Making IT work

Title of driver: Making IT work: harnessing the power of health information technology to improve care in England (Wachter review)

Impact on library policy/practice:

Whilst the report focuses on electronic health records (EHRs), there are still areas that may impact on library services.

One of these may be in integration between point-of-care systems such as UpToDate, DynaMed, ClinicalKey or CEBIS, and the electronic patient record, so clinicians have easier access to healthcare library and knowledge resources. It may be necessary to share knowledge about what point-of-care systems work with which EHRs, and how to make it work successfully. Library staff may need to work with the proposed Chief Clinical Information Officers in their Trusts to push for embedding or visibility of library services in the EHR. As well as integration with commercial point-of-care systems, library and knowledge services may want to try to make their literature search or clinical question answering service or similar, easily accessible through the EHR.

Another area may in supporting the digital literacy education of students or staff, something that HEE have been asked to look at developing. Depending on what the plan developed by HEE entails, there might be areas that library and knowledge services can get involved, but this may require library staff to have the necessary training and support themselves.

Source: National Advisory Group on Health Information Technology in England, chaired by clinician and digital expert Professor Robert Wachter

Link to main document
Link to summary version

Publication format: PDF (HTML version also available)

Date of publication: September 2016

Summary of driver:

Making IT Work is concerned with the digitisation of secondary care in England (focusing on the electronic health record). The report lists 10 principles of how to do this effectively, and makes 10 recommendations on how to achieve successful digitisation, along with timescales.

In late 2015, the Secretary of State for Health and the leadership of NHS England asked for the creation of a broadly representative external body: The National Advisory Group on Health Information Technology in England, to advise the Department of Health and the NHS on its efforts to digitise the secondary care system.

In 2016, £4.2 billion was allocated to support the work of digitisation.

A specific action for Health Education England, in collaboration with the Royal Colleges and other relevant bodies, is to develop and begin to implement a plan to raise the level of digital education in all health professional educational settings, including medical, nursing and pharmacy schools, and in continuing education settings for practicing healthcare professionals.

Key features of driver:

There is a useful history of the NPfIT programme, and some history of the US experience in digitising its healthcare system.

The 10 overall finding and principles are:

  1. Digitise for the correct reasons
  2. It is better to get digitisation right than to do it quickly
  3. ‘Return on investment’ from digitisation is not just financial
  4. When it comes to centralisation, the NHS should learn, but not over-learn, the lessons of NPfIT
  5. Interoperability should be built in from the start
  6. While privacy is very important, so too is data sharing
  7. Health IT Systems must embrace user-centered design
  8. Going live with a health IT system is the beginning, not the end
  9. A successful digital strategy must be multifaceted, and requires workforce development
  10. Health IT entails both technical and adaptive change

The 10 recommendations made are:

  1. Carry out a thoughtful long-term national engagement strategy
  2. Appoint and give appropriate authority to a national chief clinical information officer
  3. Develop a workforce of trained clinician-informaticists at the trusts, and give them appropriate resources and authority
  4. Strengthen and grow the CCIO field, others trained in clinical care and informatics, and health IT professionals more generally
  5. Allocate the new national funding to help trusts go digital and achieve maximum benefit from digitisation
  6. While some trusts may need time to prepare to go digital, all trusts should be largely digitised by 2023
  7. Link national funding to a viable local implementation/improvement plan
  8. Organise local/regional learning networks to support implementation and improvement
  9. Ensure interoperability as a core characteristic of the NHS digital ecosystem – to promote clinical care, innovation, and research
  10. A robust independent evaluation of the programme should be supported and acted upon

Primary audience: NHS England, NHS Digital, Care Quality Commission, Senior management of NHS Trusts, senior IT staff.

Date last updated: May 2017

Due for review: May 2018

Group member responsible: JC

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