health and the web: uk experience professor sir michael rawlins chairman, national institute for...
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Health and the Web:UK Experience
Health and the Web:UK Experience
Professor Sir Michael RawlinsChairman, National Institute for Health and Clinical Excellence
And
Professor of Clinical Pharmacology, Newcastle upon Tyne
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Scope
1. Healthcare and the Web: UK Overview
2. NICE and the Web- Developing guidance
- Disseminating guidance
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UK overview: general
1. Information- Public
- Professional
2. Communications - Between professionals
- Between professionals and patients
3. Research- Clinical trials
- Patient monitoring
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UK overview: the NHS
Primary care- Health records
- Prescribing
- Hospital appointments
Secondary care- Patchy
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To provide professional staff with advice on:
• securing the highest attainable standards of clinical care for National Health Service patients
• promoting and sustaining the public health
NICE’s Purpose
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NICE: setting standards
For clinicians:• Use of individual health technologies
• Management of conditions
For public health professionals:• Single interventions
• Programmes
Effect
iven
ess
in p
ract
ice
Cost e
ffect
iven
ess
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The “virtual” Institute
NICE
AppraisalCommittees
TechnologyAssessment
Groups
InterventionalProcedures
Specialist advisors
Collaborating Centres
(clinical guidelines)
GDGsPDGs
(Public health)
Public healthinterventions
CollaboratingCentres
(public health)
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Developing NICE guidance
Critical features:• Clinically/scientifically robust
• Inclusive
• Transparent
• Independent
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Disseminating NICE guidance
Predominantly web-based:• Full guidance
• Short forms of guidance
• Supporting evidence base
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Current in May 2006
Page requests: 6.2 million
200 Gigabytes
E-mail newsletter: >35,000 registered
E-mail updates: up to 6,000 per day
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Visitors
56.3%43.4%
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Disseminating NICE guidance
Limitations:
1. Short formats• How short?
• For what purpose?
2. Patient formats• Access?
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The future?
1. Developing the evidence?
2. Disseminating the guidance?
3. Discovering societal preferences?
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Evidence development
1. Web-based approaches to clinical trial registries
2. Web-based approaches to conducting clinical trials
3. Web-based approaches to developing and maintaining registries
4. Web-based access to results of clinical trials
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Disseminating guidance
Professionals:• PCs, hand-helds
• E-mail alerts
• Format(s)
• Revisions/updates
• Self-learning modules (CPD)
Patients, families, carers• ??????
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Societal preferences (1)
NICE’s Citizens Council:• Stratified random sample
– age and gender
– socio-economic status
– ethnicity and disability
– geography
• Thirty members
• Cross-section – not representative
Delibera
tive democra
cy
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Citizens council (2005)
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Societal preferences (2)
What is needed:• Broader representation (n=300 or 3000)
• Retaining the deliberative element
Could the w
eb help?
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For more about NICE….
www.nice.org.uk