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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
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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!
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Mental health
Primary Care
Ambulance
Simple is effective (!) – IDL’s and clinic letters
Mental health worker stabbed to death by client.doc
Proactive Information
• Use the data to drive the system
– Proactive rather than reactive
• Health Cards/Clinical Spine Application
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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
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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 ‘laboursaving’ 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
Proactive
Information
Feedback
Search
Audit
Information
Totalis
Warnings
Workplace
Change
Questions?
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