HC04 Logo

HC 2004

Healthcare Computing Conference

Harrogate 22-24 March 2004

A personal review by Rod Ward

HC04 Logo

These reports are written on the fly during the conference and posted on the web on a daily(ish) basis, as there are 5 concurrent themes I can not attend all sessions so these comments are based on my own experiences and views.

The official conference web sites is at: http://healthcare-computing.co.uk/

Day 2

Apologies for the lack of the lack of photos during the morning sessions which were because all of the batteries for my camera & I had to scrounge recharging facilities (Thanks Peter).

I started the Tuesday morning by attending the first session of several giving an overview of the National Programme for NHS IT. Gordon Hextall (Chief Operating Officer NPfIT), who set out to describe the objectives and scope, current achievements with implementation and next steps within the programme.

The background strategy documents were summarised, highlighting the potential to reduce adverse events, and focusing on the core components;
  • NHS Care Records Service
  • Electronic booking
  • Electronic prescribing
  • Infrastructure
  • Picture & Archiving Communication Service (PACS)
  • GP IT systems and new GMS contract

He described the achievements so far; development of professional teams of clinicians and IT specialists for detailed specification and procurement, Outcome Based Specification (OBS), proof of solution and the award of contracts on schedule.

Some forthcoming targets and timetables were described over the next 6 years, with additional work required to include prison, dental and social services.

Duncan McNiel then took over to describe the technical infrastructure and highlighting the important role of Regional Implementation Directors (RIDs).

Key targets:

  • 99.8% availability
  • 0.2 - 2 second response times
  • Failure recovery within 30 minutes.

Brief consideration was also given to security and patient consent, including access control and audit. The section on assurance testing disappeared into SANDPITS (IT testing suites) while looking at integration.

The final presentation within this section was by Steve Walker (GMS Payments project director), who set out the stages and requirements for GPs to receive their funding under the QMAS system.

The next session I attended was in the theme Developments in Primary and Community Care chaired by Dr Mike Bainbridge
Dr Simon De Lusigan spoke about "Features of an effective primary care data quality programme" describing key features and findings of a literature review which highlighted the variability of GP computing and only looked at Structured "Read coded" data. The coding imposed a biomedical model and takes time. The results were presented around 8 themes which were groups into 4 areas; measuring quality, learning form the data, understanding the data and money. Further information is available at http://www.pcdq.org and http://www.primis.nhs.uk
Dr Richard Sills described his work with US colleagues on "Computer patient interview as an important part of the EHR", which he argued could reduce the incidence of adverse events and diagnostic errors. Current poor history taking and workflow problems could be improved with high patient acceptance and more time for consultations. Further information available at: http://www.medicalhistory.com  
Tanya Braton presented work from Brunel University and partners to provide remote patient monitoring in residential care homes under the e-Vital EU funded project. They used BP, heart rate and pO2, ECG monitors etc. with the data being sent to the GP, local hospital and Madrid who could then advise local staff on management. It had been well received by staff and patients and reduced the need for hospitalisation Further information http://crnettest.arbonaut.com/evital/

The final presentation of the morning was mine about the evaluation of NMAP

For the first part of the afternoon I attended a workshop entitled "Enabling ehealth: what research is needed to underpin policy?" chaired by Professor Ray Jones. The research is part of a wider study for the Service Delivery Organisations (SDOs) and was a component of the stakeholder consultation to examine research priorities in approx. 5 years time.

The presentation was described as being by the Jean, Ray and Graham show
Prof ray Jones
Ray Rogers and Graham WrightJean Roberts Ray Rogers provided an overview of the purposes of the workshop and set out a little of the policy context explaining how the team had identified draft recommendations and research questions, on which they intended to obtain the thoughts of this expert audience.

Graham then set out 12 areas with the policy context, contribution of ICT and draft recommendations which the audience used electronic keypads to allocate priority to. Jean then led the discussions. The first few questions were to profile the audience and get them used to the voting system. A score of 1=low priority & 9=high priority. The scores gained for each policy area are given below:
ebooking 5.2
chronic disease management 6.0
GP systems 6.0
reducing adverse events 6.5
pharmacy 1 5.5
pharmacy 2 5.3
Telemedicine 6.1
Cancer services 6.0
Mental health 6.3
elderly 6.8
information for the public 6.1
relationship of health professionals with service users 5.6
Voting was followed by an open floor discussion, which included the identification of 3 other areas;
Education & training / organisations interpretation of training needs 6.3
What difference the availability makes to the acceptance of management actions 5.2
ehealth information for citizens while outside the UK 4.9
Further discussion attempted to improve 3 of the results in the middle to make them clearer.

For the last part of the afternoon I popped down to the EPR arms - a live version of the column by Sean Brennan which appears in BJHC&IM.

NB EPR=Popular Revolutionary Army in Mexico (according to Google) !
Scene - a british bar.. somewhere near Hallifax or Hudersfield EPR Arms
EPR arms All were welcomed by Sean & the barman (Paul Brown) and especially 3 of the regulars (Richard Silk - GP, John Ironmonger - Computer Supplier & Michael Fowles - Surgeon) who got a beer and took a seat before the evenings proceedings which kicked off with a pub quiz (handled with electronic voting system) to win crates of beer - the results of which were not announced until the end of the evening.

Sean then gave a presentation in his own inimitable style, which although light hearted addressed the reasons and barriers for putting IT into healthcare, including confidentiality & IT supply, all affecting the likelihood of adoption and the trade off between complexity and ease of use.

It included various interaction with the regulars and wider crowd both verbally and via the electronic voting system and various examples of poor clinical records and messages and gags
Q What's the difference between GP fundholders and the IRA
A You can negotiate with the IRA.

In my opinion this was the most entertaining session of the conference so far.
Sean Brennan Sean Brennan

Return to Index

To discuss any of my comments please mail: Rod.Ward@uwe.ac.uk

Page Created: 21.3.04

Last Updated: 23.3.04