The essential importance of involving frontline clinicians in the evolution of their workplace information systems is underlined this week in a British Medical Journal editorial.
Writing about the evolution of the national data spine, Dr Nick Booth from the Centre for Health Services Research at Newcastle University, says: “So far the new team running the national health technology programme has proved pragmatic and effective, and the reality of NHS-wide clinical record technology is closer than ever.
”But involving front line clinicians in the evolution of their workplace information systems is essential. If safeguards to confidentiality and accuracy of patient information prove insufficient, then both patients and the caring professions will not use the spine and the money will have been wasted.”
After outlining the background to the £2.3bn National Programme for IT in the NHS and the national data spine at the heart of it, Dr Booth points out: “Few clinicians have played any part in planning the spine. Populating it with appropriate and accurate information will not be straightforward.”
He weighs up the advantages the information spine can bring – as a valuable clinical resource and means of eliminating errors and duplication – against the risk of confidential, patient-identifiable material falling into unauthorised hands and the problems resulting from inaccuracy, misinterpretation and omission of information.
In single entities such as GP surgeries and hospitals responsibility for handling data can be defined and managed, but, asks Dr Booth: “When information moves beyond one organisation to a ‘wider health space’ who is responsible for its integrity, veracity, attribution and distribution?”
In theory an appropriate and effective information infrastructure has much to offer, he says, but it needs to be provided in the context of local multi-disciplinary teams involved in the care of patients in complex care pathways, tailored to local facilities and resources.