Conference&Keynotes&Wednesday22 Mar 2006 09:59 pm

The final plenary session was not well attended as many people had left the conference before it tok place.

Prof Sir Muir Gray was presented with the BCS HC achievement award as the “first knight of health informatics”. He received his knighthood last year for knowledge management in the NHS.

He then gave a lecture in which he drew parrallels between the health benefits of clean and filtered water and the health benefits of clean and filtered information. He divided the lecture around several “tools”, those for changing society, community building , knowledge logistics and those for clinicans and patients. He managed to cover the Kaleidoscopic workforce and the national knwledge service as the only way forward for the NHS. I’m sure that many of the items will be dealt within more depth on his new blog Soundshealthy

Muir’s lecture was followed by the final keynote from Prof Nick Bosanquet (Professor of Health Policy, Imperial College, London), who talked about a “new informatics for the post-boom NHS”. He examined NHS funding and how new initiatives which have already been announced will mean that growth in NHS budgets will lead to reductions in growth between now and 2010, and the subsequent mechanisms for the control of expenditure (based on calaculations available on the Reform website in his paper The NHS in 2010). He argued that we are moving to an era of local pluralism rather than central control and likened Connecting for Health to a “cast iron framework in a dynamic sysem”, suggesting that it will need to provide data for cost control and meet the “Jeavons challenge” of increasing independance and autonomy in a system with multiple healthcare providers.

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Conference&Keynotes&Wednesday22 Mar 2006 02:24 pm

Dr Martin Baggaley (C4H clinical lead for London & Consultant Psychiatist) gave an interesting presentation setting out some specific issues for mental health trusts in London. He stressed the low base, in terms of electronic records systems, that mental health trusts are faced with, and the vital need for interoperability – not just with acute trust systems, but also with other agencies such as social services and the criminal justice system.

He pointed out some of the implications of Our Health, Our Care, our Say and its implicit moves from secondary to primary care and the balance between “stalinist” central control and “arguing local fifedoms”, and the problems which emerge from this. He described the “tactical” move by many London Mental Health Trusts to use RiO until fuller tools are available from the National Programme – and suggested that the spine would be, ultimately, the best route to address the ineroperability issues he highlighted. During the question and answer session he agreed with a questioner that for many London MH trusts which already have effective sysems the best solution may be to sit tight at present. I asked another question about mental health patients having “particularly sensitive” information which they may wish to go in the “sealed envelope” before it is uploaded to the spine. He suggest that many “career” MH patients are very open about their condition & may not wish to restrict access to their records, but that for many people with transient mental health problems the development of the sealed envelope is vital before information is uploaded.

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Conference&Keynotes&Tuesday21 Mar 2006 03:28 pm

At lunchtime today there was a press briefing by Connecting for Health at which Dr Gillian Braunold (GP Clinical Lead) and Kerri Adenubi (Programme Director for GP Systems of Choice) announced a change in the mechanisms for GPs who want to use systems which are not those provided by C4H local service providers (LSPs). Gillian talked about a scheme allowing “approved” systems to be used as lng as they meet functionality requirements in the context of the “Ladder of Compliance”, and some of the financial systems to be put in place for this. It was interesting to note that district nurses and health visitors will be using the systems provided by the LSP even though the GP’s caring for the same patients may be able to use different software systems.

The next session was an update on NPfIT system deployment by Richard Grainger (Director general of NHS IT) who gave a very upbeat summary of progress so far and the likely roll out of further functionality this year. He highlighted both the sucesses and failures of GP computing in providing high functionality but being unable to share it. A key part of his presentation seemed to be that the high profile problems with the system before were often due to local configuration problems rather than the services provided nationally, or had been blown out of proportion by the press. He closed with a recognition that issues around consent mechanisms for the sharing of health records and the “sealed envelope” are likely to be high profile over the next few months – an issue highlighted by the report on E-Health Insider from a session yesterday which suggests that many people, once they are aware of proposals will opt out of having their records shared.

One interesting little procedural problem was highlighted when David Clark (Chief Executive of the BCS) was prevented from entering the auditorium to hear Richard Grainger because of a problem with his badge.

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Conference&Keynotes&Tuesday21 Mar 2006 12:06 pm

Tuesday already; the opening plenary session of the conference featured keynote presentations on the Scottish and Welsh approaches to developing electronic health records, and generally ‘wiring’ the health services in the two countries. As to expected, neither speaker could resist some comparisons with the English approach – and references to rugby.

Dr Kenneth Robertson, Clinical Lead for IM&T for the Scottish Executive Health Department, started the session with a talk titled ‘Making a different difference’, in which he discussed progress and change on some of the developments he talked about last year, as well as talking about some of the vision and how the Scottish approach would achieve it.

Kenneth talked about the Scottish approach being different from CfH, and of the need to temper the idealism of the Scottish vision with a degree of pragmatism. He focused on the Scottish work being aimed at delivery for health, with patients having access to their own EHR, a drive the increase the use of telehealth, and a need to sharpen the focus on real delivery. He mentioned a ‘big 4’set of issues affecting the Scottish approach, ie:

  • keeping the NHS as local as possible;
  • looking after people’s long-term health conditions;
  • reducing the inequalities gap; and
  • actively managing hospital admissions.

He hailed the use of the CHI (Community Health Index) number as a success, and while there is still some variability in usage levels, they are aiming for ‘universal use of the CHI number by 6/6/6’ – hence the title of this post.

One of the main priorities for next stages of work will be around sign-on and authentification, especially related to medicines prescribing.

In discussing how to get to an EHR, he suggested that the market is not yet ready for delivering the full vision that is held for Scotland, with suppliers not in a position to meet needs because of their products being too domain focused and many of the products being immature.

As with last year’s presentation, this was a useful, informative, and well-delivered presentation.

Dr Gwyn Thomas, Programme Director for Informing Healthcare, Wales, discussed the Welsh experience and approach, and examined how the local context of the country is affecting the decisions made. HIs presentation was also informative and well-delivered. He described how the choices made and to be made for Wales are influenced by many aspects of the local context, including the geography and mobility issues around Wales, but suggested that, due to this, many rural communities would seem ripe for development of telehealth applications and services. He stated that context and culture will determine success, rather than the quality of the IT systems.

Gwyn referred to the two major policy documents, ‘Making the connections’ and ‘ Designed for life’, and said that the principles within both documents would be embodies in the Welsh programme. Among the key influencing issues would be:

  • putting citizens (as opposed to consumers) at the centre;
  • working together;
  • making the most of resources; and
  • engaging the workforce.

While he did not make overt comparisons with the English experience, the messages seemed to be there.

In closing, Gwyn said that the Welsh work aimed, in part through clinical leadership and patient involvement, to support the overall care of the individual – the concept of ‘my health, my record’. He suggested that dealing with the issues was ‘complex, not just complicated’, and that complex systems approaches might provide lessons to be considered.

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Keynotes&Monday&Uncategorized20 Mar 2006 12:33 pm

The conference opened with keynote sessions from Charles Hughes (President, BCS), Richard Jeavons (Director of IT service implementation, NHS Connecting for Health), and Kattie Davis (Director of Government IT Profession, e-Government Unit, The Cabinet Office). The common theme was the need for greater professionalism within the IT professions and their key role in the delivery of public sector services.

Perhaps the most significant comments were from Richard Jeavons, after nine months in his post as Director of IT service implementation, NHS C4H, who urged everyone involved to recognise the changes which have taken place in the NHS since Connecting for Health & the National Programme for IT were created. He described plans to move from 80:20 national to local to 20:80 with power and delivery being nearer to patients and local communities. He used sections of the Departement of Health Document Health reform in England: Update and next steps (published in December 2005) as his basis and recomended everyone involved to examine the document and it’s implications.

Generally the speakesrs were strong on positive sounding phrases, but short on implementation on the ground and when challenged, during the questions session, on the way Health Informatics professionals have been treated under Agenda for Change, were unable to give concrete responses beyond saying it needs to be investigated and that it is likely to be very similar in other sectors.


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Conference&Keynotes08 Feb 2006 03:41 pm

The latest version of the HC2006 conference programme is now available on the conference website – see

This contains details of keynote speakers, the programme for each day, and the new ‘Understanding healthcare’ stream.

Keynote speakers include BCS President Charles Hughes, Dr Kenneth Robertson (Clinical Lead for IMI&T Scottish Executive Health Department), Dr David Heatley (Chief Technologist, Pervasive ICT Research Centre, BT Group) and Prof. Reinhold Haux, President-elect of IMIA.

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