Efforts to harness health informatics to improve patient care have been "impeded" by a basic lack of commitment from NHS managers.

This is a central message from the British Computer Society’s Health Informatics Forum in its response to the government’s recent Health Informatics Review.

The HIF finds much to praise in the report, although it says "the devil may be in the detail of the implementation report to be published in the autumn."

But it also says: “Lack of commitment from NHS management at all levels has impeded progress in implementing informatics support for patient care.”

To overcome this, it says that the review’s recommendations to create “credible, capable” chief information officers at board level is a necessary and welcome step. Overall the HIF strongly endorses the proposed package of moves to improve the professionalism, stength and capacity of health informatics.

The review deals with health informatics in broad terms and also makes a number of recommendations about the National Programme for IT in the NHS. In particular, it stresses the need to get benefit from existing systems. This clear message is weclomed by the HIF, which says:

“The statement about ‘Perfection being the enemy of the good’ is absolutely right and we need to review all plans, processes and procedures to ensure they are focused on supporting positive patient outcomes, not intellectually perfect systems which will be ineffectual to work with.”

The HIF also endorses the review’s renewed emphasis on standards, although it encourages building on current processes and “not re-inventing wheels."

The only direct criticism of the review is based on apparent frustration at the failure to utilise the existing body of professional knowledge and experience in health informatics.

“If we were to criticise, it would be that there is little recognition or emphasis on building from experience. As a profession we have extensive experience on the issues and problems of health informatics. We hope this will be used. Too much emphasis on central development sometimes ignores this fund of knowledge.”

In addition the BCS group says it would like to see “more emphasis” on clinical systems. “The Clinical 5 described [in the review as the core clinical functionality needed by trusts now] is fine as far as it goes, but will not have as much impact on patient outcomes as will longer term moves to a full clinical record," it says.


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