IHRIM

Faculty of Clinical Informatics Monthly Newsletter - Issue 5 - September 2018

An introduction from the Faculty Chair:

Over the past month, it has been great to see many of our 44 new Fellows getting involved with one or more of our three Standing Committees (SCs). I would just like to remind everyone that any Fellow is welcome to seek membership of any of these SCs; all it takes is an email.

In recent weeks, the Governance and Representation SC has been doing sterling work with refining Terms of Reference for Council, and all of our various groups; very necessary for any well-regulated, professional organisation.

The Membership group has done some excellent work detailing the different membership categories that the Faculty will shortly be offering. All of this SC work will, of course, be subject to Council approval. If all goes to plan, the way will at last be clear for us to set a definite date and get everything organised for the admission of further member categories after the September Council meeting.

We are picking up the pace and included on the next Council agenda are some exciting opportunities, including enhancing the ability to share information of interest with Fellows and members, and possible Faculty involvement in organising the content of a future informatics event.

Recently, we have been actively seeking meetings to secure funding for our clinical informatics core competencies project, so that we can at last get it underway; the latest signs have been very promising. A series of meetings with a wide range of key individuals and organisations have been also sought out and arranged in coming weeks, with the main aim being to continue to raise the Faculty’s profile and enhance its influence.

Towards the end of August, I attended one of the Topol Review evidence gathering days, which proved to be an interesting experience. Topol is keen to leverage the benefits of genomics, artificial intelligence, and what is termed, ‘digital medicine’. There was a mix of thoughtful views, but also of opinion, that was not necessarily always evidence based. The expectation seems to be that this future will be ‘data-driven,’ but there was a surprising general lack of understanding of the provenance of the data doing that driving, plus its quality, the role of record structures and standards, the difficulties of getting information to flow freely and safely between differing systems, and of much more. There seems to be an important void here that the Faculty should fill. I had an opportunity to ‘plug’ the Faculty and this was well received. I also made some useful contacts and intend to ensure that we follow these up.

The whole question of the regulation of algorithms and ‘AI’ has become very topical. The RCP has already produced a position statement on this, hotly pursued by the government’s, “Code of contact for data-driven health and care technology,” (note that phrase “data-driven”). This provides a questionnaire seeking comments and feedback. We must seize this opportunity to respond so please scroll down to see how you can contribute to this.

- Dr John Williams FRCGP FFCI

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We hope you continue to enjoy this newsletter and please remember it is compiled for your benefit, so please do let us know if you have any items or suggestions for inclusion in future editions.

As part of the newsletter it is our intention to share experience across the spectrum of professions who make up our cohort of members. If you would like to introduce yourself and share the intricacies of your particular speciality with the group, then please get in touch with philippa.murrey@fci.org.uk to be featured as part of our ongoing series of interviews.

Faculty Guest Blog

We're delighted to be launching the first set of guest blogs, on our Faculty website, featuring Anne Cooper, Brendan O'Brien and Maureen Baker, who very kindly agreed to share their thoughts with us.

Each month we will feature a key figure from Clinical Informatics, in health or social care, offering a fresh perspective and insights into the broad spectrum of professionals in what we obviously think is the best career around!

Code of conduct for data-driven health and care technology

The government has released an initial version of a code of conduct for the use of digital technology in health and care. It contains a set of principles that set out what they expect from suppliers of data-driven technologies, and a set of commitments that outline what they will do to support and encourage innovators in this area.

Faculty Standing Committees

As a paid Fellow of the Faculty, you are entitled to join any or all of our three Standing Committees, which are operated through conversations that take place on Google Groups Listservers:

1. Educations and Standards
· Currently chaired by Dr John Williams and Ann Slee.
· Purpose is to provide oversight and guidance on all matters concerning education, training, accreditation and professional standards within clinical informatics in the UK.

2. Governance and Representation
· Currently chaired by Dr Lance Sandle and Dr Paul Campbell.
· Purpose is to develop governance for the Faculty and provide oversight and guidance on governance matters.

3. Membership
· Currently chaired by Dr Alan Hassey and Dr Sarah Slight.
· Purpose is to provide oversight and guidance on all matters concerning the engagement, representation and support for all categories of members within the Faculty.

If you would like to join any of the groups or want to find out more about what is involved, then please get in contact with philippa.murrey@fci.org.uk.

Information about MSc Courses

We are in the process of putting together a list of MSc Courses covering clinical informatics, available across the UK, which we plan to make a resource for those looking to further their career. If you have any information about relevant MSc courses in the UK then please contact philippa.murrey@fci.org.uk.

Partnership with Digital Health Rewired Event

The Faculty is delighted to have partnered with Digital Health for this new two-day conference and one-day exhibition, taking place in March 2019. We will be closely involved in shaping the programme for this exciting new event for health IT leaders and professionals.

Social Media

As the Faculty continues to grow we are expanding our online reach. Be sure to follow us on Twitter, Facebook and LinkedIn, if you haven't already, and do share our posts when you can!

Newsletter Feedback Survey

We hope you have been enjoying the member exclusive newsletter so far? However, we are always open to suggestions and we would like your feedback on which aspects you like and what you may like to see included in the future. The following survey should only take two minutes of your time and we hope it will enable us continue to shape the Faculty communications to suit you.

Meet this month's featured member...Chris Fokke

Chris is one of the few nurses we have as a Founding Fellow at the Faculty who was recently involved in the Fellow selection process. Read on to find out more about his interesting career to date.

If you would like to be featured in future editions then please do get in touch.

First of all, please can you introduce yourself and explain your current role?
I am Chris Fokke, I am a Registered Nurse who originally trained in New Zealand, and I have been working in the UK, in the NHS, since 1989; mainly in neuroscience/intensive care and traumatic brain injury rehabilitation. I also pursued a career in community nursing and my first honours degree was in Community Health Care Studies, working as a district nurse in Oxford. I then became Director of Clinical Practice, in Bath, in a Regional Specialist Hospital (Royal National Hospital for Rheumatic Diseases in Bath), and it was there where I became aware of the importance of clinical informatics.

During that period, I completed an MSc in IT, at the University of the West of England, and in 2009 I decided to change my career from an executive nursing role to a strand of IT and informatics. Utilising and applying both nursing degrees, first I worked as a Clinical Programme Manager, in Basingstoke Hospital, and then, for a further six years, as the Chief Clinical Information Officer (CCIO), in Hampshire Hospitals NHS Foundation Trust, an acute trust.

In the last year, I have been working as a CCIO within Southern Health NHS Foundation Trust, which provides community, learning disability, mental health and integrated specialist services. My role in both settings has been to push the integration of the clinical and IT/informatics function within the organisation, supporting clinicians, managers and executives to achieve this. I like my role best when I am working alongside clinicians who give direct care, making clinical systems and informatics work for them.

What led you to become involved with informatics and where has the journey taken you?
When I was a nursing director, I learnt to understand the importance of clinical systems and clinical informatics, and how this could help clinicians, yet it was difficult to translate clinical user requirements to IT professionals who were not used to the clinical terminology and culture; I decided that the best option would be to join the IT function but maintain my clinical focus at the same time.

The journey has taken me from clinical project management, to rolling out clinical systems into healthcare settings, to helping design, develop, deploy and maintain an in-house electronic patient record (EPR) system. More recently, I have been involved in coordinating the introduction of an Urgent Treatment Centre (UTC) system within Southern Health.

What impact is informatics having on nursing and what future developments would you like to see?
In my seven years as CCIO, it has been consistently proven that the nurses are the ones who embed the clinical systems and make them work. As CCIO, when rolling out a new system, the emphasis is to ensure that all the nurses in the Trust are aware of the rollout, and that they have an opportunity to trial and comment on any system. Or, better still, I would have nurses with an interest in informatics helping to design and work alongside IT developers prior to rolling out new systems or new features.

As a nurse, I would like to see much more emphasis on nursing informatics in nurse education; both pre and post graduate. I see this as fundamental to our nursing profession. I have engaged with many nurses, who were initially very sceptical about nursing informatics but as they became more familiar with the topic, with hands-on experience, they managed to proceed to be shortlisted for national nursing innovation awards.

What has been your proudest moment, as a clinical informatician?
Whilst attending a board meeting, the Clinical Director of the Elective Services informed the group that without my personal and passionate approach, as a CCIO, the newly embedded EPR would not have been successful in the organisation. Until that moment, I had no idea about the impact that I had as a CCIO. It meant that my constant engagements with informatics supporters, and critical friends in the organisation, and my non-defeatist attitude was successful. Having solid support from the clinical executive members of the Board ensured that I could do this, but it was great to have the acknowledgement and recognition at that meeting.

How would you like to see clinical informatics improve interoperability between and within health and social care?
I believe this is quite simple to achieve, since we have the relevant NHS IT protocols already available, e.g. HL7 or FIRR. The problem is that no-one (NHS England or NHS Digital) is mandating that systems should not be procured within the NHS unless they have full interoperability. Without a clear mandate it will be difficult to enforce interoperability; why would vendors put a big emphasis on such development, since it isn’t necessarily in their best interest?

I think it is a shame that we still need to talk about system integration and interoperability so many years down the informatics track, in the NHS. My hope is that NHS England will show some teeth to system providers and enforce the mandate for full interoperability. If they don’t, then the NHS and social care systems will probably not seamlessly integrate, causing duplication and sub-system processes, such as faxing, scanning, and emailing information; all the frustrating methodologies that give clinical systems and informatics its bad press and negative clinical attitude.

How did you first get involved with the Faculty as a Founding Fellow?
Having met Professor John Williams and Ian Carpenter at various national and international events over the last few years, we have stayed in touch and I was delighted when they told me that they were trying to establish the Faculty. I applied to become a Founding Fellow immediately, since I believe it is crucial that clinical informatics is seen as an important clinical component within clinical care and treatment; it needs the emphasis it deserves along with the other clinical faculties. As clinicians, we all know how difficult life becomes when, for whatever reason, the clinical systems are down. The disruption and potential harm to patients’ treatment and care is immense.

How do you see the Faculty making a difference to Clinical Informaticians across the UK?
I would like to see the Faculty as a national and international voice on the topic of clinical informatics. I would also hope that the Faculty membership will comprise of peers who can share innovation and informatics opportunities, and support or coach those who aspire to a career in clinical informatics. As a nurse, I would like to see a greater nursing membership and promotion of the Faculty within the UK nursing faction, such as the Royal College of Nursing and the Nursing and Midwifery Council.

During my experience, I have also realised that the role of CCIO, or being a clinician with an interest in Clinical Informatics, can be quite unique; it is easy to dilute away from being an autonomous practitioner to one who is working in isolation. The Faculty is a key entity for those in these types of roles, being able to provide useful resources, forums, discussion groups and coaching. I, for one, would be keen to support other nurses who aspire to hold a role in nursing informatics, such as, as a Chief Nursing Information Officer (CNIO).

From your years of experience, do you have any nuggets of wisdom to impart?
To me, there are a few golden rules that need to be in place to ensure that I can work effectively and efficiently in clinical informatics. This is my own reflection, and should not be seen as general user requirements:

· It is hugely satisfying working with those who provide direct care and treatment at the clinical interface and making clinical systems work for them.
· As a senior clinician working in clinical informatics, it is important to ensure that you have clinical executive support. Without this, it is difficult to maintain clinical engagement and keep the clinical informatics strategy aligned with the overall organisational strategy.
· As a clinician, it can be great fun to work with IT development team members. I have found it hugely rewarding and fun to work closely with developers, who have no clinical background yet are immensely dedicated and committed to working and developing clinical systems that have a positive impact on patient safety, care and treatment, and make clinicians’ lives easier.
· As a CCIO you need to be prepared to, ‘feel the pain,’ when systems don’t work for clinical staff. This means engaging at the clinical interface, working alongside staff, and sometimes having an uncomfortable time initially. However, this is always offset by the fact that staff appreciate the close clinical engagement, and this usually results in better engagement and designing, and implementation of solutions.
· As a clinical Informatician, you always need to know your subject and be an evangelist for informatics. As CCIO, both in acute or in the community setting, I was usually referred to as either the EPR-man or ‘Jack’ (usually when rolling out an e-prescribing system!).

Upcoming Events

Each month we will endeavour to keep you abreast of any useful events coming up. If you know of any that you think other members will benefit from then please do let us know and we will post them on here at our discretion.

September 2018

25-26 September: UK Health Show

Driven by expert informed opinion, world-class case studies and delivered by the digital leaders transforming the NHS and UK health sector, HETT is for the clinical, IT, informatics and local authority professionals who are stepping up to play their role the digital transformation of the NHS.

On 26 September: 2nd Clinical Informatics Congress will be taking place as part of this event, where Faculty Chair John Williams will be leading two sessions and Kevin Hunt, Faculty Business Manager, will join him for a session.

Please do encourage colleagues to come along to learn more about the Faculty and Clinical Informatics landscape today.

Free

27-28 September: HSJ Integrated Care Summit

The HSJ Integrated Care Summit focuses on breaking down barriers across organisations within the evolving health and social care landscape, to develop truly integrated patient-centred care pathways.

Invitation only through registration

October 2018

7-8 October: Pharmacy Show

The UK's largest integrated pharmacy event, open to pharmacists, managers, pharmacy technicians and members of the pharmacy team. Join pharmacy experts and key opinion leaders, new and existing suppliers and policy makers to keep up with all latest developments, improve patient outcomes and get practical training and advice.

Free

(Entrance to The Pharmacy Show 2018 is restricted to healthcare and allied healthcare industry professionals only.)

11-12 October: The 38th PHCSG Annual Conference, 'Enabling the Virtual Doctor Patient Relationship' and AGM

Healthcare is becoming increasingly dependent on technology and more and more interactions will become digital. What needs to be in place to make this happen and how do we make it work for patients and doctors?

£58.80 – £298.80 (incl. VAT)

17-18 October: Best Practice Show / Best Practice in Nursing

Best Practice offers a stimulating conference programme delivered by healthcare leaders, policymakers and strategists and most importantly - those who are battling to make a difference on the frontline of general practice.

Best Practice in Nursing is the home of nursing at the heart of general practice, running alongside Best Practice – and there are no boundaries between the two events! Combined they offer a fantastic opportunity to bring the primary care community together en masse to focus on the transformation of general practice and its integration into a stronger primary care system.

Free for first 5,000 delegates (£699 after that)

Key Media Stories in August

This section is to highlight some key media stories over the past month that may be of interest.

Multiple IT Systems led to missed warning signs by doctors & social workers in case of murdered toddler Adopted 18-month-old toddler Elsie Scully-Hicks was killed by her adoptive father after a pattern of several warning signs were missed by doctors and social workers handling the case due to multiple IT systems where information was not effectively passed across. Matthew Scully-Hicks received life in prison and no disciplinary action was taken against staff involved.

Electronic implanted devices proven to be hackable with ability to cause death

A pair of security researchers demonstrated their ability to disable an insulin pump and a pace-maker during the Black Hat security conference. Despite this, manufacturers Medtronic will not be fixing the bug but they have advised clinicians to take extra care with networks they connect devices to.

New IT review ordered by Hancock

Matt Hancock has ordered a review of a proposed plan to switch IT systems within health and social care settings to check if a move to G suite software would be more cost effective. The current contract with Atos is drawing to an end and does not focus on G suite.

AI proven to be able to detect eye disease

A study conducted between Moorfields Eye Hospital and Google DeepMind has shown an AI machine to be capable of detecting over 50 eye conditions successfully. It was shown to perform as well as the leading two retina specialists in the world, with a margin of 5.5%.

Funding cut for NHS Digital

More than 600 staff were asked to reapply for their jobs as part of the 'Org2' restructuring process, lead by Sean Walsh. This is to bring more 'cyber-literate' professionals on-board in the face of a emerging technologies, such as AI and cyber security, whilst streamlining staff in the face of funding cuts.

Hancock meets with 10 technology business 'disrupters'

Within days of assuming the position of Secretary of State for Health and Social Care, Matt Hancock met with 10 'disruptive' digital healthcare companies, a majority of which have existed for less than 5 years. The Department of Health only commented to say that it had been an 'introductory' round table.

Restriction on £412m 'technology fund' announced by Matt Hancock

Following the announcement of a £412 'technology fund' during Matt Hancock's inaugural speech, an NHS 'prospectus' was circulated to leaders of sustainability and transformation partnerships (STPs), which informed them that the funds would be released slowly, over a period of time, up until 2020.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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