For the benefit of Trefor (hope you are enjoying your hols) and others an edited
extract follows. My bill for telephone and on-line charges is on its way to Ian
:-)
The DoH gets a bit of stick ....... too many words, not enough action.
Regards
Alan
Alan Cooper, Managing Change
E-mail: [log in to unmask], Tel & Fax: +44 (0)1264 737609
S-mail: Change House, Shepherds Rise, Vernham Dean, Andover, Hampshire, SP11
0HD, England
Managing Change means "A proactive approach to change"
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HOUSE OF LORDS SESSION 1995-96 5th REPORT
SELECT COMMITTEE ON
SCIENCE AND TECHNOLOGY
INFORMATION SOCIETY:
AGENDA FOR ACTION IN THE UK
REPORT
____________________________
Ordered to be printed 23 July 1996
____________________________
LONDON : HMSO
HL Paper 77
Edited Extracts on Healthcare
CHAPTER 4 VIEWS OF WITNESSES
4.90 The British Medical Association (BMA) highlighted three main types of
application for the information highway in medicine. First, there were the
library aspects of service provision, where access to information was provided
through the World Wide Web or through Medline. Secondly, there were
administrative applications, ..... Thirdly, there were the clinical aspects, ...
for example .... sending an electronic referral letter from a general practice
to a hospital .... Dr Ross Anderson, a Consultant to the BMA ....., told the
Committee that it was the "very simple aspects of the information superhighway
such as electronic mail .... which probably have the greatest potential for
bringing real short term gains. ......
4.91 The Department of Health also emphasised the administrative benefits of
electronic communications ..... They also believed that using e-mail for
messaging and transmission of forms in the NHS "could save at least L100 million
a year ...
4.92 The Royal College of Nursing (RCN) listed a number of possible examples of
administrative applications of electronic communications which could be of
direct benefit to patient care. These included improvements in communication
between multidisciplinary teams such as care programmes
for mentally ill patients, and rapid dissemination of urgent information such as
drugs to be recalled. .....
4.93 Several witnesses mentioned telemedicine ..... The benefits were greater
when the distances involved between the locality of the GP and the specialist
were greater, .... or if the [road] traffic was bad ....
4.94 In the United Kingdom over 90 per cent of GPs have computers ... "probably
the largest single group of clinicians anywhere in the world .... ".
4.95 Lack of critical mass does not appear to be the major barrier .... The BMA
identified the need to legitimise the computerised medical record as one of the
main impediments to progress. It has been part of the terms of service of GPs
that they must make records on paper. The Department of Health, whilst agreeing
with the significance of this legal constraint, said that "the major barrier in
many places is the willingness of hospitals to allow it to happen".
4.96 In an ideal world, an official from the Department of Health thought that
more financial resource for GP practices would be the single most important key
to increasing the rate of uptake of IT in the health service. ... He also
recommended on-line booking of outpatient appointments: "..... If you can book a
holiday anywhere in the world then it is about time that you can book an
outpatient's appointment before you leave the GP's surgery".
4.97 One of the main concerns raised by the Royal College of Nursing (RCN) was
security. The RCN said that the NHS needed to communicate with social services
and the private sector and patient information would need to be transferred to
these agencies. "However the standards within the NHS Wide Network do not apply
to [these agencies]. The RCN is concerned that the same stringent standards must
be applied ...."
One of the problems identified was the lack of a formal approval process for
software used throughout the NHS: as well as causing problems for compatibility
this also raised concerns over whether data could be protected from corruption
and unauthorised access. In addition, "the guidance issued by the Department of
Health only considered the threat from external (to the NHS) unauthorised
access" and the RCN said that there was also a risk from `internal' unauthorised
access and use of patient information. The RCN called for encryption to be used
..... and suggested that it was a role of Government to provide a framework for
security standards.
4.98 .....
4.99 The RCN considered that US software had already had a negative impact
because of the marked differences between the nursing cultures of the US and the
UK. ... It called for "an agreed `core specification' for nursing and health
care information systems" which would focus on the relationship between the
nurse and the client. At present most of the software in use was more suitable
for contracting and meeting patient charter standards rather than supporting
patient and client care.
CHAPTER 5 OPINION OF THE COMMITTEE
5.81 .... the Committee considers that the most widespread benefits from the use
of the Information Superhighways in healthcare are in the areas of
administration and communication. ..... The facility of GPs to book hospital
appointments on-line would make life easier for all concerned, both patients and
practitioners, and the Department of Health should set in place policy
guidelines to encourage this. .... within a secure intranet system designed to
ensure confidentiality.
5.82 ... we recommend that the Government should legitimise the keeping of
medical records uniquely in machine-readable form, subject to strict safeguards
concerning security, durability and back-up procedures, by removing the legal
requirement for GPs to make records on paper. In their evidence the Department
of Health expected that the necessary legal change would be made "very, very
soon ... within weeks or months" but this change has not yet occurred.
5.83 ... The Department of Health should draw up a clear plan of action to
fulfil its own estimate that using e-mail for messaging and transmission of
forms in the NHS could save at least L100 million a year. ....
5.84 The standards applying to the security of health related information within
the NHS Wide Network should apply equally to local authorities and the private
sector.
5.85 .... The use of an NHS intranet to disseminate new health warnings should
be investigated .....
CHAPTER 6 THE AGENDA FOR ACTION
[re-iterates as recommendations items 5.81 to 5.85
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Source: http://www.hmsoinfo.gov.uk/hmso/document/inforsoc/inforsoc.htm
Note the report is split into about 6 chunks, many from 40K to 100K and that the
transmission was very slow when accessing the above (less 100 bytes per second).
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