Wayne Parslow
Improving patient care versus Information Governance - does something have to Every time we acquire a service we leave forensic evidence. Every time we buy something with a credit card, go past a camera or visit a doctor, a little bit of information is left behind. There is a sea of data out there that is of critical value to us, and those who provide our healthcare.
Almost every aspect of a patient's journey through a clinical procedure is recorded though not, as you might expect, in a single system. Those who we trust with our health have an incomplete picture of us. This is because our data is held across a wide variety of IT systems distributed across many organisations and controlled by multiple information governance (or IG) rules, including primary care, acute care and social care and mental health.
IG exists to provide the laws under which this information may or may not be used and by whom. It is there to protect us from prying eyes – whether their motivation to do so will be to our benefit or not.
When a patient presents in A&E at 3am, drunk and with facial injuries, the A&E staff may not know that this person has a history of violence towards clinical staff. How they can react in the right way?
When an unconscious heart attack victim presents in A&E, how can clinical staff discover whether they are allergic to an enzyme routinely administered in such situations?
These examples show how vital information is held in systems which, through IG rules, clinical staff do not have the right or technical infrastructure to access.
Protecting patient data against unauthorised access is necessary for patient safety
Bringing patient data together from all the potential sources that exist has been a long-term goal for the NHS. The most common wisdom around this has been if you want systems to interoperate, then build a new system. However, the complexity of IG around this "new" system has traditionally stopped this from happening. Protecting patient data against unauthorised access is necessary for patient safety, but it can also make improvements to overall patient care more difficult to deliver.
To meet the needs of clinicians while respecting IG demands interrogation of the workflows around the use of patient data. Rather than building a new system, it's time to look at understanding the scenarios faced by clinicians in the real world so that IG can support the circumstances better.
From an integration point of view, this means getting information out of systems that are in place at the point of care rather than building a new system from scratch. Leaving the data where it is and linking it together based on the context of the situation means that IG considerations could be respected while the appropriate data for the circumstances is also delivered.
What does this mean for the future? Well, the information needed to support critical clinical decisions is already out there, in a system somewhere. Instead of building a new system, we have a National Spine for the transmission of data across the Health ecosystem. We also have state of the art techniques to give us utility based computing and interoperability, so why can't we strive toward a similar goal with the information about our collective wellbeing?
Taking this new approach means that IG will move up a layer, be responsive to circumstantial context and, I believe, will improve the lives of all of us.
Wayne Parslow is general manager, EMEA for Carefx
From Bubb's Blog
From Whitehall Watch
