Welcome to the latest issue of Intelligence, the quarterly HSJ supplement dedicated to innovation, information and technology.
In this issue we look at how new health portals are helping drive the choice agenda and improve health outcomes. A number of recent website launches are offering up easy to access information and the ability to interact with health providers, all in the hope of improved outcomes.
As Lyn Whitefield says in her column, clear consumer trends show that the public want to collect and share health information online, and the Department of Health has seen this potential: 'HealthSpace started out as a glorified version of the page at the back of the Telephone Directory that was provided for you to jot down your GP’s and other useful numbers.
But it is now routinely mentioned in policy papers as a point of interaction for patients and a way of reaching individuals with diet, exercise and other tips.'
Managing the flow of information is also at the heart of our feature on e-procurement and the latest drive towards inter-operability and stream lined processes to make procurement an efficient part of the NHS.
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NHS Summary Care Record
NHS Connecting for Health has developed a security system that it has dubbed 'e-Gif 2.5' to give patients access to their summary care records through the HealthSpace website.
At a briefing to mark the end of the first six months of the SCR early adopter programme, Gillian Braunold, clinical director for the SCR and HealthSpace outlined the special arrangements made for patients who wanted to view their summaries online.
Patients need two forms of ID that show their identity and address to register for a pack that contains a 'secure log-in card.' This has a grid of unique numbers and letters.
When patients want to view their records online, they must enter their name and password – as they do already to access the other features of HealthSpace – and three characters from the grid.
Dr Braunold said this was a more secure system than the 'memorable information' prompts used by online banking services, which meet the security requirements of level 2 of the government’s e-Government Interoperability Framework (e-Gif).
NHS staff must use a smartcard and have a role-based 'legitimate relationship' with the patient to access an SCR. But patients can 'opt out' of having an SCR created and limit access unless they give explicit consent. Fewer than one per cent have opted out to date.
NHS Connecting for Health announced that at the end of the first six months of the early adopter programme, more than 50,000 summary care records had been uploaded to the data “spine” that underpins the NHS Care Records Service.
The records come from Bolton, which was the first of the four early adopter sites to be named. Bolton’s Out of Hours service was also expected to be the first organisation in the country to start using the new records.
But patients in Bury were expected to be the first to start using HealthSpace to view their own summaries. These have been launched holding details of allergies and medications, but will expand to include both NHS and patient-generated data over time.
'HealthSpace is running now. It is the beginning of a personal health organiser for everybody in England,' said national patient lead Marlene Winfield.
'Eventually, people will be able to do things like enter care plans, record any needs they have while in hospital and say whether they are organ donors. It will be their way to have a dialogue with the NHS.'
Guide to hospital data made available to senior clinicians
RoyalCollegeof Physicians' Health Informatics Unit publication guides consultants through opportunities and pitfalls when analysing routine hospital data
The RCP's Information Laboratory (iLab) has published Hospital Activity Data: A Guide for Clinicians to help consultants interpret hospital activity data from sources including their own trust information departments and external benchmarking companies such as CHKS and DrFoster Intelligence.
The iLab report of 2006, which surveyed physicians’ experience of hospital episode statistics (HES in England, PEDW in Wales), recommended that more be done to increase clinician awareness of the strengths and weaknesses of routine data, highlighting the need for better communication between clinical, information and coding staff within trusts, if data quality is to be improved for uses such as PbR.
The guide for clinicians answers common questions arising on subjects like information flows and secondary uses of data; the clinicians' role in collection and validation; improving quality; and real life case studies. It also includes "Top Ten Tips for Clinical Coding", aimed at junior medical staff. Although written primarily for senior clinicians, the content has had input from information and clinical coding experts. The Information Centre for Health and Social Care will distribute 20,000 copies to acute hospital trusts and independent treatment centres In November.
The guide's author and iLab manager, Dr Giles P Croft said: 'Because it's readily to hand, routine data is being used increasingly at individual consultant level, yet there are serious concerns about appropriate, responsible use. In many ways HES data struggle to represent today's complex clinical patterns of working. However, helping clinicians to understand what it's capable of as well as its weaknesses, what to look out for and the right questions to ask, helps to prevent instant dismissal of the data as "rubbish" and starts to break the cycle of neglect. But it's a two way process - those producing the analyses need to listen to doctors and start prioritising their requests, rather than being blinkered to the purely corporate agenda.'
More details and electronic versions can be found at http://hiu.rcplondon.ac.uk/iLab along with reports of previous work and example analyses.