every clinical project Every performance standard

20 Things that (some other people think) are barriers Luddite clinicians Poor information systems Legacy New Cost of change and new systems Split of primary and secondary care Data standards Burden of data collection Capacity of NHS ICT staff Capacity in clinical informatics Capacity in project management Legacy of NPfIT

21 What can I do to help? Question