UK
Contents
NHS (National Health Service)
Undertstanding the NHS clinical informatics context is impossible without learning about its "Connecting for Health" (CfH)programme. Here, after a brief overview of CfH, some of the services and initiatives in the programme are going to be introduced.
Connecting for Health
NHS Connecting for Health is delivering the National Programme for IT to bring modern clinical information systems into the NHS in order to improve patient care and services. Over the next ten years, the National Programme for IT is going to connect over 30,000 GPs in England to almost 300 hospitals and give patients access to their personal health and care information, transforming the way the NHS works.
Choose and Book
The new Electronic Booking Service (Choose and Book) allows GPs and other primary care staff to make initial hospital or clinic outpatient appointments at a convenient time, date and place for patients. When patients need to be referred to a consultant or other healthcare practitioner, they will be asked by their GP where they want the treatment to take place. They will then be able to 'book' the appointment on the spot and leave the surgery with their appointment time and date. If preferred, patients can make their appointment later - after consulting with family carers or colleagues - either on-line or through a telephone booking service. Choose and Book completely changes the way the paper-based referral system currently works. It removes the lengthy wait (often weeks) between visiting the GP and receiving an appointment from a hospital. Choose and Book gives patients choice over when and where they will receive treatment, so improving their experience.
Electronic Prescription Services
NHS Connecting for Health is responsible for introducing an Electronic Prescription Service to which prescribers and dispensers in primary care in England will be connected. By 2007, every GP surgery (for use by the GPs, nurses and other prescribers working from the surgery) and community pharmacy and other dispensers will have access to the service. This service will enable electronic prescriptions to be generated, transmitted and received so that pharmacists and other dispensers can dispense against them. Over time, dispensers will also be able to submit these electronic prescriptions to a reimbursement authority in order to claim payment. In many, and eventually most, cases, electronic prescriptions will replace paper ones.
Quality Management and Analysis System
The Quality Management and Analysis System, known as QMAS, is a new single, national IT system, which gives GP practices and Primary Care Trusts objective evidence and feedback on the quality of care delivered to patients. The system shows how well each practice is doing, measured against national achievement targets detailed in the GMS (General Medical Services) contract, which sets out the way GPs work and the way they are financially rewarded. QMAS allows GP practices to analyse the data they collect about the number of services and the quality of care they deliver, such as maternity services or chronic disease management clinics. This provides a positive incentive for GPs to treat patients in the community rather than referring them to hospital for treatment such as diagnosis or minor operations.
Careers in clinical informatics
The National Health Service (NHS) in the United Kingdom (UK) is the largest employer of health staff. On their NHS careers website - [1] -, they define and describe their view of what clinical informatics is, and the types of job roles available.
In their definition, 'Clinical Informatics (CI) concerns the capture, communication and use of patient data and clinical knowledge by Doctors and other Clinical Professionals and the development and implementation of electronic tools to support the whole cycle of clinical information.'
They describe several types of job roles for clinical informaticians, including administrative roles and roles for clinical professionals.
Clinical informatics in practice
How clinical informatics is seen on the ground, as opposed to its theoretical aspects, can best be assessed from the sorts of descriptions, tasks and functions that different hospitals' Clinical Informatics Departments describe themselves as undertaking.
Clinical Informatics Department, Wrightington, Wigan and Leigh NHS Trust. [2]
The Clinical Informatics department is described as being 'part of the Clinical Support Services division' and covers:
- Access to Health Records
- Clinical Coding and Contracts
- Clinical Effectiveness and Audit
- Clinical Records Library
- Research and Development
- Research Ethics
- Information Governance (Caldicott/Data Protection)
- Trust Web Services
Worcestershire Countywide Information and Communications Technology (ICT) services ([3]) has a Clinical Informatics Team that is primarily set up to support the Health Care Professionals in the county through providing services such as:
- Input data onto the various computer based systems.
- Process the data input on the computer systems.
- Clarify and Rectify data.
- Use data to generate ongoing reports.
- Provide Ad-Hoc reports for Health Care Professionals.
- Support the clinical applications used by Health Care Professionals.
- Work towards the modernisation of Informatics.