Just Do I.T.

(?)

Information Totalis

• Proactive Information Systems

• Proactive Workplace Changes

• Clinical/Non-Clinical Feedback

• Warnings

Proactive Information Systems

• Information/Care Pathway–Predictive

OpenEHR Archetypes/Templates to support Emergency Medicine in the NHS: Shannon, Simpson

– C:\Documents and Settings\Mark Simpson\My Documents\Briefcase\Connecting for Health\2007 IT meeting\cow.JPG

–Anticipate need

–Intuitive• Eg Hypertension in ED• Head injuries

Proactive Information

• True Do Once and Share– Make it happen!

• One history• One PMH• One Drug History etc

• STOP Silos of Information!– Mental health Mental health worker stabbed to death by client.doc

– Primary Care– Ambulance– Simple is effective (!) – IDL’s and clinic letters

Proactive Information• Use the data to drive the system

– Proactive rather than reactive

• Health Cards/Clinical Spine Application– Possibly single greatest step– Step change in public involvement– Wholesale change to processes (later)– Continual update of data – NOT just at

points of health contact

Change Workplace

• Change Process– Polyclinics– See & Treat– Need for Reception?

• An end to waiting?

– Need for Triage?• An end to multiple

queues?

– Public involvement

Change Workplace

• Buildings and Designs– Built for the purpose of enhancing information

systems– ‘Participatory Design’ Participatory design.pdf

– No longer shoehorning into existing footprints designed to accommodate 1950’s demand!

– Remain flexible for continuing change in processes

Change Workplace

• Technology– Patient Tracking– Mobility– Inter-connectivity

• Mobile phones• Blackberrys etc• PDA’s• Home• Alerting systems

Change Workplace

• But amongst all this digital-information change we must not forget…

Feedback Loops

• Clinical Feedback– Automated feedback

• Diagnosis matching• Critiquing• Have a record of every patient I have managed

– Become part of more useful appraisal and revalidation

– Identify risk – Without stifling innovative practice

Feedback Loops

• Search – Audit – Innovate– Vast amount of data held away from inquisitive

minds– As revolutionary as Google was for the internet –

equivalent power in NHS work place search engines.

– Current search ability appears as after-thought– Graphs of personal performance– Myriad of audits – physical search hinders most

work

Warnings

• Trap for many ‘labour-saving’ systems – Increase workload in

isolation– Change management

often poor– Old system fondly

remembered

Warnings

• Security and Trust– Paramount in public eye is trust in the

information system– Resilience in security– BUT this must be balanced

• Security with effective clinical interaction• Technology – proximity badges (cf bluetooth)• Efficiency in ED absolute – every ineffective

addition multiplied by 125,000 episodes!

Warnings• Security

– Public involvement– Predictable breaks in information security

• Clooney clooney health workers suspended.doc

• Hammond _42465461_hammond_bbcpicgall.jpg

– BUT must resist information isolation• Victoria Climbié Laming Climbie.pdf

– Public Trust via Caldicott Guardian/ Information overseers

FeedbackSearchAudit

Warnings

WorkplaceChange

ProactiveInformation

Information Totalis

Questions?

Just Do I.T. ?

Only if Information TOTALIS