Credit: NHS Digital

BLOG: Embracing the clinical informatics revolution in healthcare

Dr Raj Kumar, NHS Digital Clinical Director and Responsible Officer, looks at the 'clinical informatics-fuelled' transformation of healthcare.


[Leeds, UK] The role of the frontline clinician has changed significantly over the last 20 years – largely due to the ongoing digital revolution which has transformed the way we use IT to transform the way we practice and deliver healthcare.

Our journey over the last quarter of a century in this area has been a remarkable one. The last quarter through the millennium and after, has been one of the most exciting and progressive periods for clinical informatics-fuelled healthcare transformation.

From my early years as a junior doctor in the early 90s when we, as clinicians, never had to log on to a computer or input data ourselves, we have come a long way, the days of medical secretaries using the computer simply to type letters and data/ audit clerks being the sole dominators of information input in hospitals has changed dramatically.

We now use smartphones, tablets, laptops and desktops on a day-to-day basis inputting data about our care, accessing data about patients, sharing and disseminating data, looking up guidance electronically and using protocols and pathways that are electronically delivered.

Most importantly, we communicate in real time with each other, which is absolutely crucial when it relates to delivering effective and timely care for our patients.

'Knowledge of IT an essential requirement for everyone'

The word 'paper' became a dirty word as we gradually moved to paperless and now almost all communications are digital.

'Faxes' are now rude words to use though they still are present for backups. We have truly come a long way at an accelerated pace in terms of IT-related change for healthcare like never before.

It has moved on even in terms of our knowledge requirements in clinical informatics. In the early years, clinical informatics was a speciality that tended to attract clinicians with a specific interest in IT that would often pull them away from the frontline clinical care services that they were trained to deliver.

Those days of IT geeks are long gone, and the world of clinical informatics is now filled with frontline clinicians who regard knowledge of information technology as an essential requirement for everyone – from all frontline clinicians to clinical leaders across the spectrum of health and social care.

The clinical care frontline has evolved in a manner that supports all staff to have access to safe and high quality data on patients.

Working as a GP in the community, we have district nurses who walk around with iPads/ laptops connected to GP systems, so any time they see a patient, they can simply open up their computer and access most aspects of the current care related data and input into the same in a live manner.

We have social workers who are now gradually starting to share and input relevant data into GP notes, midwives, dietitians, lifestyle advisers, physiotherapists and clinical pharmacists who are able to directly input into notes that can be shared with other clinicians and support staff.

Consultants are now able to manage patients and access their GP notes in some hospitals directly and in all others have access to their Summary Care Records. Their care and input into the patient on discharge is often transmitted as a summary to GP practices and community teams in real time, electronically at the time of discharge.

In most areas, GPs have direct electronic access to hospital-based investigations such as scans and blood results almost as soon as they are undertaken and reported. Almost all of the communication between secondary and primary care twenty years ago would have taken well over a week to reach.

Another significant change to the world of medicine and prescriptions is the development of the Electronic Prescription Service (EPS). This has transformed the way GPs work with real time digital prescriptions reaching chemists near instantly, safely and securely.

Information guidance systems are available to all clinicians and patients through multiple tools that the NHS has created such as patient online, NHS Choices and now the NHS Patient App is set to revolutionise the way patients engage with their GP practices.

The NHS Clinical Informatics Congress

Within NHS Digital we recognise that simply retaining existing legacy systems and being responsible for clinical related data and governing evolving requirements for healthcare alone is not going to sustain an informatics-enabled workforce.

As one of the largest organisations in health informatics, we recognise the fact that we need to not only be a visible leader in this area, but also take the leadership baton in helping to support the ability of clinicians on the frontline to have the knowledge on all aspects of the digital revolution that is currently around us  and also to support clinical leaders to understand future digital solutions that could support their current and future challenges.

To support the above process, NHS Digital runs multiple initiatives, often in partnership with other NHS organisations.

But a key initiative focused firmly on clinicians and the clinical workforce was the first NHS Clinical Informatics Congress last year.

This was led and delivered by clinicians and firmly aimed at frontline clinicians delivering care and clinical leaders who are supporting transformation projects.

The first congress in Manchester was an early success, and this year’s event takes place at the UK Health Show at ExCeL London on September 26.

Prior to last year, people used to ask me the same questions. How can I get into clinical informatics? How can I find out more about developments in NHS Clinical Informatics? What new streams of resources are coming our way? What direction do we need to focus to remain in line with national thinking? Where do I get to know more about Clinical Safety in IT? How does the NHS engage with the rapidly evolving Machine Learning and Artificial Intelligence world that is mostly led by the private sector?

These questions and many more can all be answered at our NHS Clinical Informatics Congress.

BJ-HC is a media partner for the UK Health Show. 

Raj Kumar

NHS Digital Clinical Director & Responsible Officer

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