UKCHIP newsletter June 2013 by UKCHIP

NEWSLETTER JUNE 2013

Welcome to the June Newsletter Big leadership news in England and Wales recently with NHS England boss Sir David Nicholson and Wales CIO Gwyn Thomas both announcing their retirement. Eventual new appointments will be of interest and hopefully influence on the agendas we are all leading and supporting. Elsewhere in this issue you will find an update on what we have been doing since our last publication, but of course between times you can find much of this information on our website and other social media connections. We issued a press release on the recent announcement of (hopefully additional) funding of £260 million for Trusts to spend on electronic record initiatives:£260 million Digital Challenge fund needs help from professional informaticians Borrowing from a number of national news sources UKCHIP notes that both the Health Secretary Jeremy Hunt and NHS England have recently announced a £260 million fund for hospitals to increase their use of e-prescribing and electronic patient records. The „Digital Challenge‟ fund will be used by hospitals to, “replace out-dated paper based systems for patient notes and prescriptions, and is a critical stepping-stone in helping the NHS go digital by 2018”, the Department of Health said. Doctors and nurses are to get better information about patients so people get safer care thanks to the £260 million NHS technology fund, announced by NHS England today. The fund will be available to NHS providers to support the move from paper-based systems for patient notes and prescriptions to integrated electronic care records and the development of e-prescribing and ereferral systems. All acute trusts are expected to get “some money" from this new £260m Digital Challenge fund, but will have to match the investment, NHS England says. UKCHIP as the professional regulation body for Health Informatics supports the initiative especially from the viewpoint of ensuring safer care for patients but would like to emphasise the need for accredited professionals to be involved in all aspects of these increasingly complex initiatives. We would be really interested in your views on how this would best be utilised in the areas that you work in or let us know if you don‟t think this is a step in the right direction. Mik Horswell, UKCHIP Board Chair

Inside this issue

Page

UKCHIP News

EQAS Updates

E-Health Week, Dublin

Events and conferences

Rural Healthcare in India

Travelling Fellowships

Page 2

UKCHIP NEWSLETTER

UKCHIP News Since the last newsletter UKCHIP Board and Council have been involved in a variety of activities including: Writing to Jeremy Hunt and the Health ministers of the UK Countries to stress the importance of high professional standards in health informatics in light of recent reports and negative health stories. Presenting an information stand and workshops on professional standards at HC2013 thanks to all those who stopped by to talk to us. Attending the first meeting with the Academy of Healthcare Sciences (AHCS) and other healthcare science professional bodies, to start agreeing the standards necessary for bodies who wish to come under the AHCS as an umbrella body for accreditation by the Professional Services Authority (PSA). A review of the UKCHIP Code of Conduct, to ensure it is up to date and robust. Testing and collecting feedback on the online registration renewal process, so that it can be improved. The last Council meeting was held on 10th April and the next will be 17th July. If you have any ideas or comments you would like to send to the Council please email secretary@ukchip.net.

Dr Gwyn Thomas to Retire Dr Gwyn Thomas has recently announced his retirement as Chief Information Officer for Wales and Informatics Director for health and social services. The former head of the NHS Information Authority moved back to Wales in 2004 to head up the Informing Healthcare Programme, and subsequently to take on wider responsibilities for IT in the public sector. Dr Thomas developed a very different strategy for NHS IT for Wales to that developed in England, built around developing national IT systems that NHS organisations have been able to adopt in an incremental manner. These have included a new patient administration system for the acute sector, Myrddin, a Welsh Clinical Portal, digital services for GPs, the Individual Health Record, and a patient portal, My Health Online, which is focused on transactional services such as booking GP appointments. In a statement Dr Thomas said: â&#x20AC;&#x153;I intend to carry on promoting the value of informatics to the safe delivery of healthcare and to take advantage of new opportunities to try to continue to make a difference from another vantage point.â&#x20AC;? Dr Thomas has always supported the development of professionalism in health informatics and he has been awarded an honorary chair in the medical school at Swansea University, helping to design and deliver educational programmes to build leadership skills for informatics professionals. Although he will retire from the civil service at the end of August, Dr Thomas will become parttime chair of Health Data Insight, a community interest company aiming to make healthcare information more accessible and understandable, to drive better decision making in health and social care. UKCHIP would like to thank Gwyn for his consistently constructive support and offer every best wish for the future.

JUNE 2013

Page 3

eHealth Week, Dublin 2013 – spoilt for choice The recent (13-15 May) eHealth event in Dublin managed to combine a multiple stream conference and an extensive exhibition with EU:US eHealth Cooperation, a very successful eHealth Marketplace, a Ministerial eHealth High Level Conference, significant numbers of specialist project and programme meetings and specific Health Informatics Society presentations. The Irish Convention Centre on the quayside was well-served by transport and its facilities for delegates and speakers were excellent; from plenary to small working group locations. The event was held during the Irish Presidency of the EU, so had considerable ministerial/ high level presence throughout the event from the island of Ireland (including the Taoiseach (Prime Minister)), the European Commission and from the US, mainly Massachusetts with which Ireland has close and effective health links. Key points arising from the Irish Presidency – facilitated Declaration on eHealth captured the key threads of the event, attended by over 2000 people. The Declaration, launched by James Reilly, Irish Minister of Health, „aimed at prioritising the use of ICT in health among Member States to contribute to better safer, sustainable and innovative healthcare systems for all European citizens‟ (http://www.dohc.ie/issues/eHealth/eHealth_Irish_Presidency_Declaration.pdf?direct=1) Additionally, the EU:US activities further developed themes of both technical interoperability and workforce professionalism. Future joint working will deploy what Moshtashari /Friedsmani (US) described as a „low regret‟ strategy, involving both experiential adoption and sharing / cross-mapping of counterpart contributory actions from both EU and US. Of particular interest to UKCHIP, presentations of workforce issues identified potential partners and interested parties in the US, and a number of EU countries and multi-national projects. As could have been expected, despite weather that went from hail to bright sunlight, the hospitality in Dublin was superb, and knowledge of eH/ health informatics was greatly enhanced by attendance and by subsequent interactions. Jean Roberts, UKCHIP Director (Standards), EU eHealth Stakeholders Group (workforce issues lead ).

JUNE 2013

Page 4

Sustainable 24/7 Rural Healthcare with Eco Conservation Dr.D. Lavanian, Chair HL7 – India and CEO, HCit Consultant, ceo@hcitconsultant.com Provision of healthcare to the rural population in India continues to face multiple challenges. Use of information technologies like telemedicine and telehealth have addressed only part of the problem. This paper puts forward an ecofriendly plan to provide low-cost, 24/7, preventive and primary healthcare in the rural environs using Tele-touch©. This primary care plan would examine, investigate, diagnose, provide medication and follow-up rural patients for 1 to 3 days at an average cost of around US$ 1.10 per patient. India is the 2nd most populous country in the world with a population of 1.2 billion [1]. Of this, the rural population stands at 0.863 billion [2] (2012), which works out to 71.9% of the total population. A study has quoted that “About 60 per cent of India's rural population lives on less than Rs 35(US$ 0.64) a day” [3]. Though governmental healthcare support is available in rural areas, the rural population tends to travel to and visit private hospitals in towns nearby, because of lack of facilities in governmental health centers. WRT the government, Sub Centres (SC) are the first contact point between health workers and the village community. (National norms of population coverage: 5000 in plain area and 3000 in hilly / tribal area). The first level of contact with a medical officer occurs at a PHC (Primary Health Center). There are, as of date around 23,887 PHCs [4] to cover 0.863 billion which translates approximately to a doctor:patient ratio of 1: 36,128. Incidentally, India‟s official doctor:patient ratio is approximately 1:2000! [6] To make things worse, many of these centers are defunct to the extent that the Supreme Court had to bring up this point to the notice of the government. “In a strong indictment of the country's rural healthcare infrastructure, the Supreme Court on Wednesday said that primary health centres (PHCs), conceived as the pillar of the system providing medical care in the countryside, had become totally defunct. ''In rural areas, there are no doctors. They (PHCs) are functioning only on paper. There is no facility at PHCs. Hospitals function without any doctor,'' a bench comprising Chief Justice K G Balakrishnan and Justices Ashok Bhan and P Sathasivam, said.” [5] Innovative solutions like telemedicine, telehealth, mobile vans and periodic camps have been and are being deployed, but fall short of providing effective around-the-clock (24/7) care. These innovations either provide face-to-face health care sporadically, or provide remote advice and support, on a fixed timetable. What is desirable is an out of the box solution that could provide an acceptable quality of preventive and primary care, around the clock, to villages and small hamlets free of cost or at very low rates. The solution would also need to work without cabled power. Further, it would need to be accountable and auditable for the quality of care provided. A business plan, to run this project on private entrepreneurship, would be nice to have, as it could help replicate the solution all over India.

UKCHIP NEWSLETTER

Page 5

The Program Essentially, complex plans and technologies are irrelevant from a patient‟s point of view. All he wants is quick access to reliable medicare at times of need and to be provided trustworthy advice and medications towards a cure. Nothing else matters to him. We therefore, spent around two years working on various aspects to put together a plan named „Telemed-Touch©‟, that is based on patients needs, keeping in view local constraints and sensibilities. We now present to the reader, salient points of an innovative pilot that would prove on the ground, the capabilities of Telemed-Touch©. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

The project would be run across around 100 villages covering a total population of approximately 250,000 It would cover preventive and primary care and referrals for secondary and tertiary care It would provide for examination, triage, provisional diagnosis, care instructions, clinical advice, medications and follow up of patients Each Medicare center (MCC) would be accessible 24 hours a day Clinical data would be collated and available in near-real-time for analysis The above data would be used, in future phases, for geographical disease forecast and clinical decision support The MCC would also support the government during natural disasters and for broadcast of instructions The center would run on solar power and create jobs locally Healthcare IT applications would use subsets of internationally accepted vocabularies and standards and be HL7 compliant, to ensure interoperability The program would be cost-conscious and could run either on governmental support, or as a commercial, for-profit model Program details

Telemed-Touch© is a unique program that is a symbiosis of the healthcare person‟s caring touch and cutting-edge healthcare technology. It is a new paradigm that utilizes force multiplier strategies to create a hybrid healthcare model to ensure: 24/7 availability of quality healthcare end-to-end ownership with accountability and a judicious mix of revenue generators to ensure excitement for private equity and partners How it works: Men / women would be carefully selected from each village, trained and placed on duty to provide support to patients visiting them at any time. We call them DEvTAs (Doctor validated and trained assistants). They would be provided with the RMedpacs©, a package that would contain low cost diagnostic instruments, training documentation, IT devices, solar power generator(s) and medication. DEvTAs would be trained to enquire for symptoms, test for clinical signs like icterus, pallor, abdominal tenderness, dehydration, etc and measure respiratory rate, pulse BP, etc. The mode of communications would be a low cost camera mobile phone/tablet, which would run on 2G connectivity. App(s) placed in the device would permit transfer of the patient complaints, vitals and clinical data to a central telemedicine advisory center. Each patient would be given a unique ID and the DEvTA would be paid an incentive for each patient seen. A telemedicine call center would be set up at a central city, with requisite triage, emr, and related applications. This center would be manned 24/7 by call takers, nurses and clinicians. DEvTAs would call up this center and interact with the patient on behalf of the medical staff. He would (Continued on page 6)

JUNE 2013

Page 6

Sustainable 24/7 Rural Healthcare with Eco Conservation (Cont.) (Continued from page 5)

essentially be the eyes, ears and hands of the remote medical staff. Based on these findings and interactions, the patient would be triaged (fig.1) followed by provision of advice and care. The patient would, where relevant. be given 1 to 3 days of medication (oral bioactive generics) (as per need) and asked to return for a review. On review, if the patient is found to have recovered, the case would be closed. In case the patient requires care in a hospital, he would be advised so and given medication to support him during transit. The patient would be charged, for the complete cycle of care (not exceeding 3 days) a rate averaging Rs 60 (US$ 1.10) per episode. Expected results and present status The pilot is expected to run for 2 years during which mid course changes could be made, if found necessary, for improving the program. Based on the results the proposal is to expand to 500 then 5,000 villages over 5 years by which time the program would become self sustaining and profitable. Detailed plans and commercials for the pilot are ready, awaiting funds from any national or international donor agency. References 1. http://populationcommission.nic.in/content/932_1_TablesMapsAndBarCharts.aspx 2. http://indiawater.gov.in/imisreports/Reports/BasicInformation/rpt_RWS_RuralPopulation_S.aspx?Rep=0&RP=Y 3. http://timesofindia.indiatimes.com/business/india-business/60-per-cent-of-Indias-rural-population-lives-on-lessthan-Rs-35-a-day/articleshow/12981727.cms 4. http://www.data.gov.in/access-point-download-count?url=http://www.data.gov.in/system%2Ffiles% 2FNumber_Of_SCs_PHCs_CHCs_During_Five_Year_Plans-1.xls&nid=4665 5. http://articles.timesofindia.indiatimes.com/2008-10-02/india/27941854_1_phcs-rural-healthcare-health-ministry 6. http://pib.nic.in/newsite/PrintRelease.aspx?relid=77859

UKCHIP NEWSLETTER

Page 7

UKCHIP EQAS Updates New Pathways for Swansea University’s MSc in Health Informatics Recent changes in the MSc in health informatics make it an even more attractive prospect for anyone wishing to pursue a degree in this dynamic and exciting field. The course has recently undergone revalidation, and can now offer several new pathways prospective and current students. In addition, the relocation of the course to the Centre for the Improvement of Population Health through e-Records Research (CIPHER) within the College of Medicine, has maximised student opportunities for easier access to secure, anonymised health data for research purposes. Assessment methods have also been changed, and can now include practical tasks such as the creation of an intranet site or personal contributions to an academic online debate, as well as the more traditional academic assignment writing tasks. The options now available are as follows: Option 1 – The Research Pathway Option 2 – The Data Analysis Pathway Option 3 – The Project Management Pathway

The course is available as either one year full time study, or three years part time. Attendance requirements are minimum – each module requires only one week attendance at Swansea. Applications are welcomed from those with a relevant bachelors degree in a related subject and also non graduates with relevant work experience, and who can demonstrate experience and an understanding of health informatics. The MSc in Health Informatics, which is fully accredited under the UKCHIP EQAS, also offers students a chance to apply for free affiliate membership of UKCHIP on successful completion of the degree. To find out more please contact the Programme Director, Tony Paget on a.m.paget@swansea.ac.uk or tel 01792 602874.

eICE Health Informatics e-Learning gets an Update This free e-learning course, hosted by the Health and Social Care Information Centre, aims to provide an introduction to informatics for clinicians and clinical students, and now has updated content, assessments and new features for organisation administrators. The course consists of six modules; Information Governance, Information Sharing in the NHS, The Importance of Good Clinical Record Keeping, Clinical Coding and Terminology, Clinical Information Systems and eHealth: the future direction. Anyone can sign up to use the modules, and organisations, such as universities, can also be set up so that their students register under their course and are administered by the university. The e-learning is accredited by UKCHIP EQAS and has been endorsed by a number of clinical professional bodies. The e-learning can be accessed at www.cln.nhs.uk/eice or contact the team at eice@hscic.gov.uk.

UKCHIP NEWSLETTER

Page 8

Events and Conferences Healthcare Conferences UK hold a number of healthcare informatics conferences for those working in or with an interest in healthcare IT and developing electronic systems to support quality, efficiency and the secure management of electronic records in the drive to deliver a paperless NHS by 2018. A 20% discount is available to UKCHIP contacts by quoting ref: hcuk20UKCHIP when booking. (*Cannot be used in conjunction with any other offer.) Forthcoming events include: Quality Accounts Wednesday 5th June 2013, London Measuring, Monitoring and Acting on Patient Experience Feedback Tuesday 11th June 2013, London Electronic Document Management in Healthcare Wednesday 26th June 2013, London Electronic Prescribing in Hospitals Wednesday 3rd July 2013, Manchester You can book online via the links above or email your details to kerry@healthcareconferencesuk.co.uk. www.healthcareconferencesuk.co.uk

Imprivata’s 2013 UK Workshops ‘Delivering the Promise of Enabling Healthcare Securely for Clinicians' Following last year‟s popular roadshow events we are pleased to announce two further events in June. We are also delighted that our Guest Speakers for this event will be Neil Darvill, Director of Informatics and David McKee, Assistant Director of IT from St Helens Health Informatics Service (HIS), and Dr Peter Williams, Clinical Director for Acute Medicine at Whiston Hospital (25th June only). North of England: Tuesday 25th June – Whiston Hospital South of England: Thursday 27th June – Imprivata Uxbridge We bring these events to you in partnership with our key NHS Partner – BMS These 2 Workshops, will showcase how St Helens HIS, in seeking to make efficiency savings through the innovative use of technologies, and ultimately to improve the quality of service that clinicians can provide to their patients, have utilised the Imprivata Single Sign-On and Authentication Management solution to actively improve the speed and ease of accessing data across primary, secondary and community environments whilst simultaneously improving security. This event is for Clinical, CCIO and ICT professionals who want to understand how it is possible to deliver “Instant Access” to patient information from anywhere; thereby maximising clinical efficiency, improving patient safety and ultimately delivering better patient care. For more information and to book a place please contact Paul Morgan on mobile: 07974 820203 (best number) or office: 01172 232172 or email paul.morgan@estratevents.com.

Advanced Analysis of Linked Health Data, Swansea University, 1 – 5 July 2013 The Health Information Research Unit (HIRU) in association with the Centre for the Improvement of Population Health through E-health Research (CIPHER) is hosting a prestigious 5-day training course on the analysis of linked health data. The course is entitled Advanced Analysis of Linked Health Data, and it will be held at Swansea University from Monday 1st to Friday 5th July 2013. This course is ideal for health and social care researchers, social scientists, clinical practitioners and health care managers who wish to build on their pre-existing theoretical knowledge and skills in the analysis of linked health data. Please visit the website for further information and details of how to register. http://www.linkedhealthdata.swansea.ac.uk/training.html

JUNE 2013

Page 9

Southern Institute for Health Informatics 2013 11th September, University of Portsmouth The conference theme is the challenging question: "From 'Big Data' to Collective Wisdom?" Speakers will include: * Professor Jonathan Kay, Chief Clinical Information Officer, NHS England * Dame Julie Moore, Chief Executive, University Hospitals Birmingham NHS Foundation Trust * Professor Jonathan Montgomery, Chair, Health Research Authority * Professor John Williams, Director of the Health Informatics Unit, Royal College of Physicians of London * Dr Justin Whatling, Chair, BCS Health Executive The programme will address a range of topics related to how information can change practice and culture in health and social care. Why is there such tolerance of unsafe processes in the NHS? Will information transparency help to break down a bullying culture where it persists? Why is there still such an information gulf between care sectors? Can operational care data reliably guide individual patient management and service commissioning? Is the latest 'paperless NHS' aspiration achievable and, if so, how? Online booking will be available soon. If you would like to register your interest early please feel free to

EMIS National User Group 20th Annual Conference 2013 2nd - 4th October 2013 East Midland Conference Centre The 2013 EMIS National User Group Conference is set to be the biggest yet. Now in its 20th year and building on the success of last year's conference, the EMIS National User Group Conference 2013 will enable both healthcare professionals and EMIS users to learn about current developments and share best practice, whilst providing an excellent opportunity for people to network at a well-established conference within the industry. See the website for more details. Now in its third year, the Healthcare Efficiency Through Technology Expo has established itself as the must-attend event for everyone involved in NHS reforms and healthcare efficiency and technology. It is free-to-attend for everyone from the NHS and wider public sector. It is the only event of its kind, dedicated to helping healthcare professionals deliver more efficient and effective services which ultimately enable better patient care and outcomes. For more details see www.healthcareefficiencythroughtechnologyexpo.co.uk

UK Health Informatics Forum Bristol, 5th December 2013 Reducing Health Delivery Costs through Implementation of ICTs The UK Health Informatics Forum is very different to larger exhibitions and conferences, the combination of limiting the numbers to 100 delegates with the unique structure and format of the Forum allows Health Experts real quality one-on-one time with the most influential Government, Public and Private Sector Officials in the Health industry. There are no booths or sales presentations, the focus of the Forum is to put decision makers together who have a common interest, to improve transparency between stakeholders and importantly allow time to explore opportunities to improve service delivery to the citizen. For an event brochure, please contact Lizzie Morgan - Event Manager, t. +441172 232172 or e. lizzie.morgan@estratevents.com

Working to create a credible and valued health informatics profession

UKCHIP is the regulatory body for health informatics

Contact us: Mik Horswell marketing@ukchip.net Di Bullman registrar@ukchip.net Tel: 0113 397 4384 Helen Davies admin@ukchip.net Tel: 0844 870 7902 Write to us at: P.O. Box 66 Usk NP15 9AJ Registered in England & Wales, No. 4771281

professionals, established to promote professionalism in health informatics. We are a non-profit making independent organisation. We publish an online register of health informatics professionals who meet our clearly defined standards of competence and agree to work to a professional code of conduct. Registration is open to anyone currently working in health informatics regardless of sector. This includes; the NHS, the private health care sector, commercial suppliers to the NHS, academic institutions, social enterprise organisations or the voluntary sector.

Visit the UKCHIP website: www.ukchip.org Online registration

Free online self-assessment

Development Opportunities

Events