Tuesday, November 24, 2009

Evaluating eHealth: How to make evaluation more methodologically robust

Evaluating eHealth: How to make evaluation more methodologically robust is a new paper just published by the Open Access Public Library of Science.

The authors point out the necessity for evaluation of eHealth computer systems and the difficulties such evaluation will encounter. "There is a consensus about the evaluation of clinical treatments, such as drugs, in which randomized control trials are state of the art," they say. "No such consensus exists yet for the evaluation of highly complex service interventions such as computer systems." The authors conclude that "multiple methods research" is necessary for eHealth systems evaluation: "Research commissioners and research teams need to recognize the importance of undertaking combined quantitative and qualitative work when evaluating IT systems."

It fits beautifully with the paper I'm currently writing for my DPhil and contains clear and logical arguments about some of the socio-technical approaches needed within NPfIT.

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Wednesday, March 11, 2009

RCN conference - Moving technology into practice

Today I've had a "Day in the Bay" - the subtitle of the Royal College of Nursing's Conference "Moving technology into practice" - and the bay in question was Cardiff Bay as the conference was at the Wales Millenium Centre - an impressive venue I'd not visited before.

The day was opened by Tina Donnell the Director of RCN Wales. She dealt with housekeeping issues and then described her impressions and experiences with ehealth - particularly related to the use of telecare functions will serving with the territorial army. She focused the audience on developments in Wales particularly the work of Informing Healthcare and the growing emphasis on nurse involvement in these developments at all levels. Identified timelines for development and the need for technology to support the "management imperatives" were stressed, and on a wider, UK, basis ehealth has been adopted as one of 7 professional priorities identified in the RCNs 2008-09 strategy.

Dame June Clark then took the podium to introduce the first keynote speaker Norma M. Lang from the University of Wisconsin, Milwaukee, who took for the title of her presentation "From patient data to nursing knowledge for nursing practice. She described she and her colleagues/team have been doing in the US in identifying from a range of strategic documents key practice standards or phenomena of concern for nurses and nursing and identifying the process for developing and embedding actionable nursing knowledge within clinical information systems. She set these out as her vision for the future.

After a good networking opportunity over a cop of coffee the next speaker was David Baker from the Association of Nursing Students who presented the results of a survey of student preparedness for ehealth and the Oct 2008 workshop held to discuss these and develop an action plan for the RCN as reported on this blog as: RCN workshop - getting eHealth into pre-reg education. The survey results and workshop report are now available online. The lack of students passwords for clinical systems which encourage the sharing of passwords caused most discussion in the subsequent question and answer session.

A second David followed - this time David Lloyd from Bangor university, who described the welsh context for ehealth developments and highlighted a range of issues about the sharing of patient records, particularly patients who may receive treatment in both England and Wales where different electronic records systems are being deployed which may not be able to share data. He then went on to set out the principles of the Model of Nursing Information first set out by Rodney Hughes and explored the concepts of maximum and minimum nursing data sets. Some of the important issues for consideration which are raised by these approaches were then explored. Pauline Tang from Cardiff University then picked up the threads and explored some of their significance for education and practice.

The final keynote was by Peter Carter the Chief Executive and General Secretary of the RCN. He emphasised the importance of developing quality measures relating to nursing, collecting the information to analyse them and then using them to improve patient care. There was a close similarity between the indicators he identified and those discussed previously which are being used in the US and were described in Norma Lang's presentation. He argued, as had many in the audience that senior level nursing input was vital and was proud of being instrumental in getting a nursing director into Connecting for Health and discussed the implications of the impending arrival of the Care Quality Commission replacing the previously separate regulators for health and social care. He used a humorous story to illustrate the importance of practitioners rather than "techies" being the ones to specify, refine and implement clinical systems.

The formal conference was closed by June Clark who tried to summarise the key messages from the day. Ehealth is not for the future nut is for now and that we (nurses, nursing & the RCN) are not ready. She touched on the coming "nursing metrics" and the importance of nurses taking responsibility for using knowledge systems to underpin their decision making.

After the close of the formal conference delegates were invited to a reception in the Senedd, the home of the National Assembly for Wales, hosted by Lord Dafydd Elis-Thomas the presiding officer of the Assembly, who welcomed delegates in Welsh (translation provided) and highlighted recent developments in the Welsh NHS and the inclusion of nurses on important strategic bodies. Brief comments were also made by Peter Carter and June Clark who also presented Norma Lang with a Welsh Love Spoon.

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Tuesday, March 03, 2009

RCN advertising for an eHealth Nurse Adviser

The Royal College of Nursing is currently advertising for an eHealth Nurse Adviser.

The remit is to influence UK policy and practice now and in the future in the area of eHealth, and support and engage nursing staff in this agenda. Advising and representing them on eHealth issues, you will form collaborative eHealth partnerships, embed eHealth across the RCN, engage and support members with regards to eHealth including working with our Information in Nursing Group, and manage our eHealth web content. A background in and enthusiasm for eHealth to ensure that it plays a significant part in nursing care in the future is a must.

They are offering £45,336 p.a. pro rata (outside London), £48,336 p.a. pro rata (London based) inc. of Inner London Weighting, with the location negotiable/to be agreed. Applications need to be in by the 20th March.

The job or secondment is for up to 21 hours per week days to be agreed

Further information is available from or by contacting Jackie Cheeseborough [Jackie.Cheeseborough@RCN.ORG.UK] or tel +44 (0)20 7647 3616.

If I wasn't busy doing other things I might have considered applying.

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Monday, October 13, 2008

Conference - Moving technology into practice

The Royal College of Nursing is organising entitled "Moving technology into practice: A day on the Bay" to be held in Cardiff on Weds 11th March 2009.

The Keynote speaker will be Dr Norma Lang, PhD, RN, FAAN, FRCN, Aurora Distinguished Professor of Health Care, Quality and Informatics, University of Wisconsin Milwaukee College of Nursing; Professor and Dean Emeritus, University of Pennsylvania School of Nursing.

Norma is an internationally renowned expert in establishing methods to measure nursing quality and a pioneer in the field of quality assurance in nursing. Her nursing quality model has been adopted in the United States, Canada, Australia and the UK. Dr Lang also led the development of ICNP, the ground-breaking international classification system that serves as a common tool to describe and compare nursing practice.

The day will be chaired by Tina Donnelly, Director, RCN Wales and Professor Dame June Clark, DBE, FRCN, Professor Emeritus, Swansea University

The supporting sessions include:
* Getting e-health into pre-registration education
David Baker, Representative of the Association of Nursing Students
* Linking nursing clinical decision making with e-health
David Lloyd, Lecturer, Bangor University or Pauline Tang, Lecturer, Cardiff University (representing a group of nurse lecturers from North Wales)

The closing session will be by Dr Peter Carter, OBE, Chief Executive and General Secretary, Royal College of Nursing Reception

The conference will be followed by a reception hosted by Lord Dafydd Elis-Thomas AM.

Booking forms and further details are available from:
or email:

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Monday, September 29, 2008

RCN advertising for a E-Health Nurse Adviser

The Royal College of Nursing is currently advertising for an E-Health Nurse Adviser.

They are offering £48,336 per annum pro rata (Including London Weighting) for the Part-time, 21 hours per week post

This role is permanent but secondments for one year in the first instance will be also be considered Flexible UK base.

Leading this UK-wide specialty, you’ll influence and shape policy and practice in eHealth, one of the most exciting developments in nursing practice for many years. You will champion the benefits and opportunities presented by new technology, advising government on its impact and engaging nursing professionals with its possibilities.

This is a high-profile role for a qualified nurse that demands a sound practical understanding of information governance and the use of digital information and communications technology within nursing practice and its potential for improving service delivery and patient care. This is also very much a communicating and influencing role, for which excellent interpersonal skills are a must.

If I hadn't already got a full time + post myself I would be applying for it - but if you are interested take a look at: and get your application in by the closing date of 16th October 2008.

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Friday, August 22, 2008

eHealth Canada

It is always interesting to compare eHealth developments around the world, and a recent report from Ontario caught my eye, particularly as i shall be in Canada in 2 weeks for the Medicine 2.0 conference for which the final programme has just been released.

In Ontario their Smart System's for Health Agency (SSHA) has undertaken a range of new initiatives, in their province-wide information technology infrastructure.

These include:

* 63,295 new ONE Mail users, 15% above target, added at 58 organizations for a total of 116,739 accounts province-wide

* 1,541 new ONE Network sites added for a total of 7,213 sites connected

* 60 per cent of Network Refresh Project sites transitioned to SSHA’s upgraded network, significantly expanding current and future bandwidth requirements, while also improving reliability, security, privacy and overall quality of ONE Network

* 2 complex initiatives, Ontario Laboratories Information System and Enterprise Master Patient Index, transitioned to SSHA for ongoing application maintenance.

It would be interesting to see how these developments are affecting front line care, and if any readers from the area would like to comment please let me know.

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Thursday, May 01, 2008

RCN vacancy for e-Health Nurse Adviser

The Royal College of Nursing (RCN) has today advertised for an e-Health Nurse Adviser.

The advert says "This is an opportunity to influence policy and practice in the area of e- Health and to support and engage nursing staff in it. You will participate in UK government and international initiatives and build the RCN’s profile in relation to e-Health issues."

Further details & application form can be obtained by putting in the reference number: NU0210/0508 at

I will be interested to see who is appointed to this role and whether this changes the RCNs position or actions on e-Health.

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Thursday, November 01, 2007

professional issues in e-health - report

Bournemouth University, School of Health and Social Care, Centre for Practice Development have recently published a report on "An investigation of the emergent professional issues experienced by nurses when working in an e-health environment", which was produced in collaboration with Information in Nursing Forum at the Royal College of Nursing.

It provides a useful snap shot of the British nurses about ehealth and the gap between the vision presented and the experiences of frontline nurses, and has implications for management, education and practice.

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Wednesday, September 19, 2007

Doing IT – Learning from one another

The Royal College of Nursing, British Computer Society Nursing Specialist group and eHealth Nursing Wales will be holding a joint conference entitled Doing IT – Learning from one another on Wednesday 14th November 2007 at Ty Maeth, The Heath, Cardiff.

The programme includes:

*10.30-10.45 Opening: Chair: Dame June Clark
*10.45- 12.15 Using IT to improve patient safety
*10.45 - 11.15 Wales Dr Gwyn Thomas, Director, Informing Healthcare
*11.15 – 11.45 Scotland Heather Strachan, Nurse and AHP lead, Scottish Executive
*11.45 - 12. 00 Northern Ireland (Speaker to be confirmed)
*12.15 – 12.30 England Barbara Stuttle, Nurse lead, Connecting for Health
*12.30 -1.00 Panel: What can we learn from one another?

*1.30- 1.35 Chair: Richard Hayward
*1.35 – 1.45 Where do we want to be? Janette Bennett
*1.45- 3.45 How do we get there?
*1.45-2.10 Education, education, education Carol Bond
*2.10-2.30 Thinking Nursing Dave Lloyd
*2.30-2.50 Engaging front line nurses Bernice Baker
*2.50-3.10 The TIGER initiative Paula Procter
*3.10-3.45 Panel

Further details and application forms are available from:

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Friday, August 24, 2007

Medinfo Day 5

The final day of the conference started with plenaries presenting the state of ehealth development in 3 different countries. Sarah Cramer (Cancer Care, Canada) described the developments in her country with an emphasis on Ontario. She talked about a risk averse political system that introduced change driven by concerns about access and waiting times. They set out from a very low IT base an established a unique patient identifier as the first step towards enhanced information sharing. She listed the key sucess factors and outlined future implementation plans.

Ian Reinecke (CEO National E-Health Transition Authority, Australia) described the reasons for a national approach to support interoperability, infrastructure and good governance related to privacy and confidentiality. He described the work programs being undertaken, including the adoption of SNOMED CT, and how the ehealth agenda was needed for clinical process reform.

The third presentation provided a similar overview of developments in New Zealand.
Francois-Andre Allaert
After coffee I attended a couple of papers relating to secure data transmission. The first, by Francois-Andre Allaert set out proposals in France for a unique health identifier, interopable at a European level. He highlighted issues of data protection and confidentiality and listed the key faetures as being: content free, longevity, permanence, unambiguous and unique, public and irreversible. He described the one way "Hash Coding" of the social security number, name and date of birth to enable secure tranmission of non identifiable data for epidemiological research. This session produced the longest Question and answer session I've seen at the whole conference with issues around the hash algorithm and different formats being interspersed with social issues around immigrants, name changes due to marriage etc.
Michael Spritzer
The second paper was by Michael Spritzer from Germany who talked about a DICOM supported teleradiology system and the approaches taken to separating the content (xray and CT images) from patient identification information which is only recombined within the secure web browser of authorised users.

Ken RubinThe final closing ceremonies opened with a presentation by Ken Rubin (Chief Healthcare architect - EDS) who was given the unenviable task of summarising lessons from the conference. He admitted this was beyond his abilities and carried on to give his prepared presentation outlining "What is a sustainable system and what does it mean for healthcare".

Jan van BemmelNancy Lorenzi presented the IMIA Award of Excellence to Jan van Bemmel who gave his presentation reflections on curiosity in which he covered the history of astronomy and knowledge, using quotes from Einstein to explore the meaning of science and research with several nods to religion.

The ceremony included lots of "Thanks to..." comments and Charles Saffrin presented the awards for best paper, poster etc with sponsorship from Pen Computing.

Nancy then handed over the presidency to Reinhold Haux who described the IMIA-WHO communique signed this week and the IMIA strategic aims for the next 3 years of his presidency (including a ?planned? slip replacing humility with humidity - which got a laugh after a wet week in Brisbane). He also gave a plug for MIE2008 in Goteburg.

Medinfo2010 teamThe final actions were to "handover the gavel" to the team who will be running Medinfo 2010, in cape town. There was then a short opportunity to say farewell from the convention centre to friends and colleagues new and old, before people started departing to get various flights all over the world.

I hope to post a final piece with my reflections on Medinfo but it may not be until I get back to the UK.

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